Mental health in schools

In March, the DfE updated its guidance on mental health and behaviour in schools, with schools saying that "this is a difficult area" and that they want to know what the evidence says, share approaches to supporting children at risk of developing mental health problems and be clear on their own and others' responsibilities".

The paper aims to set out advice and practical tools to help schools promote positive mental health in their pupils, to identify and address those with less severe problems at an early stage, and build their resilience. It also offers advice on identifying and supporting pupils with more severe needs and making appropriate referrals to specialist agencies where necessary.

The overall message is that schools have an important role in promoting good mental health in their pupils.

The first chapter, entitled "Promoting positive mental health", describes the factors that make pupils more vulnerable to mental health problems, and those that make them more resilient. It points out that "a key to promoting children's mental health is ... an understanding of the protective factors that enable children to be more resilient", then provides a table showing factors that increase risk and those that protect against it. The table divides the factors according to whether they are attributes of individual children, of their families, of their schools or of their communities.

With this foundational information in place, the guidance goes on to list ways in which schools can create a culture that supports pupils' mental health, such as:

• having a committed senior management team that sets a culture in which all pupils are valued, gives them a sense of belonging, and makes it possible to discuss problems in a non-stigmatising way;
• working with parents and carers, as well as pupils, ensuring their wishes are taken into account;
• continuous professional development for staff that makes it clear that promoting good mental health is the responsibility of everyone in the school;
• clear systems and processes to help staff identify children with possible mental health problems; and
• working with other organisations to provide support for pupils with mental health problems, with a clear cycle of assessment, action and review.

The guidance states that schools with the listed characteristics "mitigate the risk of mental health problems in their pupils".

The following chapter offers guidance on identifying children with possible mental health problems, whilst noting that only medical professionals should make formal diagnoses. Two key elements to reliably identifying children at risk are:

1. effective use of data, so that changes in pupils' patterns of attainment, attendance or behaviour are noticed; and
2. an effective pastoral system, so that at least one member of staff knows every pupil well.

Where a school suspects a pupil may have mental health difficulties, the guidance recommends using the Strengths and Difficulties Questionnaire (which is linked in the text) or other assessment tools. It reminds schools of the relationship between mental health and SEN, briefly defining SEN and linking to the SEN Code of Practice. The chapter ends by stressing the need for schools to have a good understanding of the mental health services provided by local voluntary sector organisations and the NHS, including pupils' GPs.

The next chapter describes strategies that schools can use to promote good mental health. It suggests:

• using the PHSE curriculum to develop pupils' confidence and resilience;
• coupling positive classroom management techniques with one-to-one or small group sessions where pupils can discuss coping strategies, and having facilities outside the classroom where individuals or groups can resolve problems;
• employing a school-based counsellor;
• enlisting the services of a local child psychologist;
• developing pupils' social skills;
• working with parents and carers (with the caveat that older pupils may not wish to involve them and have the right to consent to their own treatment);
• implementing a peer mentoring system.

The guidance recognises that pupils with more complex problems may require additional input, such as one-to-one educational or therapeutic support, an individual healthcare plan, or medication. A link to governmental guidance on supporting pupils with medical needs is provided.

The section ends by referring to Annex C of the paper, which describes different types of mental health disorder and the interventions used to treat them. It reiterates that schools should not attempt to diagnose pupils: the information in Annex C is for reference only.

The final chapter focuses on the role of local mental health services. It offer suggestions on how to get involved in defining local services, referring serious cases to CAMHS, and commissioning services directly. Annex B of the paper lists a selection of useful national contacts.

This article has already mentioned Annexes B and C. Annex A, headed "Facts about mental health problems in children and young people", catalogues the characteristics of mentally healthy children, summarises different categories of mental health problems that affect children, and notes that "9.8% of children and young people aged 5 to 16 have a clinically diagnosed mental disorder".

The guidance is peppered throughout with case studies demonstrating how individual schools have implemented the suggested policies and practices.

Since it was reissued, the Government has announced that assessments of mental health provision are to become a routine part of Ofsted inspections, and the Institute of Public Policy Research has published a report proposing that secondary schools play a central role in early intervention mental health services for children and young people.

The 2015 inspection handbook of the Independent Schools Inspectorate (ISI) does not explicitly refer to mental health and, as far as we are aware, it has not declared an intention to follow Ofsted's lead. Nevertheless, although the guidance is non-statutory (and thus not mandatory), it appears to be a useful resource, and the Ofsted announcement may indicate the direction that official policy is taking on this issue. So, in our view there are reasons – beyond a desire to promote the wellbeing of pupils – to pay attention to it. You can find it here.

If you require further information on anything covered in this briefing please contact Rachel Holmes ([email protected]; 020 3375 7561) or your usual contact at the firm on 020 3375 7000. Further information can also be found on our Schools page.

This publication is a general summary of the law. It should not replace legal advice tailored to your specific circumstances.

© Farrer & Co LLP, June 2016