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Bringing mental health care to schools

What could better mental health care in schools look like? School counsellor Charlotte shares her views, and why she thinks there are huge opportunities currently being missed. 

A young girl with anorexia came to see me for advice. She was not only battling an eating disorder but also struggling with a lack of self-confidence. Together we discussed her condition, and I carried out an assessment. It was clear to me that she need to be referred for further help, but she didn’t want to engage with it.

Luckily, in that situation I was able to draw on my experience in mental health care and provide her with support myself. And now, 3 years down the line this same young woman now gives assemblies in schools, on overcoming mental illness.

It’s inspiring to see a young person go through such a transformation, which is why I’m so passionate about what I do.

I’ve worked in young people’s mental health for the past 15 years, and during that time a lot has changed.

We’re now talking about mental health more than ever before - it’s finally getting the recognition it deserves – but there is still a long way to go. We have work to do to change common attitudes towards mental health, and ever-stretched services need improving to make them work harder for young people.

My background is in Cognitive Behavioural Therapy (CBT), and I have worked as an Assistant Psychologist within Child and Adolescent Mental Health Services (CAMHS). I’ve seen first-hand how hard mental health care professionals work, but there is no getting around the fact that services such as CAMHS are under huge pressure, and the impact of cuts are far reaching.

There are huge opportunities in schools

I now work as a school counsellor in the North West of the country. It’s been an eye-opening experience.

What struck me most is the sheer volume of young people experiencing mental illness, and the lack of understanding amongst teachers. I am in no way blaming teaching staff - they have incredibly demanding workloads and they receive little support or training on mental health.

In most schools, teachers typically refer students straight to CAMHS for assessment, and this can sometimes lead to pupils waiting up to 9 months before receiving any kind of support. You wouldn’t expect to wait that long to be seen for a physical condition, so why do we accept it for a mental illness?

It dawned on me that there was a huge opportunity being missed – bringing assessment and low-level support into the school itself.

I’m in a fortunate position as our school is very health-focused and value the recommendations I make to improve student wellbeing. I am also lucky that the experience and contacts I have, mean that I am trained to carry out assessments in school and can get people referred quickly, whilst providing individual or group CBT for students. Training and guidance is also offered to the pastoral staff in the school, to help them support a child or young person with lower levels needs.

I realise not every school will have a CBT-trained counsellor, and my experience has shown me that mental health care can vary vastly from school to school. That is why at my school we have developed a model for a ‘whole school approach’ to mental health care, with targeted interventions, training of staff and clear referral pathways. 

In my opinion, early intervention is crucial if we want to truly help young people facing mental health issues, and prevent conditions from deteriorating. And I believe schools could be doing more to ensure young people get support as quickly as possible.

There are still questions to answer

It’s clear to me that whilst we are moving forwards with the awareness surrounding mental health, there is still a lot we don’t know.

Dealing directly with students has taught me that the same treatment doesn’t work for each individual, and personalised care is key. I’m also passionate about ensuring young people are involved in finding a treatment that works for them, and that their views are fed back into research to assess the effectiveness of treatments.

And we must work towards parity with physical heath – both in terms of the funding of services and care, and in research to ensure that treatments are effective. There are a huge number of treatment options available now, and new technology such as digital apps are on the rise, but they lack a clear evidence base.

 Without proper research, how do we know if these new treatments actually work?

I would love to see treatments assessed based on individual needs, and the ability to be able to personalise care to match young people to the right treatment for them. I would also like to see proper evaluation into the impact of certain interventions, for example the Children and Young People’s Improving Access to Psychological Therapies programme (IAPT).

Research must be a key part of our approach to mental health across different setting and conditions, and I have huge hopes for the opportunity it offers. 

Last updated: 29 August 2017

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