Written Statement - Providing for the Emotional and Mental Health Needs of Young People in Schools

Prosperity for all: the national strategy identifies mental health as a priority area.  This builds on Together for Mental Health (2012) where we recognised that by identifying and addressing issues early we can prevent more serious problems occurring later in life.  

School settings are key to promoting good health and in May 2017 we published a School Nursing Framework for Wales which sets out the Welsh Government’s framework for a school nursing service for children and young people that is safe, accessible and of a high standard.  The Framework aims to proactively build on the current school nursing service and extend good practice to all school age children and young people.  In particular, the all Wales Standards for NHS School Nurses for the Promotion of Emotional Well-being and Supporting the Mental Health Needs of School Age Children, sets standards for NHS School Nurses to ensure they are competent in supporting the emotional well-being and mental health of children and young people attending educational establishments.

Most children between the age of three and 18 attend school for up to 30 hours a week.  This makes schools key locations for promoting positive mental health and well-being and providing evidence based prevention and early intervention.  There is a need for teachers to have help and support in responding to children experiencing difficulties such as anxiety, low mood, and compulsive, self-harm or conduct disorders, whilst the NHS has a role in training and consultation across sectors; and providing early help in schools by suitably trained staff.  School-based services can improve accessibility; better address school related stress; ease pressures on specialist Child and Adolescent Mental Health Services (CAMHS) by reducing inappropriate referrals; and facilitate a wider culture which promotes and values positive mental health and well-being within schools.  These issues are directly linked to the goals in the Wellbeing of Future Generations Act 2015, namely a healthier Wales and the Government’s well-being objectives to deliver quality health care services fit for the future and to promote good health and well-being for everyone.  

Recognising this important issue, we  have agreed to make £1.4m new Welsh Government  funding available, to strengthen the support from specialist mental health services to schools and build relationships which extend from the classroom to those specialist services.    

Initially operating as a pilot programme to test several models of intervention, the intention is that activity will commence by the end of 2017 and cover two full academic years, concluding in the summer of 2020, and the results of the pilot will be evaluated.  

Three pilots will operate covering secondary schools, middle schools and feeder primary schools in the north east (Wrexham and Denbighshire), south east (Blaenau Gwent, Torfaen and south Powys) and west Wales (Ceredigion).  The choice of pilot areas encompasses the diverse social demographic and geographical distinctions within Wales.  By including pupils in year 6 of primary, as they work towards transition to secondary school, we can evaluate the outcomes of providing emotional and mental health support amongst this younger age group.  

Specialist CAMHS practitioners will be recruited to act as link workers with the pilot schools, working in a multidisciplinary model to reduce emotional distress and prevent mental illness by offering early support, and appropriate referrals and interventions when needed.  The model will enable:
 

• support for teachers to better understand childhood distress, emotional and mental health problems, and reduce stress in teachers concerned about their pupils by up-skilling teachers to recognise and deal with low level problems within their competence;
• ensuring that when issues are identified that are outside teachers’ competence and skills then liaison and advice is available to enable the young person to be directed to more appropriate services, such as specialist CAMHS or Local Primary Mental Health Support Services, enabling the school to meet the ongoing educational needs of the young person; and 
• ensuring systems are in place to share appropriate information between CAMHS and schools, shared care arrangements are agreed between CAMHS and schools for those young people requiring more intensive support, and that arrangements are in place to escalate/de-escalate as the young person’s needs dictate.

Funding includes provision to evaluate the pilots, and the evaluation will take into account a broad range of measures from the teachers and pupils’ perspectives. This work will link with wider activities aimed at improving the emotional wellbeing of children and young people, such as the Adverse Childhood Experiences (ACE) Support Hub, one of the aims of which is to ensure that professionals are ACE informed.  Also activity around development of the new curriculum, which includes the Health and Well-being Area of Learning and Experience.  This will ensure an integrated approach to ensure the best possible outcomes for children and young people in line with the Well-being of Future Generations (Wales) Act 2015.

We will ensure you are kept informed of this important initiative as activity progresses.