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Tested to the edge?

A recent review held by Children’s Commissioner Anne Longfield found that more than a quarter of children referred to mental health services in England last year received no help. Perhaps more shocking, is that some of the children included in this group had attempted suicide or lived with life-threatening conditions such as anorexia nervosa or psychosis.

Utilising data obtained from 48 of England’s 60 child and adolescent mental health service trusts, the report also revealed that 28 percent of child referrals were denied treatment, mainly on the grounds that their illness was not deemed serious enough.

Even children who managed to secure treatment faced an average waiting time of 100 days. Of the delays in accessing treatment, Sarah Brennan, Chief Executive of mental health charity Young Minds, said: “Services have been cut and young people [have] nowhere to go.

“They are then more ill when they get help, so services have become overwhelmed…Six months for a young person is huge and in that time, young people are becoming more ill.”

Mirroring Ms Brennan’s concerns, the DfE’s former mental health champion, Natasha Devon, suggests that it is necessary to analyse the root causes of mental health conditions, to identify problems in their early stages, and find ways of preventing them: “Time and again over recent years, young people – and the people who teach them – have spoken out about how a rigorous culture of testing and academic pressure is detrimental to their mental health.

“At one end of the scale, we’ve got four-year-olds being tested, at the other end of the scale, we’ve got teenagers leaving school and facing the prospect of leaving university with record amounts of debt.

“Anxiety, for example, is the fastest growing illness in under-21s and we need to look at what’s happening to young people – the culture and the society they live in, the pressures that are on them.”

Exam
Image credit: Flickr

Pressure to achieve

It could be argued that a significant pressure placed on pupils is academic attainment via a culture of intense assessment. Recent research carried out by the National Union of Teachers (NUT) discovered that 90 percent of the 6,500 primary teachers and leaders surveyed thought that SATs preparation had worsened their pupils’ wellbeing, mental health and self-confidence, while 87 percent were concerned that the tests affected children’s engagement and motivation.

Additionally, 97 percent of the respondents believed the key stage 2 SATs disadvantaged pupils with special educational needs and disabilities (SEND), and 84 percent thought that pupils with English as an additional language (EAL) were hindered by the tougher tests.

Nearly all teachers surveyed (97 percent) thought the reforms to assessment had been badly managed by the DfE and more than 90 percent said that the “expected standard” pupils were required to work towards, was beyond the reach of many of their pupils.

Kevin Courtney, acting General Secretary of the NUT, stated: “The impact primary assessment is having on children’s mental health and wellbeing, alongside what it is squeezing out of the school day, makes it irresponsible not to listen to teachers’ concerns.”

MH blog - Wikipedia
Image credit: Wikipedia

The scale of the issue

Mental health conditions are sometimes seen to be rooted in teenage angst, but this is far from the truth. Data from the charity Young Minds demonstrates that 1 in 10 children and young people aged five to 16 suffer from a mental health disorder – around three children in every class. Nearly 80,000 children also suffer from severe depression, and around 8,000 of these children are aged 10 and under.

Writing in The Guardian last month, Ms Devon sought to highlight the reasons why schools have become the last line of support for vulnerable pupils. Recounting a meeting with a concerned teacher over the “epidemic of self-harm” among her pupils, Ms Devon admitted that she did not feel equipped to advise the teacher, as the Child and Adolescent Mental Health Service (CAMHS) in the teacher’s area was overstretched and had previously rejected support to the school’s pupils as their needs were not classed as “severe enough” for an appointment.

The article also underlined the alarming increase in self-harm amongst 10- to 14-year-olds, where figures based on A&E attendance from the charity Self-harm UK revealed a 70 percent increase since 2014.

Even more concerning, is the recent study into teenage suicide conducted by the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness, based at the University of Manchester, which found that there was a history of self-harming in 54 percent of the 130 teenage suicide cases they reviewed over a 16-month period. Alarmingly, the findings also revealed that 27 percent of the young people who had committed suicide had experienced exam stress or other academic pressures.

MH blog youtube
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Reform is required

The Children’s Commissioner has called for urgent reforms to the mental health system, citing a “constant stream of children, parents and professionals” that inform her of their inability to access help when they really need it. Conservative MP and Chair of the All Party Parliamentary Group on Mental Health, James Morris, also concedes that a “fundamental transformation” is required.

The government has pledged to spend an estimated £1.4 billion to expand CAMHS provision and ensure that “young people get support before they reach a crisis point”. This is welcome news, but it does not address questions over the £85 million of budget cuts that CAMHS has suffered since 2010. Nor does it address the serious shortage in school nurses, who have the “skills and experience” to support pupils with mental health concerns. According to the Royal College of Nursing (RCN), more investment is needed rapidly to reinforce provision.

According to the Health and Social Care Information Centre, the number of school nurses in England has fallen by 10 percent since 2010, leaving 2,700 school nurses to care for nine million pupils. This equates to a ratio of just one nurse to 3,333 pupils.

Of the 277 nurses surveyed by the RCN, 68 percent believed there were insufficient school nursing services in their area to provide the care and support children and young people need and 70 percent of them said their current workload was too heavy.

Janet Davies, Chief Executive and General Secretary of the RCN, stated: “School nurses have the skills and the experience to provide a wide range of mental health support, from counselling to promoting healthy lifestyles. But, as our survey shows, there are too few of them, and they are simply too stretched.

“Only by investing in school nursing and wider mental health services, can this crisis be tackled and children be given the best chance possible of leading happy and healthy lives.”

Bowing to increasing pressure to provide urgent assistance, the government has agreed to “strengthen the links between schools and mental health services through a £3 million pilot” and will “invest £1.5 million on developing peer-support networks in schools”.

Only time will tell if the government’s intervention is enough to address the epidemic of poor mental health blighting our children, but frustratingly, it will come too late for some.

What can your school do to support pupils?

  • Embed growth mindset lessons into the timetable – this can be as simple asking a local Buddhist centre to teach pupils relaxation techniques and coping mechanisms, discussing failure and ‘near misses’ as a necessary part of the learning process or investing heavily in a growth mindset programme devised by an expert, such as Carol Dwek.
  • Consider implementing a school counselling service. Our Counselling in Schools – 3 Minute Read summarises ways of achieving this.
  • Work closely with parents/carers to find ways to support their child in school, and consider asking them if they will consent to their child’s GP sharing information with the school that could be beneficial.

Bibliography

BBC (2016) ‘Mental health support ‘denied to children’’, <http://www.bbc.co.uk/news/education-36398247> [Accessed: 20 June 2016]

Eleanor Busby (2016) ‘Nine in 10 teachers believe Sats preparation harms children’s mental health, survey finds’, <https://www.tes.com/news/school-news/breaking-news/nine-10-teachers-believe-sats-preparation-harms-childrens-mental> [Accessed: 20 June 2016]

Hannah Graham (2016) ‘Is enough being done to protect primary school children in the North East from mental illnesses?’ <http://www.chroniclelive.co.uk/news/north-east-news/enough-being-done-protect-primary-11484081> [Accessed: 20 June 2016]

Natasha Devon (2016) ‘Teachers have to be therapist one moment, social worker the next’, <http://www.theguardian.com/education/2016/may/31/teachers-natasha-devon-childrens-mental-health-tsar-schools> [Accessed: 20 June 2016]

NHS (2016) ‘Exam stress linked to teen suicide’ <http://www.nhs.uk/news/2016/05May/Pages/Exam-stress-linked-to-teen-suicide.aspx> [Accessed: 20 June 2016]

TES (2016) ‘School nurses could help solve mental health crisis but workload is too heavy, union says’, <https://www.tes.com/news/school-news/breaking-news/school-nurses-could-help-solve-mental-health-crisis-workload-too> [Accessed: 20 June 2016]

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