There is arguably no more sensitive and important a topic than the mental health of the children in our care. Every teacher and leader wants to make a positive difference - especially for those pupils who can be our most vulnerable.
As the new government and education ministers promise change, we are left with the question: should those policies include schools doing more for pupils with mental health challenges?
The scale of the challenge of increasing mental health issues among children is daunting. The percentage of children reporting low happiness with their health has increased in recent years, with rates of likely mental disorders and eating problems still at elevated levels compared with pre-Covid. For older teens (between 17 and 19), probable mental health issues have increased from one in six in 2021 to one in four in 2022.
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With the reduced capacity of mental health services to support children and families, and schools, the issue is acute in many areas. Understandably, school leaders have looked to plug the gap and support in any way they can.
But what does the evidence suggest on supporting mental health in schools?
Mindfulness has been suggested as a well-evidenced area that could be scalable in schools to support adolescent mental health. However, a landmark study conducted by Oxford University - entitled My Resilience in Adolescence (or Myriad), was trialled with about 28,000 pupils and the results were largely disappointing.
The training provided (on paying attention to the present moment, breathing and other mindfulness strategies) did not improve mental health. In fact, those pupils with the highest risk of mental health problems did discernibly worse after receiving the training.
Cognitive behavioural therapy is another evidence-based approach undertaken by mental health experts. A trial in Australian schools tested a universal approach but it once more showed no benefit to pupils, despite a great deal of enthusiasm from schools engaged in the approach.
Mental health: a matter for the experts?
This problem gets to the heart of the paradox of supporting mental health in schools. They should be wary of trying to do more. It is a hugely complex area and leaving it to the experts, even if that means a delay, may sometimes be the best solution.
There is, of course, some evidence that mental health support in schools can have positive benefits, but it appears that universal approaches - the types of approaches that schools can manage - are problematic.
One issue is what experts Dr Lucy Foulkes and Jack Andrews describe as the “prevalence inflation hypothesis”. Put simply, this describes how greater awareness of mental health issues is leading to more accurate reporting of issues among teens. This is good. But it may also lead to some over-interpretation of milder forms of distress, worry and similar being misinterpreted as mental health problems. This is bad.
The issue is acutely relevant for school leaders making plans to address mental health for all pupils. It may be that highlighting the issues proves vital for some, but it may trigger issues for others. Though the urge for a teacher or leader will be to act, we need to recognise that the complexity of the problem is such that we need to leave it to expert mental health practitioners.
For national policymakers, the best evidence would indicate that the attention needs to be on renewing and making Child and Adolescent Mental Health Services fit for purpose. Schools may need to do less and mental health services do more.
It may go against the instincts of school leaders and teachers, but making fewer attempts to solve the problem with universal mental health approaches may be better. Schools can still do brilliant work developing wellbeing and securing academic success for their pupils, but they should be wary of attempting to do more to solve mental health issues.
Alex Quigley is the author of Why Learning Fails (And What To Do About It)
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