Rory* attended mainstream school until the age of 14 when he was permanently excluded owing to violent behaviour and threatening arson. At age 15, he was diagnosed with severe emerging borderline personality disorder, characterised by extreme emotional instability and frequent self-harming behaviour. He was admitted to a secure unit.

His engagement in education before he was admitted was described as “minimal”. His prospects for education after his diagnosis were bleak: the system struggles to provide an educational service to children with severe needs, with an oft-talked of cliff-edge of support at 16 (the age many special schools teach up to) and then again at 18.

But Rory trod a different path. He entered a unit where the model of education is geared towards people in his situation and it is one that could provide mainstream colleges with a blueprint for engaging some of the most hard-to-reach students who can come under their care.

The place Rory was admitted to when he turned 16 was The Wells Unit in West London, which is part of the national secure forensic mental health service. It treats young people between the ages of 12 and 18, and is one of only six units in England that cater for children who have severe or complex mental illness, some of whom have committed criminal offences.

The 10-bed, in-patient secure facility provides specialised treatment for these young people, most of whom have psychosis, quite often drug-induced. Many are initially considered to be an extreme danger to themselves or to others. Those who are in need of an extended programme of treatment stay in a unit for up to three years, with weekly multi-disciplinary, multi-agency meetings and a full care planning review every two to three months.

With such extreme needs, you may think education would take a back seat: but you would be wrong. The young people are provided with post-16 education. Social justice charity Nacro is responsible for education in The Wells Unit.

Trust and relationships

While recovery and rehabilitation are the key focuses, with therapy taking place once or twice a week, education is actually how these young people spend most of their time. Classes are likely to be scheduled for 15, 20, even 30 hours a week, depending on individual circumstances. However, these classes can be highly specialised.

Whether or not the young person continues with formal, qualification-based study depends on what is considered most useful for their recovery. For some, that will mean a continuation of a formal academic path. For other young people, alternative programmes of education are provided.

That flexible and bespoke approach is one of the key reasons why the young people engage with the education programme, explains Mark Welsh, Nacro’s assistant principal for education and training in secure settings. Another key factor in engagement is the time put in to build positive relationships.

Welsh says that the nature of some of the young people’s illnesses makes building trusting relationships a complex process; in extreme cases, when students’ behaviours provide a risk both to themselves and to others, safety is paramount.

“We had one young person who hadn’t attended school in the past six years and our education staff would only be able to see him with spit goggles on and various other protection, because of his urge to attack anyone that he saw,” he recalls.

In these circumstances, some would expect that this young person would never be able to engage in education, but such low expectations are part of the problem. With that person, the staff gradually developed a relationship with him, Welsh explains, with sessions building up from individual five- to 10-minute blocks to attending 2:1 classes outside of the residential area.

You need high expectations, Welsh reiterates. “We make sure that what we’re doing has an impact, that we are tracking and monitoring progress. That’s not necessarily always academic progress in terms of GCSE grades - for some that could be softer skills like motivation or communication with others.”

A good example of how far a young person can progress is Maz*. She was admitted to a secure forensic adolescent mental health unit following a two-year period of progressively deteriorating behaviour. She’d previously been a conscientious student - attending mainstream school and gaining 14 GCSEs at A* to B - but got caught up in substance abuse, culminating in a drug-induced psychosis and criminal activity.

When she got to the unit, she was exhibiting paranoia and grandiosity, and was lacking in self-care and hope for the future. She was suspicious of staff and peers, who kept their distance from her owing to her intimidating, aggressive manner.

But within eight weeks she was attending education sessions and engaging more proactively with staff and peers. She also undertook intensive psychological therapy and drug rehabilitation, as well as family therapy to rebuild relationships, enabling her to take leave locally and to the family home.

The stigma of mental illness, coupled with Maz’s drug use and a criminal history, meant that finding a college willing to take her was tough because of safeguarding concerns. But with extensive pastoral support from her tutor at the unit, she went on to continue her A-level studies at a local grammar school, with a view to going to university.

Researchers Claire Dimond and Denise Chiweda published a study on the model used at The Wells Unit, which found that “treatment is focused on the importance of relationships: the relationships the young people have with their families, peers and community professionals, and with the staff and young people on the unit as well as the relationships the staff have with each other”.

The use of trauma-informed practice is also powerful, says Clare Kirk, head of learner services and safeguarding at Nacro. “It sounds like common sense; you would hope that everybody would take into consideration what somebody has been through,” she says. “But it’s about being in touch with that, sensitive to that and working in a way that supports that young person.”

Trauma can take a huge number of forms, such as threat to life, severe physical harm, receipt of intentional harm, exposure to violence, the loss of a loved one, learning of violence to a loved one, or causing death or severe harm to another.

A trauma-informed approach promotes safety, trustworthiness, peer support, collaboration and empowerment, and recognises cultural, historical and gender issues. Kirk gives the example of a young person arriving late to a lesson. “A teacher might automatically want to address that lateness head-on and perhaps ask the student to leave,” she says. “For us, it’s about looking at the trauma that young person may be experiencing. It’s not about letting young people get away with challenging behaviour but seeing it in terms of what they are going through and how it’s then addressed.”

How transferable are these approaches to colleges with thousands of students? Certainly, some of these techniques can be used in some form through learning support and via CPD for lecturers. However, a big barrier to this, says Welsh, is staff perception of mental illness. He describes one college where he says staff were excessively concerned: “They kept ringing on a weekly basis, saying, ‘We’re not sure if he can keep his placement - he seems just to be wandering around in his spare time and doesn’t know what to do with himself.’

“Of course he didn’t know; he’d been in the unit for two years,” says Welsh. “That’s not anything to do with his mental health, that’s not knowing what to do with the time.”

Welsh is certain that colleges can provide education for pupils with more extreme challenges: these providers just need a change of attitude, the right training and the right preparation. When the right risk assessments are in place, with the right levels of support, he believes there is no reason why that young person is going to be any different from any other student.

And he stresses that, for some young people, their time in a secure forensic mental health unit may be their first experience of education without harmful distractions, negative influences or damaging peer pressure. This can make their engagement with learning a new and surprising form of liberation. And when colleges see that transformation for the first time, the hard work will be rewarded.

“Certainly when some of the children take to it, education here can be exactly that,” Welsh says. “We say to them, ‘No one would wish this on you, but you’re here now, so take this opportunity with all this support around you, and all these people who want you to do well.’ And, on the whole, they do take the opportunity. It can be a really positive environment.”

Sarah Simons works in colleges and adult community education in the East Midlands and is the director of UKFEchat

*Names have been changed

This article originally appeared in the 13 SEPTEMBER 2019 issue under the headline “One boy hadn’t attended school for the past 6 years”