5 Steps: Understanding mental health need in schools

With the changing face of school accountability, the demand for evidence-based practice is growing. Using practical and trusted tools allows schools and colleges to assess the needs of their population, so that they are able to respond to and implement strategies appropriate to those they work with. At Walsall Academy, the tool we are using is the Wellbeing Survey which can be accessed via the 5 Steps framework. Why is it important to address mental health needs? Anyone who works in schools today will be aware of the increasing concern around children’s mental health, and the priority placed on meeting these needs by the UK Government. This can be seen in the Department for Education’s September 2020 update of Keeping children safe in education. Research has indicated that around 10% of 5-15 year olds have a mental health disorder [1]. It is well established that the mental health of children is going to impact on their cognitive development and learning [2], with many children also missing out on education as a result of their mental health difficulties [3]. When you also take into consideration the impact of the coronavirus pandemic, the importance of establishing proactive mental health support in schools becomes paramount. We are currently seeing many children return to school having missed out on education and social interaction outside their family home, as well as coping with anxiety and grief as a result of the virus. How have we assessed and met the mental health needs of our pupils? At Walsall Academy, before becoming involved in the Wellbeing Survey, identification of mental health needs relied on staff referring children to the school’s Safeguarding Team. This was usually prompted following concerns being raised by staff. In 2016, we were offered the opportunity to engage with the team at the Anna Freud Centre and the University of Manchester through establishing the Wellbeing Survey in our school. This initiative has provided us with a standardised way of measuring the mental health and emotional needs of our pupils. It has achieved this through a process which was developed and supported by external teams with experience in establishing survey processes within education settings. Through implementing the survey, we found that we were able to become more proactive in identifying and meeting the needs of whole cohorts - rather than responding reactively to individual referrals. As a result, for many pupils, their needs did not escalate to the point at which they required an external referral. Instead, through early intervention, their needs were met via a single agency response. To implement wellbeing interventions, we needed to be able to analyse the data. After carrying out the survey, we were sent a detailed report of pupil needs for each year group involved. From this, a whole school response was planned. We took forward a number of activities, for example promoting positive wellbeing events such as Mental Health Awareness week and teaching pupils about what factors in their lives can impact on wellbeing. For some pupils, an individual response was required. We offer counselling sessions, both one-to-one and for groups as appropriate. Pupils can access weekly drop-in services, where they learn about relaxation techniques and access a peer support group called Spectrum. Staff support is a high priority and several staff have completed Mental Health First Aid Training. All staff are being trained in attachment and trauma, including support staff (e.g. lunchtime supervisors). Learning Mentors are also available for those pupils requiring a high level of flexible support throughout the school day. A pupil with the highest level of need will also have a mental health plan, which has been developed with them and their parents or carers, and which is shared with their teaching staff. These plans are regularly evaluated and adapted, as needed. What can other schools do to start the process? For an organisation or individual aiming to implement interventions to improve mental health and wellbeing, there are a number of steps that should be considered. These are set out by the 5 Steps framework, and we have found that key ingredients include:

• The school having clear leadership and organisational direction with regards to mental health. For example, do all stakeholders understand and agree with what is being proposed? Do the new proposals align with current school policies, or are there areas where there is potential for conflict? Is there a key person who can drive the changes forward? Staff training is key in establishing this organisational direction and enabling the new mechanisms to work.

• With organisational direction established, methods of promoting wellbeing can be considered. Each setting will approach this differently depending on their population. We looked at how to promote positive wellbeing through whole-school teaching opportunities, including assemblies and specific classroom teaching. As pupils’ awareness of wellbeing increased, they expressed a desire to support others - and so peer support groups were established. This has provided pupils with additional support, beyond the usual adult-led interventions.

• Key to the successful implementation of our approach is establishing support for staff. A Mental Health Lead was appointed and became an advocate for staff too, with responsibility for promoting staff wellbeing and mental health across the school. This led to additional interventions, informed by the needs of our own staff team.

In conclusion, we are now well placed to respond to the mental health needs of our school population. As with any strategy, pupils’ needs will change. This year, with the global pandemic and closure of schools to most pupils, it has become increasingly vital that we continue to evaluate and adapt our response. The Wellbeing Survey provides us with a planned, systematic way of responding to such changes. Through collecting data, we gain valuable insight into the needs of our very own population, allowing us to give targeted support to all those who require it. References:

1. Meltzer, H., Gatward, R., Goodman, R. & Ford, T. (2003), The mental health of children and adolescents in Great Britain: https://www.dawba.info/abstracts/B-CAMHS99_original_survey_report.pdf Office for National Statistics.

2. Anna Freud Centre (2020), Prepare for change: https://www.annafreud.org/schools-and-colleges/5-steps-to-mental-health-and-wellbeing/leading-change/prepare-for-change/

3. Time to Change (2014), Students missing out on education because of mental illness.