Schools struggle to get pupils seen by qualified mental health professionals because training for counsellors focuses too much on treating adults, warns the head of a children’s mental health charity.
Patrick Johnson, the director of learning at Place2Be, told a meeting of headteachers, charities and academics in parliament last week that it was “no surprise” there were shortages of qualified staff “given that approximately 90 per cent of formal counselling training courses are for those working in adult mental health, not with children specifically”.
Dean Johnstone, the chief executive of another charity, Minds Ahead, argued for youth mental health work to be “transformed into a career of choice for young graduates”.
Last year, Schools Week revealed that the number of educational psychologists working with schools fell 13 per cent over five years. The number employed by local authorities dropped from 1,990 in 2010 to 1,650 in 2015.
This doesn’t mean insulating young people to some of the inevitable pressures and stresses of school life
According to research by the Care Quality Commission (CQC), young people in some areas can wait up to 18 months to receive the mental health support they need.
Earlier this month, the CQC called on Ofsted to rate schools on how well they responded to the mental health needs of pupils.
According to Julian Astle, the director of creative learning and development at the Royal Society of Arts, schools had to choose between depth — expert provision from a professional — and breadth — where all school staff were trained to support young people presenting with mental health issues.
“In the RSA academies, we are purposefully going for greater breadth with an ongoing programme of training for all staff, non-teaching as well as teaching.”
At the meeting, hosted by the Liberal Democrat MP and former health minister Norman Lamb, the headteacher of Reach Academy Feltham, Ed Vainker, spoke of the “mistaken belief” that schools “are either rigorous, have high expectations and excellent results, or are supportive, nurturing and place mental health at their heart”.
Vainker said that his organisation believed those two elements “can go together and that excellent outcomes for pupils require a warm, nurturing, supportive environment for the pupil and their family”.
Jon Brunskill, a teacher at Reach Feltham, said there was “more that teachers should, and can, do”, but said ultimately the increased challenge “will only be met with a co-ordinated, multiagency approach with the child at the centre”.
David Hall, from the University of Exeter, said there was an “urgent need to lower the level of pressure on schools and children.
“This doesn’t mean insulating young people to some of the inevitable pressures and stresses of school life, but it does mean that these should be kept within tolerable levels.”
Evidence heard at the meeting will form the basis of a “call to arms” report by Minds Ahead and the education think tank LKMco, which will be published “soon”.
“So many of the issues we explore in our research trace their origin back to a youth mental health crisis that has been neglected for too long. Today’s session was an attempt to tackle the underlying issues head-on,” said LKMco director Loic Menzies.
A government consultation on young people’s mental health closed earlier this month. Proposals include £95 million funding for schools to appoint and train designated senior leads for mental health from 2019, and £215 million for new mental health support teams to work between schools and the NHS and treat pupils in the classroom.
“Every day we get calls to our Parents Helpline from parents whose children have been waiting up to 18 months for treatment,” chief executive Sarah Brennan says.
Chloe is now getting help with her mental health.
“I now see a psychiatrist on a fairly regular basis and it helps to be able to be open about how I feel now.”
“As this report shows, we need to see urgent action across the board,” says Claire Murdoch, the national mental health director for NHS England.
She says the CQC is right to highlight the need for there to be “better cross-sector working” involving health providers, schools, regulators and government – as well as children and parents.
Scotland’s mental health minister Maureen Watt says the government will “continue to support the improvement of mental health services through the £150 million of extra funding we’re providing over five years to help deliver our Mental Health Strategy”.
NHS watchdog expresses concern over wellbeing of thousands of patients and cost to NHS of ‘out of area’ care
Thousands of people with serious mental health problems are being locked up in treatment units far away from their homes, and left isolated and less likely to recover, the NHS’s care watchdog has warned.
The Care Quality Commission (CQC) is concerned that such patients’ chances of making a full recovery are being hit because they are denied regular contact with relatives and friends.
Of people with complex psychosis and other serious mental health conditions 63% end up being sent “out of area” for care because the local NHS does not have the beds, staff, or both to treat them.
Many people are being cared for sometimes more than 60 miles away from home, and for almost three years at a time, according to a CQC survey of care providers published on Thursday.
Mental health campaigners said the CQC report on the controversial practice, which ministers have pledged to scrap by 2021, should prompt the NHS to provide more beds closer to patients’ homes.
Paul Lelliott, the regulator’s deputy chief inspector of hospitals, said: “We are concerned about the high number of beds in mental health rehabilitation wards that are situated a long way from the patient’s home. This dislocation can mean that people can become isolated from their friends, from their families and from the services that will provide care once they have been discharged.”
The 600 to 700 patients a month sent out of area are also a concern because they spend twice as long there as they do in an NHS unit near their home, “which can increase their sense of institutionalisation, affect their onward recovery, and can be very costly”, Lelliott added.
Mental health rehabilitation services cost the NHS in England £535m a year, of which £356.6m is spent on out-of-area placements.
Private health firms receive 78% of the NHS patients sent out of area for care. The CQC found that they treat each NHS-funded patient for an average of 14.5 months compared with 7.5 months on an NHS ward. And patients they care for typically cost the NHS £162,000 per stay, compared with £81,000 in a unit run by the NHS itself.
“Tory ministers need to explain why there are so many private providers of rehabilitation units, why longer stays are costing twice as much as in the NHS, and come forward with plans to reduce the number of these placements,” said Barbara Keeley, the shadow minister for mental health and social care.
Rajesh Mohan, chair of the Royal College of Psychiatrists’ rehabilitation faculty, said: “The reason more and more patients are being sent inappropriately out of area is because NHS rehabilitation services have been closing at an alarming rate. In 2009 there were more than 130 such services in England; by 2015 that number had fallen by a third to just 82.”