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Prepared for life? How schools can support children and young people’s mental health

Andy Bell, Centre for Mental Health, January 2020

Our experiences of school often play a bigger part in shaping our mental health than anything except perhaps our families and closest relationships as we grow up. In recent years, this has begun to be acknowledged more widely than ever. But how schools can maximise opportunities to promote good mental health and minimise the risks of mental health difficulties is as yet less well understood.

Schools can help children and young people to flourish and to enjoy a healthy start in life. But equally they can cause trauma, heighten distress and erode wellbeing. It is no longer enough to debate whether schools influence children and young people’s mental health, rather we need to ask how to ensure they are able to do more good than harm.

A child’s mental health will affect every aspect of their life, and not just during their school years. Evidence shows that adults who had mental health difficulties as children, particularly those who had behavioural problems, face a higher risk of every adult mental illness and lower earnings well into middle age. So the benefits of promoting good mental health during school years will be profound and long-lasting.

Research with young people and school staff has shown that schools can influence mental health in many ways, some of which can be managed by individual schools while others can only be determined by national policies. Key areas of both concern and opportunity include the school curriculum, where an ever-growing focus on academic attainment and a ‘teach to test’ culture have overshadowed creative and cultural education, life skills and opportunities for physical exercise and play. While there has been a welcome change in national policy to incorporate mental health into compulsory PSHE, it’s important to look at the whole curriculum and consider the psychological impact of the current assessment system.

The management of behaviour in schools is also crucial for mental health. Children with mental health problems face a higher risk of exclusion, often following extended periods of behavioural difficulty. School exclusion, in turn, is a risk factor for later mental health difficulties as well as poorer outcomes across the board. The use of restrictive interventions in schools, including seclusion and restraint, has also been identified as potentially harmful to mental health: such interventions may result from behaviour born of traumatic experiences, and may in themselves make that trauma worse. Helping schools to become trauma-informed may bring significant benefits, not just by focusing on individual children’s behaviour but by creating a safer and healthier environment for all.

Mental health among children and young people is highly unequal. Children from low income families are far more at risk of poor mental health than better off children. Looked After Children, children and young people with learning disabilities and LGBT+ young people are all much more likely to have mental health difficulties. While these stark inequalities are not attributable to schools alone, children’s experiences of bullying and isolation are significant risks, as is the ‘hidden curriculum’ of streaming, school trips, sports and assemblies, as well as in social segregation between schools. And the experiences of young Black men of the school system is a reminder of the ways in which education can either perpetuate or challenge deeply ingrained inequalities and injustices.

National policy makers have now recognised the importance of improving and extending mental health support in schools. The next few years should see significant investment in psychological support in schools and closer links with the NHS. We now need to ensure that this comes with a wider effort to give every child and young person a mentally healthy education that prepares them for life. School nurses will have a pivotal role to play in making this happen, in the schools they work in and in coming together nationally with the Children and Young People’s Mental Health Coalition to make the case for change in policy and practice.

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