Why SEMH support is schools’ biggest challenge

It is well established that the provision of education for pupils with special educational needs and disabilities (SEND) is a system in crisis.

But there are mounting signs that, within this crisis, the challenge of supporting pupils with social, emotional and mental health (SEMH) needs is the area that schools are particularly struggling with.

An analysis of how well the school system is serving students with SEND reveals that those with SEMH needs are faring the worst of all.

In an overwhelming 81 per cent of cases, the most effective support was not in place for pupils with SEMH needs, a report from a Department for Education programme concludes.

And this week data from a Teacher Tapp poll shows that effectively supporting pupils with SEMH needs is seen by primary teachers as one of their schools’ biggest problems. This issue was cited by 61 per cent of teachers surveyed - a figure that was up by six percentage points compared with 2023. SEMH needs were behind only funding in teachers’ list of concerns.

This followed a Tes-commissioned survey revealing that only one in 10 primary teachers believed their training prepared them to effectively support pupils with SEMH needs.

Why is this such a challenging area for schools? And what can schools do to help this growing cohort of pupils despite the constraints of squeezed budgets?

Big rise in pupils with SEMH needs

The number of pupils who are defined as having SEMH needs is rising.

The number with education, health and care plans (EHCPs) where SEMH is the main area of need has risen by 77.8 per cent in the past six years, official DfE data shows. SEMH is one of the fastest growing areas of need.

As Tes reported earlier this week, it is thought that the pandemic is partly to blame for this increase because children missed out on socialising opportunities during lockdowns, with many also witnessing stress and emotional issues within their families.

These problems were likely exacerbated by long waits for child and adolescent mental health services (Camhs), money for SEND being diverted to finance local authority deficits and a post-pandemic focus on academic catch-up over wellbeing, experts say.

Headteachers and trust leaders warn that schools are constrained by a lack of funding in meeting the needs of these pupils, and by problems that extend beyond the school gates, including lengthy waits for social care and Camhs.

Experts in the sector, speaking to Tes, have questioned how useful the SEMH description of need is, and warned that it risks schools being asked to step into areas that should be covered by health services.

• Pupil wellbeing: Why we must address emotional wellbeing at primary level
• Pandemic legacy: Covid hit socioemotional skills in ‘half of pupils’
• Teachers’ concerns: Behaviour overtakes workload as a top concern for primary teachers

The damning statistic suggesting that more than four in five children and young people with SEMH needs could have their needs better met comes in a report published by the Delivering Better Value in SEND Programme towards the end of last year.

As part of that programme, an analysis was carried out on more than 1,600 children and young people with EHCPs to see if their needs could be met in a more effective way.

It found that this was the case for 81 per cent of children and young people with SEMH needs - a figure that was higher than for any other area of SEND. The second highest figure was for those with moderate learning difficulties (63 per cent).

While funding pressures are a challenge right across the SEND system, these are keenly felt by pupils with SEMH needs because responses may have to be highly tailored for the individual, school leaders say.

“For mainstream schools, SEMH is the hardest of the broad-area needs to be able to come up with effective strategies that work for multiple children, because the very nature of SEMH means it is very individualised,” says Becky Arnold, headteacher of Framingham Earl High School in Norfolk.

“There are certain things we can do that we know that for the majority of children with autism will be effective…whether it’s ear defenders or calm corridors, or thinking about the displays in rooms or how we set up the tables, or the explicit instructions we give,” she says. Whereas for SEMH needs, “it is far more nuanced, and the children tend to need very different things”.

In her school, around one in five pupils have SEND, and for more than half of the pupils with EHCPs this includes SEMH needs.

She feels that students would benefit from bespoke support involving a hybrid model, with both alternative provision and time in school spent in small group settings - but the barrier to this is the huge expense involved.

“We have created a situation where someone is identified as having a mental health need and this is classed as an educational need”

This is echoed by a senior leader in a multi-academy trust that runs 33 academies, including schools with an SEMH specialism. The biggest challenge for both mainstream and specialist schools in meeting pupils’ SEMH needs is funding, says Dave Whitaker, chief education officer of Wellspring Academy Trust.

The government has indicated that, as part of its reform of the SEND system, it will expect more pupils to have their needs met in mainstream schools. But to achieve this, Whitaker says, “There has to be a major injection of funding to improve the capacity of the system to stop us haemorrhaging money out at the other end through expensive private school placements.”

Effectively supporting pupils with SEMH needs also comes down to the skill of the workforce, he says. “I sense there is a huge desire among school leaders to be more inclusive towards pupils displaying challenging behaviour, including those with SEMH, but sometimes they are struggling to know how to deliver it. This is not a moral or ethical question about providing support, it is a question of the practical application of how to better support pupils and then how can it be funded.”

The NEU teaching union wants the government to ensure that funding is provided for an increase in pastoral teams, SEND teams and trained support staff to help teachers to support pupils with SEMH needs.

Daniel Kebede, the union’s general secretary, tells Tes that supporting pupils with SEMH needs is an area of serious concern. “Much of this is due to the consequences of unmet SEND provision and long wait times for Camhs and other specialist support services,” he says.

Schools overlapping with health services

The SEMH label was introduced in the 2014 SEND reforms. But when it was designated an area of need, it was not set out “how this overlaps and interacts with mental health diagnoses in a health context”, according to Claire Dorer, CEO of the National Association of Special Schools.

“We have created a situation where someone is identified as having a mental health need and this is classed as an educational need, rather than a health need,” Dorer adds. “Schools struggle to access health support and this is leading to special schools effectively developing their own in-house mental health teams.”

It is “conceptually problematic” for support for the mental health of a child with SEMH needs to be delivered only within an educational context and not a health context, she says. Schools can deliver interventions and support that may mitigate against mental health problems, “but you would expect mental health professionals to deliver treatment interventions”.

Dorer believes the government should set out what a school’s responsibility is and what the healthcare responsibility is for pupils with SEMH needs.

Setting out the “ordinarily available provision” - what you would expect most schools to be able to offer to children with different identified needs - “could be a good place to tease out what mental health means in education versus health”, she adds.

There is also a question of whether the SEMH label is defining students by their actions rather than their needs.

Jarlath O’Brien, director of school improvement at Solent Academies Trust, which runs five special schools on the south coast, tells Tes he does not think the SEMH label is particularly helpful.

“The link between social, emotional and mental health needs and communication difficulties is established and it is bidirectional. A child with speech and language difficulties can go on to develop challenging behaviour and can then be seen as displaying SEMH needs,” he says.

Challenging behaviour

And some mainstream schools’ efforts to deal with challenging behaviour consistently could be making the situation worse for these pupils, O’Brien suggests.

“One thing which I think mainstream schools can really struggle with is the idea that you could treat two children differently for doing the same thing. As adults, we can think that this is inequitable, but actually in my experience children are pretty good at understanding why some children might need to be treated differently.”

Open many behaviour books and the opening sentence will highlight that consistency is key. On the face if it, this feels fair - but O’Brien urges caution. “I think what is most important is not consistency of action but always taking action that is consistent with the values of the school. If a school is committed to being inclusive then taking the same action irrespective of the context doesn’t make any sense,” he says.

Approaches often vary by phase, O’Brien explains, with professionals “more curious” about why younger children are displaying challenging behaviour than about “what is causing a 15-year-old who is the size of an adult to refuse to work or to be abusive to a teacher”.

Moving from mainstream into the SEND sector has “been a humbling experience” for Dr Nigel Matthias, head of King’s Academy Lord Wilson school, which educates boys with SEMH needs in Southampton. “I recognise that some of the strategies that I have previously relied upon at system level may have risked punishing pupils for behaviours they may struggle to control,” he says.

This is echoed by Robert Bell, headteacher of Consilium Evolve, an alternative provision academy in Sunderland working with students who have dropped below 50 per cent attendance.

Describing the challenges faced by students with SEMH needs, he says: “Learning is an emotional risk and, as adults, we have learned to be able to manage that…everything we do, getting out of bed in the mornings, driving the car, going to work, is managed by emotion.

“If [students] can’t regulate that emotion, don’t know how to how to express it, it becomes potentially challenging behaviour.”

Bell describes the approach taken by his school as being driven by curiosity about what is leading to pupils’ behaviour.

Teacher curiosity is key

“I always say to our teachers, ‘You can’t be curious and angry in the same space. So let’s be curious about what is happening,’” he says.

There is also a need to understand a child’s readiness for learning and the impact that their processing systems and the early years of their life have had on what they are doing now, says Bell.

His school has considered how the release of dopamine in the brain can support a student to learn. “We plan our lessons around emotion because we know that emotion drives everything that we do.”

Dr Matthias highlights the importance of using social stories in supporting pupils with SEMH needs. A social story is essentially a short, personalised narrative - usually with visual aids - that breaks down specific social scenarios, concepts or skills into manageable steps.

For many pupils with SEMH needs, the predictability offered by social stories “can significantly reduce the anxiety associated with unfamiliar or overwhelming situations”, Dr Matthias explains.

But his experience in mainstream settings was that “colleagues did not always have the experience or training to provide this type of strategy for regulating anger or anxiety”.

Overcoming ‘shame avoidance’

Another challenge can be pupils’ past experiences of school.

Those with SEMH needs normally will have experienced what they interpreted as rejection “from adults they had trusted and once felt safe with” during their education, O’Brien says.

This can lead students to decide that it is safer to remain distant, to refuse to engage or to “decide to end things at a time of their own choosing” through their behaviour.

“I used to regard this sort of behaviour as work avoidance. I then came to think of it as failure avoidance, but I now realise that what is happening is shame avoidance,” O’Brien says.

How can schools overcome this? They need to be able show pupils that “we are reliable and safe by being there every day, adopting an attitude of unconditional positive regard”, he explains.

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