18/07/2016 09:53 BST | Updated 19/07/2017 06:12 BST

Lessons in Mental Health

We all remember our days at school - our teachers, our friends, the moment the bell rang for break time. As children it's where we spend most of our time, the place where we build not only our academic skills but our knowledge of life and how to live it. But for some children and young people this experience is not quite the same.

It is thought that three children in every classroom have a mental health problem, ranging from anxiety and depression to ADHD. Some will of course be diagnosed and receiving help from children's mental health services (CAMHS) outside of school. However, others have to struggle on without the support they need.

Only 0.7% of the NHS budget is spent on CAMHS and there are wide variations in access to care across the UK. According to a recent report by Centre Forum, this lack of funding has resulted in almost a quarter of children being turned away from their local services, who only have the resources to handle the most severe cases. As a consequence, children with less serious problems are left without support, allowing their conditions to worsen and deteriorate.

Children can also go untreated due to a lack of understanding. Though they can often identify physical symptoms and point to 'where it hurts', few children will know how to articulate the mental troubles they are facing.

Many parents and teachers too are not trained in spotting signs of mental ill health. A recent report by the Centre for Mental Health showed how teachers often mistake symptoms for bad behaviour, while earlier this month, Professor John Ashton, outgoing president of the Faculty of Public Health (FPH), argued that parents themselves need educating in supporting their children with mental health issues.

It shouldn't be pot luck whether a child has access to the right services; this is why some organisations are suggesting that mental health support needs to be integral to school environment. The Institute for Public Policy Research report Education, Education, Mental Health, for instance, argues that secondary schools need to play a key role in tackling the mental health crisis.

As a nurse, I think this is great idea - in principle. School nurses are specifically trained to work with children on a daily basis, supporting them in their lives, promoting physical and mental health and providing advice to those who may be struggling. In practice, however, there are serious obstacles to schools achieving this aim.


The main issue is the sheer lack of investment in school nursing. Despite rising numbers of pupils, now at almost 9 million in England alone, figures from the HSCIC have shown a ten per cent drop in school nurses employed by the NHS to just 2700 in total - despite previous Government pledges to ensure at least one fully qualified school nurse per secondary school.

And an RCN survey of school nurses has shown just how detrimental this shortage has been. Seventy per cent said their current workload was too heavy, while more than a quarter (28%) work over their contracted hours every single day. Though they make every effort to do their very best for the pupils, almost 2 out of 5 (39%) said that they had insufficient resources to do their jobs effectively.

Most worryingly of all, more than two thirds (68%) of those surveyed said there were insufficient school nursing services in their area to provide the care and support children and young people need. Which means there aren't enough staff just to fulfil school nurses' current remit - let alone build in-school mental health services.

It is positive that we are beginning to recognise the opportunities schools provide, however what our children need is action. With a dynamic, expert school nursing workforce in place we can drive forward this strategy and tackle the crisis in children's mental health once and for all. Without it, I fear things will only continue to descend.