SCHOOLS NorthEast written evidence to inquiry into children and young people's mental health: role of education

25th January 2017

Executive summary

• School leaders in the North East are reporting a worrying increase in mental health issues among children and young people and recognise that schools have an important role to play in addressing this problem.
• Schools in our region have found many different ways to promote resilience and emotional wellbeing, but they are having to work independently and lack guidance or the ability to share best practice easily.
• Schools are keen to build skills among their staff and would appreciate support to be able to do so.
• Whilst schools are keen to do more to address issues around mental health, budgets are very tight and so more funding is needed.
• In order to address these issues, SCHOOLS NorthEast has launched a schools-led mental health commission – Healthy MindED – co-chaired by Professor Dame Sue Bailey and a young person from our region.

About SCHOOLS NorthEast

1. Set up by schools for schools, SCHOOLS NorthEast is the first and only school-led regional network in the UK. It is the representative voice for all 1,250 schools in the North East and is governed by our 11 Trustees and 26-strong board – all of them serving school leaders in the region.

2. As a school-led organisation, we are guided in all the work we do by the needs and concerns of our region’s schools. One such concern that has been raised with us time and again by school leaders from right across the North East is the mental health and emotional wellbeing of their pupils. Statistics from charities and health services evidence an alarming decline in children and young people’s mental health and this is reflected in the experiences of staff in schools across our region as they have to deal with these issues on an increasingly frequent basis.

3. There are particular issues with mental health in our region. Data from the North East’s NHS mental health foundation trusts show that in parts of the region there has been a threefold increase in referrals of school-aged children to self-harm support services. In Tyne and Wear alone an average of 15 teenagers a week were admitted to hospital for self-harm during the 2014-15 financial year and we have the highest suicide rate of all of England’s regions. Worryingly, North East primary heads are reporting a significant increase in levels of self-harm in children under the age of 11.

4. Given the amount of time that children and young people spend at school and the important relationships that they build with school staff, it is clear that schools have a vital role to play in tackling the growing challenge of poor mental health and emotion wellbeing. An important part of this role is preventative; for instance, building resilience, promoting positive mental health and destigmatising mental health issues. The other part is ensuring that pupils who encounter difficulties with their mental health are able to access the appropriate support, either within school or externally.

5. With this in mind, we are delighted that the Health and Education Committees have decided to dedicate time to examining the role that the education sector has in addressing issues around children and young people’s mental health. All too often, the role of schools in the field of mental health is treated as an afterthought and we are very glad that the Committees have recognised the importance of schools in this area.

6. Mental health and wellbeing is a key focus for SCHOOLS NorthEast and the following submission is based on over a year’s worth of work with schools on the issue.

What are North East schools doing about this issue?

7. As outlined above, the mental health of pupils is uppermost in the concerns of school leaders in our region. There is widespread recognition in the North East that in order to arrest the crisis in child mental health, and to eventually reverse it, there needs to be a strong lead from schools. In response, our schools decided to launch – via SCHOOLS NorthEast – a school-led Commission into mental health issues affecting pupils across the region. The intention was to bring school leaders together with key stakeholders to develop a fresh approach that is adoptable across all schools.

8. This Commission, Healthy MindED, has now been officially launched and we were delighted to announce at the annual SCHOOLS NorthEast Summit in October 2016 that the Commission would be chaired by Professor Dame Sue Bailey, Chair of the Children and Young People’s Mental Health Coalition and the Academy of Royal Medical Colleges.

9. Professor Bailey is co-chairing the Commission with a young person from one of our region’s schools to ensure that the voice of young people is heard throughout the lifetime of the Commission. They are joined by school leaders from across the region and school phases and types, including primary, secondary, independent and special. Also on the Commission are representatives from other key stakeholders, including the NHS, the DfE and educational psychology services.

10. Schools recognise that the issue of mental health and wellbeing in schools is complex and multi-faceted, and that the Commission cannot hope to tackle all of these problems at once. As such, the Commission will decide at their first meeting on Monday 23 January what lies within and outside the scope of the Commission. However, the following areas of focus have been proposed as a framework for addressing the issues:

- Recognition – that there is a problem with pupil mental health and wellbeing in schools.
- Definition – of what exactly this problem is and how it may differ from school to school.
- Impact – of this problem for both individuals and school communities.
- Solutions – to this problem, that have a base in evidence.
- Success – what would pupil mental health look like in the ideal world?

11. The Healthy MindED Commission will take evidence from schools across the North East, as well as key stakeholders and experts from both within and outside the region. This will allow the Commission to better understand the issues that schools are facing and to identify, examine and evaluate examples of best practice. The intention is that the Commission will eventually produce a solutions-focused report and action plan that is adoptable by all schools in the region.

12. We hope that, by taking a proactive approach and working together across geographical, phase and sector boundaries, schools in the North East can make a strong and positive impact on the mental health of pupils across our region. This will also provide a focus for schools in other parts of the UK and abroad.

Promoting emotional wellbeing, building resilience, and establishing and protecting good mental health

13. These preventative elements are the areas where schools have a particularly important role in children and young people’s mental health. Schools across our region are exploring ways of promoting emotional wellbeing and resilience in their schools and have arrived at a myriad of different approaches. For example, St Wilfrid’s Roman Catholic College in South Shields has started a whole school project to develop an environment that promotes mental and emotional resilience. This includes setting aside curriculum time, providing training for all staff, mentoring, form time activities and days dedicated to wellbeing, including a festival called Wilfest.

14. Schools in the region are also working with charities and other partners to address this issue. For example, Macmillan Academy in Middlesbrough is working with the charity GRIT&ROCK on a project to build resilience within a group of year 10 and 12 girls through climbing and outdoor activities. These kinds of projects can make a very positive impact on emotional wellbeing within a school, but they require schools to put aside time and resources, and this is becoming increasingly difficult as school budgets tighten (please see below).

15. The many approaches that schools in the North East are taking in part reflects the fact that our schools are very diverse and, as such, that their pupils have very different needs. However, it also reflects the fact that many schools feel they lack guidance on what works and what does not. Schools are experimenting and finding some really innovative solutions, but are not always able to test and share best practice. This is one of the key areas that the Healthy MindED Commission will work on. The Commission will identify examples of best practice in promoting resilience and positive mental health in schools both within and outside our region, evaluate these processes in a rigorous manner and then share these evidence-based solutions with other schools.

16. Schools are keen to point out, however, that the promotion of resilience and emotional wellbeing can sometimes conflict with the accountability agenda that schools operate under. The balancing act between pushing pupils to reach their maximum potential and ensuring that this does not have an adverse impact on their mental health can be difficult.

17. This stress around assessment and accountability is certainly not confined to secondary schools. It appears that recent changes to primary school assessment – and the chaos that has surrounded their implementation has had a negative impact on both pupil and staff wellbeing. According to a ComRes poll of 10- and 11-year-olds in May 2016, 27 percent of respondents reported that they felt “stressed” about the tests and 28 percent said that they were feeling “a lot of pressure” to do well. We would encourage the Government to work with schools on how to limit the potential negative side-effects of the accountability agenda in this area.

Support for young people with mental health problems

18. Where pupils are already presenting mental health problems, schools are keen to support them appropriately and many are finding ways to accommodate these additional needs through the school day. However, schools also recognise that in most cases health professionals are best placed to provide the necessary support. As such, schools work with a range of professionals – including CAMHS and GPs – on the mental health problems of individual pupils.

19. Schools in our region have had very mixed experiences of dealing with CAMHS. In some parts of the North East referrals are relatively quick and efficient, whilst in others referrals can take many months. Inconsistencies in waiting times and conditions for referral are well known, but it is worth reiterating that this introduces a great deal of unfairness into the system, which can have very adverse effects on young people. This is particularly clear for some of our schools that draw pupils from multiple local authorities, where young people in the same class may have entirely different experiences of CAMHS based on where they live.

20. Schools do recognise, however, that CAMHS are severely overstretched and that these inconsistencies are a direct result of this. Schools should therefore be supported to understand how to make the right referrals to ensure that CAMHS is not overloaded with inappropriate referrals. However, this alone will not solve CAMHS capacity issues and the Government should look at how to fund the service at the right level and reverse the historic underfunding of children and young people’s mental health services in favour of services for adults.

21. School leaders in our region have noted that there is a lack of joined-up thinking between education and health services and this is something that the Healthy MindED Commission will seek to address. The best outcomes for young people will be achieved only when the two sectors work together effectively.

22. Schools are also aware of the need to find better ways of working with parents to support young people with mental health problems. Parental engagement is particularly difficult for schools in some communities, but it is vital that schools and parents work together to get children the support that they need.

Building skills for professionals

23. A key theme that emerged from our consultations with schools in the North East was the issue of skills and training. Teachers are increasingly having to deal with mental health issues and are very keen to help. However, many feel that they have not received the appropriate training to develop the skills that they need to deal with situations; they are worried that they may not say the right thing or – even worse – that they may say the wrong thing. As such, we welcome the Prime Minister’s announcement that at least one member of staff in every school will receive mental health first aid training; some of the schools in our region have invested in this training previously and found it very useful.

24. However, we would encourage the Government to consider how they can support schools to build skills among a wider group of staff, rather than to rely on a single mental health first aider. Given the volume of mental health issues that many schools face, one member of staff is simply not sufficient. There is also then a danger of other members of staff feeling that they are not responsible for mental health because they are not the first aider. Some schools in our region have brought all staff – both teaching and non-teaching – together to discuss how mental health should be dealt with, to ensure that the approach is consistent and effective.

25. Another issue that schools face in this area is bringing in external support. School leaders have reported an ever-growing plethora of organisations offering services to improve mental health and wellbeing in schools. With such a vast array of services – and prices – on offer, it can be difficult to determine which interventions or services would be most beneficial. Schools would appreciate guidance in this regard.

26. It should also be noted that schools are facing severe budgetary constraints and that this has led many to cut back to what they see as the bare essentials. Unfortunately, mental health support is often sacrificed when budgets are tight and a number of school leaders have informed us that they have had to make very reluctant cuts elsewhere in order to maintain support. The new National Funding Formula will see almost sixty percent of our region’s secondary schools lose funding – 28 of them to the tune of more than £100,000. We are very concerned that, under these conditions, even more schools will have to make the difficult decision to cut support in the coming years if the Government does not deal with the serious issues around school funding.

27. One school in our region has reported that they are spending around £400,000 on dealing with their mental health issues among their pupils. This is a considerable amount of a school’s budget and so if the Government is really serious about dealing with pupils’ mental health, then it needs to provide schools with the necessary funding to tackle the problem.

Social media and the internet

28. Social media has completely transformed the way in which children – and particularly teenagers – relate to one another, and attempting to manage this has posed significant challenges for schools. A 2016 survey conducted by Comres for CBBC Newsround found that 96% of 13- to 18-year-olds had social media accounts, whilst 78% of respondents aged between 10 and 13 were signed up to at least one social network despite being below the age limit. Although pupils should only be using social media at home, the issues that arise after home time all too often spill over into the school day.

29. Teachers in our region have reported a number of difficulties around pupils’ use of social media, but there is particular concern around the impact that it is having on mental health and emotional wellbeing. Perhaps the most obvious aspect of this is cyberbullying. The internet allows young people greater access to one another and also affords a level of anonymity that was previously impossible. Unfortunately, this has made social media a fertile ground for bullying. Anti-bullying charity Ditch the Label’s 2013 Cyberbullying survey found that 7 out of 10 young people in the UK have experienced cyberbullying and that 20% have experienced “extreme cyberbullying on a daily basis”.

30. There is a great deal of evidence to show that bullying – cyber or otherwise – has a strong negative impact on mental health. It has been shown to increase the likelihood of a child experiencing anxiety or depression and can even lead to extreme coping mechanisms such as self-harm. The effects are not confined to childhood; a recent study by academics from the LSE and King’s College London has provided “unequivocal evidence of the link” between childhood bullying and use of mental health services in adulthood.

31. Cyberbullying aside, recent research by Dr Heather Cleland Woods and Holly Scott has found that the need for British teenagers to “be constantly available and respond 24/7 on social media” can lead to anxiety, depression and declining sleep quality. Social media can also put pressure on young people in how they present themselves. Apps like Instagram are focused entirely around image and are dominated by celebrities who display their glamorous and unattainable lifestyles. These celebrities are often presenting a skewed and airbrushed version of their lives but some young people take this at face value and this can cause some issues around self-image in general and body-image in particular. Some schools are addressing this issue by teaching pupils how to think critically about what they see on social media and this should be encouraged.

32. More broadly, the Internet is a largely ungoverned space and has a great deal of harmful material that young people have ready access too. Whilst schools do everything they can to keep pupils safe online within school, this is not always the case at home. This was illustrated recently when a video of the suicide of a 12-year-old girl went viral – thousands of young people across the UK are likely to have seen that video.

33. It should be noted, however, that the Internet also contains a lot of material that can be very beneficial to young people struggling with their mental health; for instance, there are some very popular YouTubers who are doing important work in destigmatising mental health issues.

34. The pressures of social media and internet use can be difficult for adults to understand, but the impact is being seen in schools across the country. Schools can also find it difficult to keep up-to-date with the changing digital landscape, as social media empires rise and fall, and support with this would be welcome.