Supporting young people’s mental health in school

1. Supporting young people’s mental health in school Jenny Spratt Kate Philip The Rowan Group University of Aberdeen (Co-authors Janet Shucksmith, University of Teesside, Cate Watson University of Aberdeen)

2. The extent of the problem • It has only recently become clear that mental ill health among children and adolescents us not confined to only a small proportion of young people but is surprisingly common. (WHO 2004a) MHF estimates that 20% of children and and adolescents are experiencing psychological problems at any time

3. Implications for school behaviour Whether a child “acts out” or “acts in” they may have barriers to learning which require to be addressed. Children “acting out” may be aggressive, threatening, disruptive and demanding of attention….Children “acting in” may have emotional difficulties which can result in unresponsive or even self-damaging behaviour Better Behaviour Better Learning (SEED 2001)

4. A role for the voluntary sector? • New Labour’s “third way” sees the voluntary sector as a partner to the state in service delivery • Particularly well placed to offer local interventions responsive to local need • Health promoting schools need to work in partnership with the communities in which they are located and voluntary sector organisations can help form these links • Child welfare or specialist mental health organisations can offer expertise which can support schools develop their capacity to address these issues.

5. Investigating the links between mental health and behaviour in schools – a research study • SEED funded, Scotland wide study • Examined the responses (both proactive and reactive) of education authorities, schools and their partners in the health and voluntary sectors to challenging behaviour thought to be triggered by poor mental health

6. Methods • Literature review • Telephone survey • All education authorities • All health boards • Relevant voluntary sector organsiations • 6 case studies of good or innovative practice (3 involving voluntary sector organisations) • Observation, scrutiny of documents, interviews with range of stakeholders including parents pupils, teachers , managers and interagency staff

7. Case study 1- The Place2Be • National organisation offering targeted therapeutic support for identified children, self referral drop in, and support for staff. • Small units based in primary schools • Franchise – same organisational structure and support in all locations – contractually agreed

8. Case Study 2: North Glasgow Stress Centre • Small local voluntary sector organisation • Underpinned by framework of emotional literacy • School based group work and individual counselling, and community based initiatives • Works in two secondary schools, both in areas of deprivation, on with high asylum seeker intake • Flexible approach – operates differently in each school • Offers multi-disciplinary training courses for professionals

9. Case Study 3: RAMH Youth counsellor seconded to Integrated Community School • Full time post – seen as full member of ICS team • Individual counselling is main focus, also group work and professional support • Teacher referral and self referral systems

10. Findings: An overview • New thinking • Schools and education authorities unfamiliar with language of mental health • Mental health touched on in a range of policy areas – e.g. anti-bullying, health promotion, inclusion, behaviour support • Hence falls into range of departments and funding streams with little co-ordination • National picture is patchy, with pockets of very good provision. • Partnership with parents and other agencies is critical to success in this area

11. A health promoting school: • Analysis of data based on WHO definition of a health promoting school report: • inclusive curriculum • ethos and environment • partnership working • This presentation focuses on partnership working

12. Partnership working:3 models • Export problems • Refer troubled children to expert services elsewhere or into containment schemes • Import skills • Import skills into schools to solve problems but devolve authority to another agency • Retain ownership • Use personnel in integrated teams to develop new approaches embedded in school life

13. Exporting problems • Both LAs and Health Boards worked hard to stop schools shipping problems off site • Barriers erected to prevent schools “firing” problems “ into external agencies” • For some children with severe / enduring problems access to specialist help always necessary

14. Importing skills • Two discernible models • Buy in – parallel structure, focussed on “fixing” the problem children, no learning, no integration • Buy in – integrated structure, painful lessons, slow learning, new thinking embedded into school structures and functioning • The first was the most common parallel working not true partnership

15. What does “ownership” mean? • Schools (and individual teachers) … • Accept professional responsibility for children’s mental well-being • Accept that some discipline problems are associated with poor mental health • Acknowledge that schools may contribute in some cases to poor mental health • Undertake to review all aspects of schools ethos and functioning to minimise negative impact and improve the positive • Work with other agencies and parents to develop capacity to achieve this

16. In conclusion • The drawing into schools of other professional groups offers the chance • To build capacity on this issue within the teaching staff • To provide young people with additional and different services to what teacher can offer • An overview would indicate that we have the latter but not the former in most instances. Additionality has been achieved, but it may take time to build capacity in this way

17. Challenges: Building capacity through interagency working….. • What roles can be successfully undertaken by voluntary sector workers in schools? • What are the challenges to the voluntary sector in schools working in this area? • How can we work to effect culture change around attitudes to mental health? Does inter-agency working lead to cross fertilisation of ideas?

18. ….and more challenges • Does the presence of interagency workers in schools allow teaching staff to relinquish responsibility for mental health? How can we avoid this?

19. Part 2. Voluntary sector in schools: Working in partnership? • Referring to relationship between the state and the voluntary sector Morrison (2000) commented: In short, there is a space here where issues of power are being worked out

20. Equal partners? • In practice, in schools, the voluntary sector organisations are hampered by their relative lack of power: • Access to schools depends upon goodwill of head teacher • Short term funding, depends on schools opinion • Referral of children often mediated by school • School traditions are long held, professionalised and protected, challenges are fiercely contested • Voluntary sector presence in schools are small units in much larger institutions

21. Embedded or separate? • “We never forget that we are hosted by the school and in a sense we have guest status no matter how integrated we are. Because of the therapeutic confidentiality we have to have enough separateness to be separate but enough integration to be working closely with the staff team” Voluntary sector worker

22. Whose agenda? • VSOs and schools may have different understanding of children’s rights • Schools institution orientated priorities e.g. discipline, curriculum delivery educational outcomes, may come into conflict with needs of individuals • VSOs concerned exclusively with well being of pupils • Yet success may be judged in terms of enabling children to “fit” into the system

23. That was almost the test, you know, fix these kids, because there is…..an expectation that we will fix them. And that is an interesting thing that we are looking at , in terms of evaluation, is people’s perception of significant change. What the person may deem as being significant to them may not, in fact, affect their classroom behaviour, so therefore the teacher sees a different change or no change at all. So therefore has the counselling in fact failed? Voluntary sector worker

24. Capacity building • All VSOs in case studies aimed to raise staff awareness and build their capacity to support mental well-being • In reality education staff viewed VSOs as an add-on to the main business of school • Little evidence of the level of integration required to support staff development • Presence of interagency staff could be counter-productive to building capacity in main body of staff • Some evidence of active resistance to developing shared understandings.

25. Evaluation • VSO’s maintenance of position in school depends on demonstrating their success to schools and education authorities • Much time and effort put into producing comprehensive self evaluations • Little incentive to honestly appraise shortcomings • Awareness of informal evaluation by school staff leads to defensiveness of position

26. Innovation • Leadbeater (1997) suggests that voluntary sector organisations can act as “a kind of research and development wing to the welfare system, innovating new solutions to intractable problems” • Q: How can that flexible approach be fostered to support mental health in the school environment