Chorus to support young people improve mental health swells

18 Aug

Localis, the think tank, published a report recently asking the government to make it compulsory for a mental health module to be included in initial teacher training (ITT). The report stated that mental health services for youngsters should be brought into schools/academies to prevent more than half-a-million pupils from being failed by the agencies.

Readers may recall that Prime Minister Theresa May announced recently that every secondary school in England would be provided with free mental health training.   Localis has now asked government to give school leaders more detail about what form this will take. It pointed out that in spite of the £1.4 billion recently committed to improving Child and Adolescent Mental Health Services (CAMHS), more than 555,000 primary and secondary pupils who have mental illnesses will not receive NHS care and attention by 2020-21.

The Times Educational Supplement (TES) reported in the summer of 2017 that an increasing number of pupils had become suicidal in their attempts to secure help because CAMHS had raised the threshold for triggering that help.   A pupil of a school in South West London attempted suicide with an overdose. When her headteacher asked her how she was feeling when she was saved, she replied: “Pretty awful.” And then she revealed that she had attempted to kill herself to attract the attention of CAMHS.  In her school alone, three other pupils also attempted suicide for the same reason.

According to the TES, Heather Dickinson from Papyrus, the teen-suicide prevention charity, says that helpline advisers frequently hear from pupils who have expressed suicidal tendencies to see professionals from CAMHS.  “People either can’t access CAMHS or aren’t getting enough from them,” she told the TES.  “Sometimes young people feel that they’re not taken as seriously by CAMHS as they might be….So they escalate their behaviours.” Dickinson has seen a dramatic rise in calls and text messages the charity receives from teenagers with suicidal thoughts.

Growing numbers of pupils are being driven to make what look like suicide attempts just to get help, because the thresholds for accessing CAMHS’s services have increased. While CAMHS is planning school-based approaches to mental health, only 3% propose placing counsellors in schools.

Meanwhile, in 2015 – the latest year for which the statistics are available – of all pupils referred to CAMHS in England –

  • 28% were not allocated a service, the proportion ranging from 18% and 75% in different areas,
  • 58% were placed on a waiting list, ranging from 6% to 78% in different regions and
  • 14% received provision immediately, ranging from 3% to 39% across different regions.

Self-harm is another cry for help.  New research has revealed that incidents of self-harm among pupils rose in almost half of all schools – including three-quarters of secondary schools. The survey of more than 1,100 school leaders showed that stress, anxiety and panic attacks among pupils increased by 79% in the last two years.

A survey by the Association of School and College Leaders (ASCL) in 2016 found that nearly 20% of school leaders said that 40% of their pupils were experiencing anxiety and/or stress.   Anne Coles, the inclusion specialist at the ASCL believes “the use of social media and technology are (sic) aggravating fragile mental health. The way young people are using social media, are (sic) connected in all the time with no let-up, and having a negative impact.”  Mary Bousted, General Secretary of the Association of Teachers and Lecturers blames the increase in mental health problems partly to child poverty and partly changes to the school curriculum and examinations.  Others attribute this rise to better diagnosis.  I would add that it could also be because mental ill-health has now been de-stigmatised.  In fact, in some quarters it has been “fashionable” for youngsters to aver that they suffer from mental health.  The reality is that the increase in mental ill-health is because of a combination of all these factors.

The Localis report states that, “despite school-based interventions being one of the most cost-effective and proximate to a young person’s everyday life”, very few local authorities are planning to commission school-based services.  The only unusual aspect of this remark is that Localis expects LAs to commission and pay for such services when their resources are severely constrained.

Notwithstanding, Localis recommends that local authorities should be statutorily obliged to provide school-based support services for all secondary pupils with up to 6.5% of the Pupil-Premium funds being retained to fund these services. It has asked the government to make it compulsory for academies to deliver school-based support services as well, potentially by opting into services provided by the local authority.

Localis suggests that school forums in every local area should be awarded the powers to suggest a lead mental health coordinator to oversee local strategies.

A Department for Education spokesperson said: “We are strengthening the links between schools and NHS mental health staff, and have announced plans for every secondary school to be offered mental health first-aid training. Later this year, we will publish a Green Paper with proposals for further improving mental health services.”

Researchers from The Key, a governors’ organisation, discovered that the incidence of self-harm among youngsters increased.  In coastal areas, 57% of school leaders witnessed a rise.  Around 60% added that there was a rise in pupil depression over a two-year period.  School leaders were fearful for the future.  Altogether, 76% of primary leaders and 78% of secondary leaders said that they had observed that youngsters suffered mentally over the fear of failure.

The Key research also revealed that pupils’ worry about drugs, sexting and domestic violence had risen over the last two years.  A West Midlands secondary headteacher said: “We are seeing students presenting a wide range of issues and we are having to increase our pastoral support.  Early help outside of school is, at best, inadequate.”

Dealing with mental health problems has not been prioritised as well as it should by government and the NHS, probably for two reasons.  First, the mental health suffering of a person is not visible, unless, of course, the mental ill-health is severe, in which case, she/he is inevitably “put away”/confined to a hospital.  Second, mental ill-health has stigmas attached to it.  The upshot of this is that those suffering from psychological/psychiatric problems are often loathe to admit them.

Egregious physical problems such as fractures are visible and attract sympathy.   Broken minds are not visible unless the suffering is considerable.   Cancer attracts sympathy; depression and obsessive-compulsive disorder – opprobrium.

The government has now pledged the creation of 21,000 new mental health posts in the NHS by 2021, an aspiration that will be warmly welcomed.  The aim is to inject £1 billion to treat a million patients.  However, resources are scarce and personnel even scarcer with so many vacancies in the NHS and Brexit likely to create an outflow of foreign expertise.

On the credit side, the government intends to ask medical schools to give psychology and psychiatry equal merit to A-levels in natural sciences.   Progress in treating mental health has been made in the last couple of decades with cures such as cognitive-behaviour therapy.

Meanwhile, the frenetic changes wrought to school structure and the curriculum, together with the pressures brought to bear on them via league tables and Ofsted inspections, have been running many teachers ragged causing them – first to be stressed out and after to suffer mental health problems. They, too, need help, but that is a subject that will have to be addressed in a separate article……..

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