On hearing the news of the death of the great Archbishop Desmond Tutu late last year, I was reminded of one of his most insightful quotes: “There comes a point where we need to stop just pulling people out of the river. We need to go upstream and find out why they’re falling in.”
It’s a sentiment that I’ve thought about a lot when it comes to children’s mental health and how we get ahead of the issue to provide tools, knowledge and skills to understand pupils’ experiences before they reach crisis point.
After all, everyone in education is keenly aware that child and adolescent mental health services (Camhs) are increasingly overwhelmed and that more young people than ever are suffering with mental health issues.
We cannot just keep pulling people out of the river – we need a different tactic.
Mental health: early interventions to support pupils
In my role as strategic lead for The Carnegie Centre of Excellence for Mental Health in Schools at Leeds Beckett University, this is exactly what we are looking at, researching schools that are taking evidence-based approaches to educate children around mental health and wellbeing.
And it is clear that there is a growing number of senior school leaders keen to implement evidence-based early intervention strategies that can move away from reactive action to focus on promoting wellbeing as an integral part of the education process.
This was very much the pathway forged at St Nicholas Church of England Primary School in Blackpool, where I was headteacher in 2013 at a time when the school “required improvement”.
One scheme we introduced, which was designed to boost pupils’ wellbeing, has not only delivered great results, it has also been economical and relatively simple to embed into typical lessons.
It works like this: every child is given a set of three cups to take with them to each lesson – one red, one amber and one green. The children are asked to use the cups to indicate how well they feel they understand the topics being covered during the lesson.
So, if a child is struggling, they move the red cup forward. Amber means they are mainly clear on the topic but might have some questions, and green means they understand and want to move on.
We found that pupils quickly got used to self-assessing their understanding of new subjects.
The cups helped teachers to quickly identify who needed help, but, critically, children had some say in how they were assessed and grew in confidence because they had a stake in their own education.
Student resilience and self-esteem grew and the school helped learners to understand that when they made mistakes, it wasn’t the end of the world but a key part of the learning process. This meant they made progress, which ultimately boosted their wellbeing further.
Of course, early intervention strategies lesson-by-lesson is one thing but there are more structural things that we could be doing, too.
Giving students control over their learning
At St Nicholas, we built an entire wellbeing curriculum, which was designed to also raise standards across every subject area. Crucially, each strategy was linked directly to Ofsted requirements.
One approach was to introduce the Chilli Challenge, which gave pupils the opportunity to differentiate their own learning independently.
As the children came into each lesson, they would see a set of cards on the whiteboard displaying coloured chillies representing increasing levels of challenge – green (nice and spicy), amber (getting hot) and red (burning up).
The teacher would write down the different activities that related to each of the levels and the children were given the choice to take on the tasks they wanted to.
Initially, more able children tended to go for the green card tasks, which often wouldn’t stretch them but they could finish quickly.
However, one key element was that wherever a child began in the Chilli Challenge, once tasks were completed, they would then be encouraged to move on to the activities in the next stage.
So pupils became increasingly more likely to stop and think about which set of activities to go for, which would enable them to do one piece of work but at the most challenging level.
It gave pupils greater autonomy in their learning and teachers the freedom to plan and deliver lessons they felt were appropriate for the children they were teaching.
The result of introducing a whole-school wellbeing curriculum was more confident and resilient children across the school, who also bucked national trends of achievement – pupils from travelling communities, boys in literacy, girls in maths.
By 2016, the school became one of only 4 per cent that moved from “requires improvement” to “outstanding” in all categories.
This underlines the fact that wellbeing and standards are not mutually exclusive and it’s no great leap to imagine the impact of a wellbeing curriculum introduced more widely.
Wellbeing support in schools
There are examples of successful initiatives internationally, too. In Sweden, 85 per cent of schools are staffed with nurses and other professionals qualified to provide mental health support on-site.
Regular one-to-one health talks with children are among some of the early intervention techniques they deploy, where visual prompts, such as pictures of animals showing different emotions, might be used to help children express how they are feeling.
Activities that build self-confidence and resilience are promoted in classrooms, too, where children are encouraged to work in small groups and stand up for their opinions on a particular issue.
Importantly, these on-site teams are managed by schools, rather than an external body, so they know the children they work with, and senior school leaders can direct key services to where they are most needed.
Of course, though, this in-school Camhs-like support is not always possible in this country, with our patchwork provision of school nurses.
However, it is still worth contacting your local authority to find out what is possible as, depending on your location, you may have access to more Swedish-style school nurse services than you are aware of.
In Canada, a slightly different approach is taken to prevention, focused on tackling the stigma around mental health in schools with targeted lessons to teach young people how to express their feelings.
Here, teachers take a pre-lesson mental health quiz and have access to a comprehensive information pack to close any gaps in their knowledge.
They then deliver targeted lessons specifically designed to improve students’ understanding of mental illness, change negative attitudes that can lead to discrimination and ensure that young people are well-informed about how they can help themselves and others.
So students might be asked to research the prevalence of depression in their neighbourhood, identify the symptoms of the condition and participate in a class discussion about effective self-help techniques and treatments available.
Interestingly, students were found to engage with the new curriculum much more readily when lessons were delivered by their own teachers, rather than a mental health professional.
Children often don’t have the vocabulary to explain their emotions and schools such as Penistone Grammar School, in Sheffield, have addressed this by introducing a resilience curriculum.
So in Year 7, every child has one lesson a week in which they might learn how the mind works or about the psychological science behind learning. Discussions around what mental health is – and isn’t – are helpful, too, and children are regularly reminded of who they can turn to if they are struggling.
Schemes such as this help to uncover hidden issues and encourage children to come forward when they need help.
Encouraging children to talk
These are big ideas but, from our work, it is clear that we cannot stick to the status quo any longer – we need to bring mental health to the fore across education.
Children need more opportunities to develop the language and confidence to talk openly about issues they might be experiencing.
What is more, we must ensure that when mental health services are put in place, they are analysed and assessed with the same rigour as academic progress.
Research carried out at Penistone Grammar to find out how different services were working revealed that 28 per cent of children who had been referred to its on-site talking therapies left feeling they had not benefited from the experience at all.
Disappointed with this outcome, the school consulted with the students on what else might work. From this, it brought in an art therapist to offer pupils an alternative to the counselling already available.
This small change cut the percentage of children who said they hadn’t benefited to just 8 per cent – that’s a third more children feeling they got the help they needed.
A vision for the future
The huge challenge that schools have faced to support children’s mental health throughout the pandemic has given rise to a whole new level of ambition for change.
Schools such as Penistone have been bold in their approach, introducing a targeted mental health curriculum and keeping the services being provided under constant review.
The broader impact of these measures has been a 60 per cent drop in after-school detentions and 64 per cent fewer internal exclusions.
The education sector is the gateway to the creation of a national public mental health strategy where the successful programmes being rolled out in individual schools and multi-academy trusts can be replicated across the UK, with senior leaders drawing on the most effective global initiatives such as those in Sweden and Canada.
While some strategies may sound expensive, the upfront costs are likely to be hugely offset by the costs associated with helping pupils, or indeed adults, that have to be supported with mental health issues further down the line.
That’s what stopping people from falling into the river is all about, and it would mean we give children and young people the opportunities in education – and life – that they deserve.
Andy Mellor is former NAHT national president and is currently strategic lead for The Carnegie Centre of Excellence for Mental Health in Schools at Leeds Beckett University