School mental health pilots encountering ‘sustainability issues’ study finds
Neil Puffett
Monday, October 12, 2020
Efforts to improve support for young people with mental health problems by strengthening links between schools and children and young people’s mental health services (CYPMHS) are facing long-term sustainability issues, a study has found.
Mental Health Services and Schools Link Pilots were jointly launched in 2015 by NHS England and the Department for Education in a total of 255 schools, with the pilot expanded to a further 1,104 schools in 2017. Run by the Anna Freud National Centre for Children and Families, it is currently in the process of being rolled out to all schools across England through The Link Programme.
As part of the programme, an NHS children’s mental health representative and a school lead from each area were expected to participate in two joint planning workshops, involving other professionals from their local children’s mental health services network, such as school nurses, educational psychologists, counsellors and voluntary and community sector organisations. In the majority of areas, there was a gap of approximately six to 10 weeks between the first and second workshops to allow for areas to progress plans and reflect on progress in the second workshop.
An evaluation of the expanded initiative found that while it had led to measurable improvements to some aspects of communication and joint working between the 1,104 schools and NHS CYPMHS involved in the second wave, there was a “very mixed picture regarding the longer-term fortunes of the original pilot areas”.
The original pilot was implemented in 22 areas across England, covering 27 CCGs and 255 schools, with £50,000 funding per CCG provided by NHS England to allow staff to be released (expected to be matched by CCGs) and £3,500 per school to backfill staff time to participate in workshops and follow-on activities.
The study found that achieving sustained joint working was most challenging in areas where the model relied on substantial direct work by CYPMHS staff in schools.
“In these cases, staff turnover was a particular issue, especially when key CYPMHS staff members left their roles and communication across organisations was not retained at the same level,” the report states.
Researchers found that views were more positive where there was a well-established link between health and education at a local strategic level, clarity of expectations for the level of ongoing contact between schools and NHS CYPMHS, and suitable local CYPMHS forums or networks.
“Nonetheless, staff turnover was an issue in the longer term, even where the initial commitment was high. The continuity of the availability of NHS CYPMHS staff was a major factor in schools’ levels of optimism or otherwise.
“It was generally those areas where the model involved heavier levels of in-school primary mental health worker time during the pilots where sustainability proved the most challenging, and in some instances this resulted in the single point of contact no longer being in place.”
The report added that while the follow-up research on original pilots only provided a “snapshot”, the common message was that “embedding improved working arrangements required further investment”.
A total of 23 areas, incorporating 23 CCGs and 1,104 educational organisations (primarily primary and secondary schools, but also pupil refferal units/special schools/alternative providers and colleges) successfully applied to take part in the expanded programme. Unlike the original pilot, participants did not receive any additional funding.
Plans to expand the programme nationally were announced in July 2019 by then Education Secretary Damian Hinds, with £9.3m of funding.