Transforming children and young people’s mental health provision: a green paper – Mental Health Leads – Opinion
The long awaited mental health green paper is finally out. Will it make a difference? Only time will tell. I’ve been looking through it and here are my thoughts on the first of the three key themes:
Designated Senior Mental Health Leads
My initial response to this role’s prominence in the paper was one of elation – this is the role I have been doing in my own school for the last 18 months (give or take and without the “senior” tag). The paper suggests that a member of staff within the school is given the role of “Designated Senior Lead”, in charge of giving “rapid advice, consultation and signposting”. This member of staff will liaise with mental health support services and have an overview on mental health in the school. They will know the places help can be accessed and who to talk to. They will be involved in identifying students with mental health problems, making referrals and tracking the progress through the system. They will look at policies and systems that can help support mental health and train staff to become more confident in working with students with mental health problems.
On first glace this role sounds ideal for any teacher who wishes to specialise in this area. The wide remit and opportunity to make a real difference is somewhat irresistible. However, having done the role the reality can be somewhat different. Schools that can barely afford to keep class sizes as low as they would like and cannot find the staff to cover the shortage subjects are increasingly pulling hours from those with extra curricular responsibilities. Whilst the mental health green paper is incentivising this role with additional funding for training, ongoing funding for this role does not seem to be forthcoming. Any extra hours outside of the classroom must be taken from the teaching budget and this role requires many hours outside of the classroom. Mental health issues don’t comply with a fixed timetable and when help is needed, help is needed there and then. As the single body responsible for (and confident with) dealing with students facing these problems, the Mental Health lead can often be pulled in many directions when they are trying to maintain a teaching commitment whilst supporting those with increasing and unpredictable needs.
To make a teacher free to deal with these issues requires a very light teaching timetable. The role I have undertaken involved me identifying students, building students’ confidence to access counselling, training staff, supporting students day to day and week to week, searching for new support services, creating partnerships with charities and commissioned providers, enabling self help, showing impact, running nurture groups/lunches, dealing with behaviour problems associated with trauma and mental health…and more. At times it is highly likely you can move from emotionally coaching a highly traumatised student through a flashback, to running down to your classroom to begin a lesson minutes later.
There is some merit to being a timetabled teacher in this role however. The students get to know you and they see your personality and perceived trustworthiness. They are more inclined to talk to you and share their feelings. Often students don’t want to talk to counsellors and much of my time is spent helping them to feel confident talking to a strange someone about the things they really struggle to even thing about. They understand the professionals can help them to recover but prefer the safe company of a teacher who cares. Getting them to no longer feel ashamed is a key role in getting them in front of the right support quickly and this can only be done in a trusting relationship.
A teacher in this role needs to be highly visible and well known. Teaching in the early years of the school setting could be key too, so students have early exposure to the member of staff and what their extra role involves. I’ve always made an effort to meet students in a neutral setting (where I have not had to take a disciplinary role) before I begin to try to direct their behaviour or give advice, this way I have shown I am someone worth listening to before they have to do the listening. The more the teacher is in the classroom, the less support they can give but the less they are in the classroom, the less visible they will be. The balance needs to be struck for the benefit of both the staff member and the students they support.
Making it count
Measuring impact in this role is key but often the results of the work done can be hard to prove. Strength and difficulties questionnaires, behaviour and attendance statistics, Boxall Profiles and self assessment all play a role but its hard to measure the impact of issues that didn’t arise. For instance how do we know what didn’t happen because of your successful intervention? The student that wasn’t excluded or the adult who left the school emotionally more stable than they might have been. As an investment made by the school, this role must show clear measurable impact to justify expenditure but if it really is going to be taken seriously and prioritised by schools Ofsted need to be taking a closer look at what schools do.
However “Ofsted for mental health” seems like a disaster waiting to happen – schools may game the system to show they are “making pupils mentally healthy” and pressure could be increased on staff and pupils to show they are “improved”. This could have a drastic affect on the mental health of all involved. Unfortunately though whilst schools can ignore it through the filter of Ofsted priorities it will be seen as something good to have, but not highly prioritised similar like any project that looks good on paper, but isn’t resourced well enough to make the difference required. Schools with tight budgets have priorities and without ringfenced investment year on year, this will be largely an exercise in box ticking.
This leads me to the “Senior” aspect of this role as detailed in this mental health green paper. It seems common sense that the responsibility of making sure every student faces no mental barrier to accessing the curriculum should be a senior role. But (as stated previously) whilst schools provision of mental health support isn’t fully inspected, the role largely seems optional and niche. In decades to come, we will look back incredulous at the idea of this role being a side note to the curricular work that is done. We will see it as the foundations of good learning and a role that has the power and responsibility to enable the work of everyone else in school i.e. it doesn’t matter how many outstanding teachers you have if the students aren’t ready to access the materials. It is my fear the schools will designate a senior member of staff this responsibility but the bulk of the work will be done at a lower level by a less senior member of staff. The implications of this are that the staff member may not be believed when they express concerns about resources and policy and that the person overseeing them may not have full understanding of the issues being discussed. If this mental health green paper is to take the approach of a Senior Lead, it must ensure this lead undergoes appropriate training.
And we’ve arrived at the next announcement attached to this role – a training budget. There is allocated funding in this mental health green paper to “incentivise” schools into putting this into place and allowing the training that is required to go with it. The mental health green paper does not set out what training it believes should be undertaken despite as recently as January calling for all schools to have mental health first aiders. There is a wide range of training available from profit seeking training providers, many without accreditation but appearing very attractive to the unaware. As a Mental Health First Aid Youth instructor, Wellbeing Toolkit Practitioner (attended “Train the trainer”), a Nurture accredited teacher and someone who has undertaken training in Functional Behaviour Assessment I have undertaken a range of training that I have felt has been incredibly useful but none that fully individually encompasses the role of the Mental Health lead. There are many providers that get close to providing professional training on the basics of therapeutic interventions over 4 day courses, providing another angle to the role of the Mental Health lead. I strongly believe the best training I received was in experience as a Head of Year, something you cannot pay for. However what individual schools will choose for their training is concerning as if they spend the money in the wrong places they may have an under experienced or low knowledge member of staff making very serious decisions on mental health provision. Personality is key in this role too, you must be able to show empathy and withhold judgement.
The Mental Health Green paper doesn’t specify this role has to be a teacher however. This role could be undertaken by a qualified Psychological Wellbeing Practitioner, who begin at Band 5 of the NHS scale (around £22,000) which is significantly cheaper than a senior teacher. The benefits of doing so mean a school has an NHS qualified mental health worker in school making informed decisions at a lower cost. Taking on the role full time is an expense for schools that they may feel they can avoid – after all the NHS is responsible for employing these kinds of staff. As an educational institute the supervision of this role might be insufficient too, and that is vital for keeping oversight on what interventions are taking place and their impact. Schools with limited budgets might opt to reduce the role to one or two days a week, but this would lead to students needing immediate support being unsupported at other times. Being a non teacher and possibly not in full time can reduce the students awareness of this person and therefore make them less likely to go to them as a first port of call. Being a teacher is also highly beneficial in this role in understanding the workings of the school and what advice can be given to teachers to support students. The ability to handle and diffuse poor behaviour is essential, again teacher skills and attributes. As someone without the qualification and experiences of being a teacher, it could be hard to place this person inside the management structure of a school, as the Designated Lead role suggests may be required. When you add in the need for this person to cascade training, the need for this person to be a teacher is ever clearer.
Support without support
When this role is established it is hugely important that the Mental Health lead has a place to send referrals for professional support. Schools have limited funds for counsellors and when these funds run out, the services are withdrawn. This can be devastating for the students. Further to this without investment in CAMHS the threshold will stay high and lower level mental health issues will be bounced back to schools. Without fully funded services to refer into, funding to buy services in house and without extra professionals available to be employed to perform these services it is going to be an increasingly difficult role for a Mental Health lead to do that will get ever harder as budgets continue to tighten. Combine this with increased exam pressures, social media, toxic masculinity, body image pressures, under-understood areas of gender dysphoria and LGBTQ+, bullying, addiction, poverty, trauma…(the list goes on) the mental health green paper really is lacking in plans to increase the level of available professional support to meet these emerging needs. The government has further outlined in its mental health green paper the idea of teams working with schools – great in principle but those working in these areas know the services are already hugely overloaded. They need more staff and more investment and they need it now.
So what do we need in a Mental Health Lead? What needs to be in the green paper?
It is my belief, alongside clear investment in training and developing mental health professionals to specialise in early intervention in child mental health, we need the government to incentivise schools year on year to maintain a Designated Senior Lead for Mental Health by providing both a training budget and a salary contribution of around 3 – 4 days a week pay. This role should be encouraged to be within Senior Management teams to advise on upcoming policy and strategy. The role could work with interested, passionate and suitably trained teaching assistants to have a wider impact whilst maintaining a balance of contact time with students. In terms of a training package, a funded Postgraduate Certificate in this area at a similar level to that of the Special Educational Needs Co-Ordinator qualification could be created with universities and IAPT professionals that offers a professionally recognised status for the leaders of Social, Emotional and Mental Health in schools. Encouragement and funding in nurture group provision and Mental Health First Aid (Youth) qualifications included as part of the PGCE qualification (using funding from the increased fees) could also help improve the situation in schools further.
It must be said that none of this will be effective if schools continue to put into place policies that drastically effect the wellbeing of their students in pursuit of the perceived academic achievements. Homework policies that push students to within minutes of the maximum EU dictated working week for a full grown adult are not helpful. Reporting systems that highlight students failure over achievement, intervention sessions that further extend their working week, target that feel unachieveable despite great efforts being made – these are all things that contribute to the stress felt by students. If we can take a whole school look at our policies and change what negatively affects students we can start to make a difference now, without any investment or significant changes in roles. Let’s help our students get enough sleep, turn off their devices, get exercise, eat well. Let’s make them feel valued and worthy of our time, and build their self esteem through meaningful participation in extra curricular activities.We have so much power to change if we are given the tools to do so. Our responsibility is not just to create adults who are educated enough to contribute to society but also to ensure they are emotionally secure enough to want to. It’s time to step back and change the exam factory approach to education, take a Maslow view of our students needs and start manufacturing happy, educated, independent and motivated adults ready to give back to a caring world that appears so new and so exciting.