3Mental health support in education providers
20.Strong partnerships between education providers and mental health services are key to providing children and young people with high quality care. We heard that schools and colleges must be well resourced to both provide on-site support and make referrals where necessary.
Workforce training
21.School and college workforces have a significant role to play in identifying mental ill health in their students and signposting them to support. Emily Frith told us:
Teachers are often the first professionals young people approach for help. Therefore, having teachers who understand basic mental health first aid is an important step in the process of getting early intervention with young people.34
22.Teachers and school staff have a role in intervening in cases where students feel anxious about work pressures, as well as in referral to professional psychological assessment and support for students who are showing signs of diagnosable mental health conditions. In order to be effective in this role teachers should be given adequate training and opportunities for continuing professional development. We are encouraged to see that the Government’s recent review of initial teacher training recommended that providers should:
equip trainees to analyse the strengths and needs of all pupils effectively, ensuring that they have an understanding of cognitive, social, emotional, physical and mental health factors that can inhibit or enhance pupils’ education.35
23.We have made recommendations on teacher training in previous inquiries. The Education Committee’s report on Mental health and well-being of looked-after children stated that:
We support the recent recommendation made by the Youth Select Committee on the inclusion of mental health training in the core content of initial teacher training. We see this as a minimum requirement. Training on emotional well-being and mental health should also be included in continuous professional development for current teachers.36
24.Similarly, the Health Committee’s inquiry on Children’s and adolescent mental health and CAMHS recommended that the DfE should include a:
mandatory module on mental health in initial teacher training, and should include mental health modules as part of ongoing professional development in schools for both teaching and support staff.37
25.Teachers are not mental health professionals, but they are in many cases well placed to identify mental ill health and refer students to further assessment and support. Training school and college staff to recognise the warning signs of mental health ill health in their students is crucial. We encourage the Government to build on the inclusion of mental health training in initial teacher training and ensure current teachers also receive training as part of an entitlement to continuing professional development.
Co-ordination between health and education services
26.The Government’s 2015 report Future in Mind made several recommendations about health and education services working together to provide effective mental health care.38 The report described creating a whole system approach which would lead to better co-ordination between education and healthcare. It specifically recommended that schools should have a named mental health lead.39
27.The mental health of children and young people is not solely an issue for the education sector. We are pleased to note ministerial acknowledgement that parental conflict is a significant contributor to the mental health problems of their children.40 We encourage the incoming Government to take further action on this issue.
28.The second panel in our first evidence session spoke about co-ordination between services in their local areas. Dr Brownlie, Clinical Psychologist, Sheffield CAMHS service, Sheffield Children’s NHS Foundation Trust, described the arrangements in Sheffield:
We have had a multi-agency approach for commissioning. The CCG [clinical commissioning group] and the local authority have been working together on commissioning and strategic development, and we have managed to engage schools within that.41
29.On 20 March we visited Regent High School where the Tavistock and Portman NHS Foundation Trust have been commissioned to run CAMHS by the Camden Clinical Commissioning Group and Camden Local Authority. The partnership between education, health and the local authority in this area was a good example of inter-agency co-ordination. They have successfully put into practice a whole system approach to mental health care and located senior staff members from the Trust in the local schools.
30.In 2015–16, DfE worked with NHS England on a £3million pilot to provide joint training to schools and CAMHS staff and to test how having single points of contact in both schools and CAMHS can improve referrals to specialist services. In February 2017, the Government published an evaluation of the pilot. It found that the scheme improved schools’ knowledge and awareness of mental health issues, and their understanding of referral routes, and boosted confidence in supporting children and young people. The evaluation concluded:
At a national level, the pilot programme very much demonstrates the potential added value of providing schools and NHS CAMHS with opportunities to engage in joint planning and training activities, improving the clarity of local pathways to specialist mental health support, and establishing named points of contact in schools and NHS CAMHS. At the same time, the evaluation has underlined the lack of available resources to deliver this offer universally across all schools at this stage within many areas.42
31.The Minister, Edward Timpson MP, told us that that the pilots had led to:
an increase in the frequency of contact between schools and children and young people’s mental health services, and a better understanding as well as the number of referrals that were made by schools as a consequence.43
He confirmed that the pilot will be extended to cover 1,200 more schools and that funding has been allocated for this next stage.
32.A structured approach to referrals from education providers to CAMHS must be developed across the country. We have seen cases of strong partnerships between mental health services and education providers, but such links do not exist in many local areas.
33.We are encouraged by the results of the CAMHS link pilot and are pleased that the pilot has been extended. We recommend that the Government should follow the advice of the evaluation and commit resource to establish partnerships with mental health services across all schools and colleges. The variation in access for children and young people to timely assessment and support for mental illness is unacceptable.
Cuts to school and college based services
34.In 2015 the Government announced £1.25bn in extra funding for young people’s mental health. However, as schools see their funding cut, an increasing number are cutting back on mental health services such as in-school counsellors. Education Policy Institute analysis showed that “due to inflation and pension pressures, schools may be left with a funding gap of 10.7 per cent in 2020–21, or £4.8bn in 2015–16 prices, which could lead to cuts in mental health provision”.44
35.In January 2017 the National Association of Headteachers (NAHT) and Place2Be conducted a survey of children’s mental health which found that around 64% of primary schools do not have access to a school based counsellor and 78% of those surveyed reported financial constraints as a barrier to providing mental health services for students.45
36.Siobhan Collingwood, Headteacher, Morecambe Bay Community Primary School, told us:
I put a general email out to several of my colleagues before I came to today’s meeting, and the responses I received have been overwhelming in terms of the number who are seriously considering cutting pastoral provision; it is the first thing to go. The first thing that will go will be the therapeutic services that are bought in and the outside services that are bought in. They are already going in April. Staff are being lost from pastoral teams from April.46
37.Dr Brownlie highlighted what she felt was the “false economy” of not investing in children and young people’s mental health. She said:
If we invest in young people and support their emotional resilience, lifelong health and wellbeing, it will save money further down the line.47
38.We asked Minister Timpson about cuts to services within schools and colleges. He responded that he was unable to provide a “full picture” as a children and young people’s mental health prevalence survey has not been completed since 2004:
That is one of the reasons we are undertaking the comprehensive national mental health provision survey in schools and colleges to really know and have a full read-out of what is happening on the ground.48
39.We heard evidence of the adverse impact of funding pressures on mental health provision in schools and colleges, including the ability to bring in external support. We know that over half of all mental ill health starts before the age of fifteen and it is therefore a false economy to cut services for children and young people. We strongly urge the next Government to review the effect of budget reductions on the in-school provision of services to support children and young people’s mental health and well-being.
34 Q5
35 Department for Education, A framework of core content for initial teacher training (ITT) (July 2016), p 16
36 Education Committee, Fourth Report of Session 2015–16, Mental health and well-being of looked-after children, HC 481, para 57
37 Health Committee, Third Report of Session 2014–15, Children’s and adolescents’ mental health and CAMHS, HC 342
38 Department of Health and NHS England, Future in Mind, March 2015
39 Ibid.
40 Q130 [Edward Timpson MP]
41 Q52
42 Department for Education, Mental Health Services and Schools Link Pilots: Evaluation report, February 2017
43 Q123
45 NAHT and Place2Be, Children’s Mental Health Matters, January 2017
46 Q48
47 Q49
48 Q99
28 April 2017