Specialist team supports students' emerging mental health needs

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Brighter Futures for Children's Mental Health Support Team (MHST) helps students across Reading to manage emerging, mild or moderate mental health difficulties, using age-appropriate interventions.

The team works primarily with children experiencing worries, anxiety and low mood, with Alec de Sausmarez, senior educational psychologist from the MHST, saying that most of the team's referrals are for children experiencing anxiety.

The MHST – funded by the NHS Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board – is focused on supporting children so that mild problems do not develop into something more serious.

The service works in tandem with existing mental health support services and professionals in schools, such as school-based counsellors, educational psychologists, school nurses, primary mental health workers and pastoral care teams.

It operates an open referrals system, meaning any child over the age of 13, parent, or professional can refer into the team. A referral can be submitted online on the Brighter Futures for Children's website, or in school with the aid of a special educational needs co-ordinator or a senior mental health lead.

The team will examine the case and decide if the MHST is the right service for that child. If a referral is accepted, an allocated practitioner will meet with the young person and their parents to carry out an initial assessment. Once the main areas of mental health need have been identified, the team will offer an intervention.

The team, which operates in more than 35 primary and secondary schools across Reading, offers a range of different forms of support, including school-wide, group-based and one-to-one interventions.

Its whole-school work involves leading assemblies on mental health, and meeting with staff termly to discuss the needs of the children in their classrooms and offer advice. De Sausmarez says that the team moulds its operations to fit the needs of each individual school, adding: “We're meeting schools where they are, so we ask what would suit them. We adapt what we do to meet those needs.”

Amanda Mavunga, the team's CAMHS (child and adolescent mental health services) clinician runs coffee mornings in almost every school the team works in, where parents can attend for a discussion on a specific mental health topic, such as anxiety or low mood.

The coffee mornings also cater to parents of children experiencing OCD (obsessive compulsive disorder), phobias, autism, ADHD (attention deficit hyperactivity disorder), challenging behaviours, low self-esteem, self-harm, and body image and eating disorders.

De Sausmarez adds that school staff are key to identifying low-level mental health needs in children.

“When a child has those low and emerging mental health needs, its usually the teachers that will pick up on it,” he says.

“We are always trying to make sure teachers know about our services. I go to after-school meetings to talk about what we do, offer advice and to make sure the referrals are coming in.”

The MHST also offers sessions for groups of around six to eight children to support mental wellbeing, including mental health ambassadors, friends for life and therapeutic story writing sessions. De Sausmarez notes that the therapeutic story writing offers a positive way for children to express their emotions, particularly those who find it difficult to do so in day-to-day conversations.

“They are asked to come up with a character and write about how that character is feeling,” he says. “It's fascinating because they always end up talking about themselves and reflecting their own lives through their writing.”

Evidence-based individual interventions are also offered by the team for children experiencing mild or emerging mental health issues, including programmes which support parents to help their child manage their anxiety, low mood, or other mental health needs at home.

De Sausmarez notes these programmes can be particularly useful for neurodiverse children, who may need extra support and structure at home.

For children in year 6 or above experiencing anxiety, a worry management programme is available, which de Sausmarez says is based on cognitive behavioural therapy, but tailored to suit the needs of children.

A graded exposure programme can be offered to children experiencing phobias or other anxiety difficulties, which helps them face challenging situations step by step.

Children experiencing low mood or depression can benefit from the team's brief behavioural activation intervention, which encourages young people to participate in activities that boost their mood, such as hobbies or seeing their friends.

All one-to-one interventions typically run over a period of six to eight weeks, with de Sausmarez adding that if a child needs further support after their intervention is complete, the team can either adjust the offer or refer them to another service, such as Brighter Futures' primary mental health team.

The MHST targets moderate mental health difficulties, aiming to prevent children experiencing these low-level challenges from developing more serious problems which would require more support from services that are already overwhelmed with demand.

The team's focus on emerging mental health needs addresses a gap in mental health support provision, with services such as CAMHS experiencing high referrals as more young people reach crisis point. “Part of the reason why CAMHS is so overwhelmed is because there's nothing at this low level,” says de Sausmarez.

He adds that the team has witnessed an increase in mental health needs among children in recent years. “There are lots of things impacting mental health needs in children,” he says. “The pandemic had some effect on that, poverty and the cost-of-living crisis has had an impact, and teacher wellbeing has a major impact as well.

“The power of the MHST is that it picks up on those low and emerging needs.

“Some of those children would not be picked up otherwise, and when left they might escalate to the point where they need higher intensity support.”

The team's interventions also consider the need for wraparound support for a child experiencing emerging mental health needs, particularly for those who are neurodiverse.

“For example, if there is a child who has both attention needs and literacy needs, they may escalate very quickly and become overwhelmed when writing is put in front of them,” de Sausmarez says. “We can do work with them directly about managing those worries, but there probably needs to be other things in place for them too, such as de-escalation techniques in school and literacy intervention as well.

“We ask what support the child already has in place and see how we can fit into that. Our service is only one piece of the puzzle, so we need to ensure we are working alongside other organisations and services.”

The MHST also signposts to other organisations, depending on the child's individual needs. “Our intervention may not be the right one for the child, so we make sure we maintain working relationships with other services,” de Sausmarez says.

IMPACT

The service has received “excellent” feedback according to de Sausmarez, who says that this positive response enabled the team to expand into south and central Reading last year – an expansion that enabled provision in a further 20 schools.

The extension was welcomed by Di Smith, the chair of Brighter Futures for Children's board, who said the MHST is “both valuable and critical, post-pandemic, in addressing the increase in children and young people's mental health needs”.

The team gathers feedback in a variety of ways, including conducting routine outcome measures with children it has supported. This involves the child filling out a mental health questionnaire at the beginning and end of their intervention programme, which have consistently indicated improvements in student wellbeing, de Sausmarez says.

The initial trailblazer team, which ran from January to March 2023, reported that 81 per cent of the children and young people that engaged with the service saw an improvement in their wellbeing scores, and 90 per cent said they had made progress towards achieving their goals.

The team also holds conversations directly with the children they have supported. One child said the sessions made them “happier and mentally healthier”, while another said that they felt they could control themselves more.

Feedback is also gathered from parents of children who have engaged with the service. One parent said: “We feel much more optimistic about the future and the skills and tools she needs for life.”

Another added that they noticed an increase in their child's confidence, and that he has more willingness to discuss issues he is facing after participating in the programme.

• Read more in CYP Now's Mental Health in Schools Special Report