Last reviewed 7 January 2022

In its Make It Count campaign, the Mental Health Foundation points out that young people are currently facing unprecedented pressures which are contributing to a range of mental health problems including anxiety, depression, self-harm and eating disorders. It says that more than 1 in 10 children aged 10–15 say they have no one to talk to or would not talk to anyone in school if they feel worried or sad.

The foundation is calling on every school in the UK to be a “mentally healthy” place for both pupils and staff and to put it at the heart of the curriculum.

Here are 10 key things that schools can do to help pupils with mental health issues to get the support they need.

1. Have appropriate policies in place

Schools are not required to have a separate mental health policy. However, many schools do. Some include mental health and wellbeing in their policies on supporting pupils with other health needs or with special educational needs. Mental health issues are also sometimes referred to in behaviour policies and in safeguarding arrangements. Young people with mental health issues will often be vulnerable to abuse, especially bullying.

Mental health policies should be driven by senior leaders. School governors, Heads and leadership teams should drive positive whole-school action to ensure all pupils are appropriately supported so they can flourish, learn and succeed. This includes pupils with mental health issues.

2. Provide adequate support for pupils

Schools should have robust arrangements in place for supporting pupils who have mental health needs. Arrangements should cover pupils with everyday worries and emotional issues through to those with recognised mental health problems, such as depression and anxiety disorders. Policies should also cover support for pupils with autistic spectrum disorder and those who suffer with problems such as eating disorders, self-harm and suicidal thoughts.

Initial support will typically include discussions with parents and caregivers and the development of agreed care and support plans. Policies should ensure that pupils who are expressing disruptive behavioural problems have any underlying mental health issues addressed.

Plans might include targeted interventions such as pastoral support, counselling and anger management. The needs of young people who have diagnosed mental health issues are usually best met through a co-ordinated approach in partnership with other services involved, especially NHS mental health services.

Appropriate guidance should be followed. For instance, the National Institute for Health and Care Excellence (NICE) publish the following guidelines.

  • Public Health Guideline PH20: Social and Emotional Wellbeing in Secondary Education (September 2009)

  • Public Health Guideline PH12: Social and Emotional Wellbeing in Primary Education (March 2008)

  • Clinical Guideline CG170: Autism Spectrum Disorder in Under 19s: Support and Management (updated June 2021)

NICE guidelines are evidence-based recommendations for health and care. They are not mandatory but represent best practice.

Guideline CG170 covers the different ways that health and social care professionals can provide support, treatment and help for children and young people with autism. It was updated in 2021 to add new recommendations.

3. Support pupils and parents in seeking help

Seeking help is a big step and is often a difficult one for individual young people or for families to make. Schools can make it easier by providing appropriate support and information in an accessible way. Teachers should ensure that their pupils know they can approach them at any time. They should be trained to listen and empathise. Counsellors should be available if a pupil wants to talk to someone else.

Many schools run mental health peer support schemes where young people support one another. Such a scheme not only provides effective support but also helps break down the stigma of mental health issues.

The need for an assessment by a healthcare professional will be identified by a GP. In some cases, schools can help by raising concerns with parents and encouraging them to seek help or by helping to facilitate contact.

4. Know where to get help

Local GPs are supported by specialist NHS teams who are part of community multi-disciplinary Child and Adolescent Mental Health Services (CAMHS).

CAMHS teams are made up of psychologists, psychiatrists, social workers, nurses and mental health link workers. They provide a range of targeted mental health interventions and treatments for children, young people and their families.

Schools should establish links with their CAMHS services and clarify referral, information sharing and joint-working procedures. Many CAMHS teams are happy to offer guidance and provide training and advice for schools.

Recent years have seen problems in accessing community mental health services due to a lack of funding and resources. However, the Future in Mind strategy, published by the Government in 2015, proposed the expansion of mental health services “built around the needs of children, young people and their families” so they get the right support from the right service at the right time.

Transforming Children and Young People’s Mental Health Provision, published jointly by the Department for Health and Social Care and the Department for Education in 2017, commits a further £300 million and includes a focus on developing links between schools and health services.

Other help is available from charities such as the Mental Health Foundation, YoungMinds, Mind, The Art Room/Place2Be, The Children’s Society, The Mix, Childline, Anna Freud National Centre for Children and Families, Children and Young People’s Mental Health Coalition and Action for Children. Many of these charities offer one-to-one support and counselling as well as training and advice for school leaders and staff.

5. Recognise the importance of positive early experiences in mental wellbeing

The foundations for healthy emotional development are known to be laid down in childhood. Positive early experiences are particularly important. Feelings of attachment, security and positive stimulation within loving relationships help to strengthen a child’s developing emotional and social systems and make them more likely to thrive.

However, not all children experience such a nurturing childhood. Some may be subject to stress and adverse experiences that instead contribute to developmental problems and emotional difficulties. This includes experiences such as abuse, mistreatment and neglect. It also includes other risk factors, such as exposure to family settings characterised by domestic violence, parental mental health problems or substance abuse.

This is an important consideration, especially in primary schools and nursery classes. Adults who spend time with young children, such as teachers, teaching assistants and other youth workers, have a responsibility to help in their healthy mental development and wellbeing. Given appropriate support, many children can overcome the challenges of early trauma and emotional harm.

6. Ensure staff have appropriate expectations for the emotional development of pupils

All children and adolescents can from time to time experience difficulties with their behaviour, feelings, thoughts and emotions. However, some may have more serious problems which are often identified by developmental concerns relating to the way they express emotions and form social relationships.

In some cases, there is a tendency for more weight to be given to cognitive, physical and verbal development than to emotional development. However, all are vital and teachers in both primary and secondary schools should be aware of what indicates healthy development in this respect.

7. Ensure staff have access to training

Understanding how emotional wellbeing can be strengthened or disrupted in childhood and at school should be a key element in staff training. Knowledge in this area will help staff to provide the kind of environments and experiences for pupils that help to promote good emotional health and prevent problems. Training for staff involved in pastoral roles is especially valuable.

Training should enable staff to identify the signs that a child might be having difficulty in their social and emotional development. It must include ongoing safeguarding training. Abuse, mistreatment and neglect, including domestic violence and family discord, are all likely to harm children and cause emotional damage.

Mental health and wellbeing is an excellent topic for staff inset training. In this context, it can cover both pupil mental health and staff wellbeing. Specialist guidance, training and support can be obtained from local NHS Trusts, particularly CAMHS teams.

The Mental Health Foundation has called on the government to guarantee at least one day’s training a year for teachers on learning about children’s mental health. 

8. Provide support for parents

Parenting can be challenging for all families at times, especially during periods of stress. However, it can be particularly challenging for families where parents or family members themselves suffer from mental ill health.

Parents who have mental health issues or physical health conditions should be supported wherever possible to help them deliver effective parenting. Support in these cases may require home liaison.

9. Include mental health in the curriculum

Teachers should include mental health issues in lesson plans and encourage pupils to explore issues around mental wellbeing. Learning about mental health is the best way to combat stigma and help young people to adopt healthy coping strategies.

Schools have a duty to provide a balanced curriculum which promotes “the spiritual, moral, cultural, mental and physical” development of pupils. Personal, social, health and economic (PSHE) education programmes play a key role in fulfilling this duty and incorporating mental health into the curriculum.

The government states that all schools should teach PSHE programmes. Schools can decide on their own course content with respect to mental health and wellbeing. Content may vary according to the needs of the group being taught but will usually cover talking about feelings, building awareness of mental health issues, promoting coping strategies and breaking down stigma.

The PSHE Association has published guidance for schools on including mental health and emotional wellbeing in personal, social, health and economic (PSHE) education programmes. The guidance is accompanied by set of lesson plans spanning Key Stages 1–4.

The resources can be accessed on the PSHE Association website. They were updated in 2021 to include new lessons on managing change, loss and grief.

Further resources and guidance for teachers can be obtained from the Mentally Healthy Schools website.

Many schools also use events such as assemblies to underline the importance of pupils looking after their mental health and talking to someone if they feel the need to.

10. Be mindful of staff mental health and emotional wellbeing

Working with families who are under strain can be stressful for teachers and other school staff. They should be adequately supported to cope with this stress and to address any mental health needs they themselves may have. See a template Stress at Work in Schools Policy. This will mean that they are more able to deliver high-quality care for pupils.

Mental health and wellbeing are increasingly being recognised as important workplace issues in their own right. School governors and leaders should strive to adopt the kind of flexible workplace policies that promote mental wellbeing and support staff who may have mental health issues of their own.

Work-life balance is widely identified as a key issue in education. Many teachers work long hours and regularly take work home to finish.

The Advisory, Conciliation and Arbitration Service (Acas) suggests a three-step approach to dealing with mental health at work:

  • train managers to spot the signs of employees who may be having psychological or emotional difficulties

  • identify any work-related causes and make “reasonable adjustments” to support people

  • promote awareness of mental health issues and create a culture where people feel they can talk about their concerns.

PAS 3002:2018, Code of Practice on Improving Health and Wellbeing within an Organization, was developed by the British Standards Institution in collaboration with the Chartered Institute for Personnel and Development (CIPD).

Appropriate support mechanisms should include effective resources, support, supervision and access to occupational health support where required.

Summary

Schools should:

  • have appropriate whole-school policies in place that promote mental wellbeing

  • have robust arrangements in place for supporting pupils who have mental health needs

  • ensure teachers and staff have sufficient training and a good understanding of their role in supporting children’s social and emotional development

  • raise awareness of mental health issues.

Further information

Further guidance and resources can be obtained from organisations such as the Mental Health Foundation. Details of their Mental Health in Schools: Make it Count campaign can be found at www.mentalhealth.org.uk.