School children's mental health difficulties reflect the complex interplay of factors that contribute to both healthy and distressed child development. The important influences on a child's development range from parental factors to family, neighbourhood, school, peer and wider societal elements. Children growing up today might experience additional stressors that can negatively impact on a their development.
These include the rising number of family separations; the tensions imposed by austerity cuts affecting the most deprived socioeconomic groups; the increasing pressures of school attainment; and the host of, as yet, poorly understood but concerning influences of social media on self-esteem and self-identity.
There have also been some positive changes, primarily the decrease in stigma associated with mental illness. Although mental illness remains one of the more stigmatised areas of health care, the improved understanding and acceptability of seeking needed care, has improved the likelihood of mental health difficulties being identified and provided for.
These two factors in conjunction - rising exposure to potential stressors, and reduced stigma associated with accessing mental health support leads us to the 'crisis' we find ourselves in today - with concerns being raised in all spheres of the poorly addressed mental health needs of children in school.
The evidence that mental health problems impact on school attendance and achievement has been demonstrated in a number of studies. Furthermore, difficulties in school and the pressures of academic attainment can also impact on mental health. Therefore the two are, if not interdependent, then very closely related. The problem therefore lies in how to address the mental health needs of children in school?
Although a renewed research agenda has much to contribute in understanding what the best interventions are, when the best time to intervene is and who is best placed and most acceptable to deliver the intervention; in practice the question of responsibility is of equal importance. Is the provision of mental health support a key aspect of education services or does this lie in the realm of statutory health services?
At present, schools provide a broad range of, in some cases, poorly evaluated services. Schools decide for themselves if they choose, with their limited budgets, to provide a school counsellor or bring in innovative services that usually lie within the charitable sector. They often have to make this choice against providing additional academic support, on which they are invariably judged by inspection bodies and league tables. Yet, this post code lottery, as to which schools decide to support children's mental health needs and which choose not to provide anything in addition to statutory provision cannot be in the best interests of the majority of children that might benefit from better access to mental health support.
At a minimum, and as a first move to address this problem, school should be given additional, ring-fenced resources, to be used for emotional and behavioural support within their schools. The schools will then be able to decide what would be needed for their children - by, for example, developing resources for the whole school as well as trying to address the needs of their more vulnerable populations.
The current unmet mental health needs of our school children will need a greater commitment by central government as well as by local statutory bodies to ensure that health and education are able to work together to support children within schools. In an ideal world, social services would also be integral to our planning for school services. The training of staff in each sector should include better appreciation of these complementary professions - in my training to become a child psychiatrist I rarely entered a school and I had little exposure to the range of academic difficulties teachers have to manage. Likewise, no trainee teacher has joined me in my work. This, alongside improved access and availability of appropriate services would be basic first steps in enabling us to provide what children and families often want - holistic, comprehensive, and thoughtful support in the place where they are spending most of their time - at school.
Young Minds Matter is a new series designed to lead the conversation with children about mental and emotional health, so youngsters feel loved, valued and understood. Launched with Her Royal Highness, The Duchess of Cambridge, as guest editor, we will discuss problems, causes and most importantly solutions to the stigma surrounding the UK's mental health crisis among children. To blog on the site as part of Young Minds Matter email firstname.lastname@example.org