Debate Outlook A mental health model for schools School counsellor and CAMHS psychologist Charlotte Lowe explains her model for supporting students' mental health. Schools can play a key role in tackling poor mental health. Too often, however, they don’t have the capacity, lacking funding and resources to support students. Over the course of my career working as a cognitive-behavioural therapist (CBT) at Lostock Hall Academy (LHA), I have developed a mental health model to meet the emotional and mental health needs of students; existing as a wellbeing framework transferable to all schools. The prevalence of mental health problems in children throughout the UK is deeply concerning, with one in 10 young people experiencing a mental health problem at any one time; equating to roughly three children in every classroom. The recent publication of the Green Paper (2017) highlights the vital role that schools can play in supporting children and young people’s (CYP) mental health. However, these plans are set to be rolled out over the next few years and in the meantime many schools are struggling to cope. The mental health model developed takes a proactive approach to combatting poor mental health, encouraging a whole-school approach to mental health and suggesting targeted interventions to support students. The model follows guidance published by the DfE, combining a range of elements which aim to meet the emotional wellbeing and mental health needs of CYP. Most schools now recognise the need to support a student’s emotional health along with their learning. However, the use of clear terminology needs to exist across the whole school to ensure there is a shared language whereby we distinguish between mental health, mental health problems and mental illness. The following is a summary of the areas highlighted as being essential to creating and implementing a whole-school approach to mental health and wellbeing Whole school approach: This is about taking responsibility. All staff need to be responsible for identifying students who may be experiencing challenging times emotionally, feel confident in having difficult conversations with students and be clear about the protocol to follow where there is cause for concern. Mental health policy: Every school needs a mental health and wellbeing policy which details how they promote positive mental health and support students experiencing difficulties. This should exist alongside other school policies and needs to be available to all key stakeholders (school staff, governors, parents/carers). The mental health policy at LHA details how the school promotes positive emotional well-being across school, as well as outlining the more specialist support available should a student experience mental difficulties. It identifies key staff in school, external agencies which offer support to CYP, guidance for staff, as well as procedures and referral pathways to follow should any staff have concerns regarding a student. Training all staff: Last year the government stipulated that at least one member of staff in every secondary school will receive Mental Health First Aid training (MHFA) over the next few years. Full staff training around mental health is provided at LHA; ensuring school staff feel confident in identifying early signs and symptoms of mental health difficulties in young people and know what support is available for them. Early intervention is vital, therefore mental health awareness training is essential in all schools. Promoting positive emotional wellbeing: The promotion of positive emotional wellbeing around school helps to tackle the stigma surrounding mental health issues. At LHA we aim for a culture whereby talking about how we feel, and seeking help when needed, is the norm. Positive emotional wellbeing is embedded in the school’s ethos and its engagement with students; promoted in assemblies, tutor time and covered in the PHSE curriculum. Students are taught about mental health and how to recognise they might be struggling. Young people have a much better chance of recovery if their problems are identified early therefore it is essential for them to be aware of common signs and symptoms. Parental support: Parental support is invaluable as they are often first to highlight concerns about their children. Schools need to make clear to parents who they need to contact if they are worried about their child, with regular contact and signposting of parents to available support being important. At LHA I have developed resources around mental health for parents and carers which offers information and advice on how best to support their child and is made available on the school’s website. Single point of contact/mental health lead: Having a single point of contact, or a mental health lead, is something deemed to be significant; it opens a single channel of communication with external agencies, such as Children and Young People’s Mental Health Services (CYPMHS) or Children’s Social Care (CSC). This person will also ensure relevant staff in school are made aware of a student’s circumstances as necessary. At LHA we found it to be beneficial appointing a deputy mental health lead to provide support to the lead member of staff. Targeted interventions: While a whole-school approach to mental health and wellbeing is paramount, it is important to meet the needs of any student experiencing mental health difficulties; and this is where assessments are a useful tool, and a clear referral pathway to targeted interventions is essential. Assessments: At LHA the mental health needs of CYP are assessed in school by the school counsellor who makes use of Routine Clinical Outcome Measures recommended by Children and Young People’s Improving Access to Psychotherapies (CYP-IAPT) programme. Conducting such assessments means referrals to CYPMHS are limited to those who really need them, avoiding backlogs and ensuring those students who need attention receive it. Specialist support in school: Employing a mental health specialist is not a realistic aim for most schools; however, I believe it is essential for students to have access to a school-based counsellor or psychotherapist. Although it is not statutory for schools to offer this mental health support, most schools now recognise how vital this support is to students. Ideally a small cluster of schools could also employ a shared mental health specialist to support their school on a part-time basis. At LHA the specialist support is provided by the school counsellor who is qualified in cognitive-behavioural therapy (CBT). Therapeutic support entails carrying out several roles: individual counselling sessions are offered to students and therapeutic groups are available which focus on specific or more general issues, such as loss and bereavement, positive wellbeing and self-esteem. Specialist support is also made available to school staff in the form of advice and support regarding any students they have concerns about. Up-skilling the pastoral team: The pastoral team in schools are in an ideal position to support CYP experiencing difficulties, such as problems with anger or mild anxiety issues. Staff should therefore undergo continuous professional development to ensure that they are equipped to help student with low level needs, and supervision to such staff could be provided by the mental health specialist attached to the school. The pastoral team at LHA receive specialist mental health training around how to promote positive mental health in young people; based around the basic principles of cognitive-behavioural therapy (CBT). Concerns around students experiencing mental health difficulties are highlighted in a weekly pastoral team meeting. This is to ensure necessary support is being put in place in school for each student Resources are also regularly updated and distributed to the pastoral staff to assist them in effectively supporting children and young people in school. Peer mentoring: LHA developed a peer mentoring programme which involved training KS4 students to become peer mentors or ‘buddies’ to younger students. Training focused on promoting positive emotional wellbeing and supporting students experiencing students with less serious issues, such as low self-esteem and confidence. External agencies: Your school’s mental health lead is responsible for keeping up-to-date with the external services available to support CYP. They must understand the referral routes as well as the support that they can offer so that referrals can be made efficiently when required. Staff wellbeing: Staff wellbeing must not be overlooked; they too are susceptible to mental health issues, with a recent report suggesting a high number of school staff experience mental health difficulties related to their job role. Ensuring staff are in an emotionally positive place means that they are better-equipped to support CYP experiencing mental distress, and at LHA staff wellbeing sessions are offered to staff. I believe early intervention and prevention is key to tackling poor mental health in CYP. To achieve this, schools need to prioritise the promotion of positive emotional wellbeing and mental support. This mental health model developed is one example of how schools can manage mental health and provide effective support to students. Charlotte has fifteen years' experience working in children and young people's mental health, including ten years working as a counsellor in a secondary school and experience of working as a psychologist in CAMHS. She is passionate about improving mental health provision for children and young people, and with the recent publication of the Green Paper recognises the increased pressure being placed on schools. Visit her website or contact her on 07734650859. Do you know of good practice in school-based support for children and young people's mental health? What's your view of the pressure on schools and teaching staff to address pupils' emotional welfare and any arising mental health issues? Share your views with us.