Mental Health and Schools Policy Viv McCotter Children and Young People’s mental health team 21st September 2017

Prime Minister’s speech 9 January “I want us to employ the power of government as a force for good to transform the way we deal with mental health problems right across society, and at every stage of life. … “I want us to forge a new approach recognising our responsibility to each other, and make mental illness an everyday concern for all of us and in every one of our institutions.”

Prime Minister announcements Green Paper on CYP mental health Thematic review of children’s MH services led by the Quality Care Commission Offering all secondary school mental health first aid training Extend the single point of contact pilots to up to 1200 more schools in 20 additional CCG areas Pilot a range of peer support programmes and approaches for schools colleges, community schools and online Launching a programme of randomised control trials of preventative programmes across three different approaches to MH promotion and prevention

The Conservative manifesto contained a number of commitments for children’s mental health We will publish a green paper on children and young people’s mental health before the end of the year We will introduce mental health first aid training for teachers in every primary and secondary school by the end of the Parliament We will ensure that every school has a single point of contact with mental health services Every child will learn about mental wellbeing and the mental health risks of internet harms in the curriculum We will reform Children and Yong People’s Mental Health Services (CYPMHS) so that every child with a serious condition is seen within an appropriate timeframe No child [will have] to leave their local area…to receive normal treatment

The Green Paper aims to build on Future in Mind and achieve a further step change in support for young people’s mental health Background The Green Paper aims to look at the role both health and education can play in supporting all young people, and those with emerging mental health problems, and how they fit into the wider landscape of support for young people. It will take the analysis set out in “Future in Mind”, and rather than restating the nature of the issues, aims to identify some specific ways in which we can improve that support. Two key themes: Preventing mental illness: we are thinking about both whole school approaches, which raise awareness and build staff and young people’s ability to build good mental health and identify early signs of problems; and earlier intervention for young people with emerging problems. We also want to protect young people online, maximising the positives and minimising the negatives of the internet. Right treatment in the right place at the right time: this means easier access to NHS mental health services for those who need it, and better access to services outside the NHS, including in schools. It also means better joint working at local level.

Preventing mental illness- the role of schools and colleges Prevention – this is about helping to reduce the incidence of mental health issues and promoting good health and well being. Identification – helping schools/teachers to spot emerging issues earlier and more accurately. Early and complementary support – we know that schools already provide support to pupils in need – e.g. through pastoral care or by having counselling services. This is key in helping problems from escalating. Access to specialist support – we want to help schools to know when and how to access to the right specialist support and treatment when it is needed.

Preventing mental illness- the role of schools and colleges Training – what more can we do to support teachers – both in terms of initial teacher training and ongoing CPD Leadership – key to providing a whole school approach – mental health leads? Teaching about mental health – how can we strengthen what is taught in school about mental health. Links with the work on SRE and PSHE already underway. Access to support – what is the schools role in providing support to children and young people? Links to right place, right time

Implementation Opportunities Whole school approach The principles for a whole school approach are advocated by NICE in their guidance PH12 Social and emotional wellbeing in primary education PH20 Social and emotional wellbeing in secondary education Implementation Opportunities Leadership and management including policy development Head teacher/ governor training in whole school/system approach Policy development – safeguarding/ mental health Opportunity to include mental wellbeing as part of Teaching Schools focus Curriculum, Teaching and learning PSHE – schemes of work mental health, Rise Above, How to Thrive, Social & emotional learning within curriculum Mental health literacy/ promotion of life skills within wider curriculum Ethos and environment Anti-bullying approaches Approaches to create a sense of belonging and involvement, teacher connectedness, positive peer relationships Opportunities in physical environment to encourage promotion of physical activity which helps promote mental wellbeing Enabling student voice Staff development Mental health first aid training Mental health competency framework PSHE Association chartered teacher framework Identifying need School nursing interventions PHE/Anna FreudToolkit to help schools/colleges measure and monitor mental wellbeing Targeted support and appropriate referral Counselling Support delivered by school nurse Single Point of Contact training Working with parents/carers Early Years/ Schools/colleges as settings for promoting mental health literacy for parents Workshops for parents hosted by schools delivered by Health (eg Islington school based workshops on building confidence and managing anxiety in your child drawing on Cathy Creswell’s work

Evidence What’s really happening? How can we support schools with evidence based approaches?

What is happening now? School wide approaches to promote MH and wellbeing 92% report a school ethos/environment that promotes mutual care and concern 64% felt promotion of mental health and wellbeing is integrated into school day 89% report at least one parental engagement activity, 57% face-to-face sessions Mental Health Lead 49% have dedicated lead for Mental Health (of which 40% is SLT member) but 68% have a dedicated member of staff responsible for linking to specialist mental health services Their remit includes coordinating and developing mental health provision in school (85%) Teaching 46% of dedicated mental health leads were responsible for teaching pupils about MH and wellbeing Training 51% of leaders say staff equipped to identify behaviour linked to mental health issues 90% of schools offer staff training on supporting pupils’ mental health and wellbeing (47% all staff) 12% use free online training such as MindEd External specialist support 68% have designated member of staff responsible for linking with specialist mental health services Fewer than one in five (19%) had a named single point of contact in NHS or other CYPMHS to contact for help and advice. Triage 82% use ad-hoc staff concerns as way of identifying needs 24% use targeted screening of pupils to identify mental health needs Pastoral workforce 77% of secondary teachers/middle leaders involved in timetabled tutor time 266.000 FTE teaching assistants/support staff* in state funded schools (Nov 2016) Non-CYPMHS support 61% of schools offer counselling Around half of staff are involved in pupil counselling Other staff in schools with MH responsibility: SENCO, Ed Psych, School nurse, external MH specialists working in school Sources: Supporting Mental Health in Schools, survey report (2017), Teacher Voice Omnibus Summer 2016, Teacher Workload Survey, School Workforce Statistics *teaching assistants include higher level teaching assistants (HLTA), special needs and minority ethnic pupils support staff and other staff with pupil support roles.

Questions for discussion on preventing mental ill-health What commitments would schools and colleges want to see in relation to mental health and wellbeing, building upon existing changes ? In particular: What responsibilities could a school lead for mental health have? Leadership and establishing ’whole school approaches’ – how do we build this support into career pathways? Who are the other important stakeholders in prevention and building good wellbeing, what sort of commitments could be made through local authority public health and wider services? how do we reach parents and carers effectively and directly? what role can/should schools play reaching families? how do we promote other effective protective activities by young people out of school?

Questions for discussion on the right treatment in the right place at the right time How do we establish an effective first response for students in schools and colleges, with routes into specialist provision where needed, and ongoing support through treatment and beyond? Who should be involved, and how do we ensure the right support is provided at every stage? How do we properly manage staff who support children and young people who need support? How do we balance the different needs of schools and colleges, local authority services, and the need for quality assurance/clinical supervision of some interventions.