Role of education in mental health

The Houses of Parliament Health Committee is beginning an inquiry into the role of education in promoting well-being, and preventing the development of mental health problems.

This is an issue that is close to the hearts of staff, governors, and indeed the pupils themselves at schools across the RSA Family of Academies, and also an area where we have some considerable expertise.  We have therefore submitted a response to the inquiry, re-produced below, and have also offered to give oral evidence to the inquiry if they would like to hear more about our work in this area.

“I am Chief Executive of RSA Academies, a charity and Academy sponsor that currently works with a Family of seven schools teaching 4500 children aged 3-19 across the West Midlands, all of which work in communities of deprivation.

Over the last eighteen months the issue of children’s mental health and well-being has become an increasing cause for concern amongst our teachers, head teachers and governors.  They see the number of children with poor mental health increasing, whilst many of the non-statutory services that once supported more vulnerable children and their families are disappearing, and the statutory services for young people with the highest needs are stretched to the point that children with very high levels of need are turned away, and even those whose referrals are accepted may face a lengthy wait to see the appropriate professional.

There can be no question that large numbers of children and young people are experiencing sub-optimal mental health and well-being, and the number of these children in our classrooms today.  The 2014 enquiry into Children and Adolescent Mental Health Services (CAMHS) drew together the following useful statistics:

  • One in ten children aged between 5 and 16 years has a mental disorder.
  • About half of these (5.8%) have a conduct disorder, 3.7% an emotional disorder (anxiety, depression), 1-2% have severe Attention Deficit Hyperactivity Disorder (ADHD) and 1% have neurodevelopmental disorders.
  • The rates of disorder rise steeply in middle to late adolescence and the profile of disorder changes with increasing presentation of the types of mental illness seen in adults.

The Health Committee  also received evidence suggesting that around 30% of English adolescents reported a level of emotional wellbeing considered as (sub-clinical) “low grade” poor mental health, that is they regularly (at least once a week) feel low, sad or down. The levels were higher among girls than boys, and children and young people in the poorest households three times more likely to have mental health problems than those growing up in better-off homes.

The implication of these statistics is that in every school, indeed, in every class, there will be at least one child with some sort of mental disorder, and in many schools there will be a handful of these children in each class.  It means that in our secondary schools a significant minority of the pupils in each class will be grappling with ‘low grade’ poor mental health – feeling sad, low or down.

Given these figures, it seems to be unarguable that education – schools – can and must have an important role in promoting emotional well-being and preventing the development of mental health system.  Some schools, including those in the RSA Family of Academies, already take extensive steps to support good mental health. For example:

  • Whitley Academy’s outstanding inclusion provision includes an additional facility, ‘The BASE’, which uses preventative measures and early interventions to promote good mental health, emotional well-being and a positive attitude to learning so that students achieve their full potential. The work of the multi-agency team has been highlighted in the national media.
  • As well as strong Student Support and Learning Support teams at Arrow Vale Academy, the PASS survey has also been effectively used to target pupils with low self-esteem and negative attitudes towards school. Data from the survey inform key interventions including a range of mentoring programmes which build self-esteem and confidence.
  • RSA Academy Tipton was rated ‘outstanding’ in care, guidance and support in their last Ofsted inspection. Its comprehensive SEN provision supports young people most prone to mental health issues, and it also has a strong reputation for pupil leadership initiatives.
  • Abbeywood First School has used pupil premium funding in a number of ways to support the well-being of these youngest children including by employing a play therapist to work with children who require emotional support and a psychological play therapist to work with children and their families to improve personal development and welfare, and have also trained staff to provide THRIVE for identified children to support personal development, behaviour, and welfare.

So why aren’t all schools doing this sort of work, and what are the challenges that schools face in maintaining and developing these services?  Funding, as already mentioned, is a key barrier.  Almost all schools are facing real terms cuts to their budgets, in many cases having to secure savings of the order of tens of thousands of pounds.  In such circumstances they will be forced to review anything they offer that is not considered essential or core to their business.

And this brings me on to a broader important point, which is that the current school accountability framework is driven almost entirely by league tables derived from pupil performance in SATs and GCSEs.  In judging whether a school is ‘good’ or ‘outstanding’ in Ofsted terms exam results are everything, and a child’s well-being counts for nothing.

I am not, however, recommending some further extension of Ofsted’s remit to also carry out a check on mental health.  Ofsted visits are already over-stretched, and it is highly unlikely that they could do this in anything other than a superficial, tick-box way.

Rather, I would ask that the Health Committee recommend a review of all current and proposed education policies from the perspective of their impact on promoting emotional well-being and preventing the development of mental health problems.  Alongside this, given the much publicised challenges around teacher retention, they might also look at the impact on policies on the mental health of adults working in schools.

My hypothesis is that such a review would be very likely to conclude that a number of policies are contributing to, rather than mitigating, the apparently growing levels of mental health difficulties amongst our children.

The high stakes accountability system has increased the pressure on schools to maximise the measured achievements of the children in their care, with ever younger pupils starting to feel the pressure to do well.  Examples affecting primary schools include:

  • The introduction of phonics screening at the end of Year 1. Anecdotal evidence suggests that many schools have responded to this by moving away from play-based learning to an increasingly formal curriculum in in Reception and Year One to ensure that as many pupils as possible ‘pass’ the test.  Whilst many children will cope well with this curriculum, those who start school behind their peers e.g. some boys, summer born children, and those from lower income families are likely to struggle with this more formal learning environment, with their frustration potentially leading to behavioural and other difficulties.  International comparisons suggest there is no benefit to starting formal learning at such a young age, whilst the rising incidence of conduct disorders and ADHD indicate that for a small minority at least the change could be damaging to the child’s mental health and well-being.
  • The ‘raising of the bar’ for SATs results, and the greater pressure on schools, including the threat of ‘forced academisation’, which sees increasing numbers of primary school to narrow their Year 6 curriculum so that it is almost entirely focused on SATs preparation. The raised pass mark also means that in 2016 almost half of all 11 year olds will have been labelled as ‘failing’ to meet the expected level in all subjects: a potentially damaging knock to a child’s self-esteem as they enter adolescence.

A number of proposed education policies look likely to make things worse rather than better in future. For example:

  • If the proposals to increase grammar schools go ahead 75% to 80% of the pupils in these new grammar school areas will have been labelled a failure by the age of 12
  • The plan (currently on hold) to make pupils who fail their SATs in year 6 re-sit these test during their first year at secondary school would be potentially even more damaging. We know that the transition from primary to secondary school can be a difficult time for many young people, socially, emotionally and academically.  Adding to this pressure by asking around half the nation’s children to re-take a test that they have sat and been seen to fail during their final year of primary school seems unlikely to boost their confidence or well-being.
  • As they move up the school the emphasis on studying e-bacc subjects, taken together with the funding pressures, is highly likely to lead to schools offering a reduced range of options at key stage 4, with non e-bacc subjects including creative and vocational options likely to be most at risk. As with the move to more formal learning in Reception and Year One the move to a more academic curriculum will be entirely appropriate for many if not most pupils.  But for a sizeable minority it is the non-core subjects – art or drama, PE or dance, or vocational options – that young people are most interested in, because they have talent in these areas or can see how they relate to the world of work.  Without opportunities to study these subjects, and being aware that they are unlikely to ‘pass’ the core academic subjects, it will be an uphill struggle to maintain positive self esteem and motivation among a sizeable minority of young people.

In conclusion, whilst specific interventions designed to support children’s mental health and well-being can and should be delivered in schools (funding permitting), the most important role of education in preventing the development of mental health problems in children and young people might be, as with the Hippocratic Oath, to ensure that education policies “do no harm”.

Alison Critchley
January 2017