Survey of Schools' Work with Child and Adolescent Mental Health

A research team led by University College London and the Anna Freud Centre wanted to look at how schools support young people with mental health problems, against a backdrop of rising need.

Authors Helen Sharpe, Tamsin Ford, Suzet Lereya, Chris Owen, Russell Viner and Miranda Wolpert

Published by Child and Adolescent Mental Health, May 2016


Following cuts to mental health services, schools are increasingly a focus of attention as a key site for supporting the mental health and wellbeing of children and young people. An online survey was completed by 577 school staff from 341 schools in England, detailing the provision of specialist mental health support in their school for the paper Survey of Schools' Work with Child and Adolescent Mental Health Across England: A System in Need of Support.

The researchers found 68 per cent of schools said they had specialist support available. Secondary schools were more likely to offer support than primary schools, with 79 per cent of secondaries reporting specialist provision compared to 57 per cent of primaries.

The most popular approach to supporting mental health was to train staff - 77 per cent of primary schools and 82 per cent of secondary schools did so. This was followed by a "whole school" approach reported by 67 per cent of primary schools and 66 per cent of secondary schools. A "whole school" approach aims to change the ethos of the school rather than introducing single interventions, and may include classroom teaching, staff training and parenting support. A minority of schools taught mindfulness - 18 per cent of primaries and 27 per cent of secondaries - although this was more common in special schools at 44 per cent. Anger management, support groups and peer support were more common in secondary than primary schools.


Nearly two-thirds - 62 per cent - of schools said specialist support was provided by counsellors, 20 per cent by clinical psychologists, 81 per cent by educational psychologists and 49 per cent by other external agencies. Sixty per cent of schools said support was provided by NHS Child and Adolescent Mental Health Services (CAMHS), 44 per cent by private organisations and 32 per cent by the voluntary sector. CAMHS and voluntary sector provision was more common in secondary schools than primary schools.

Sixty one per cent of school staff said the capacity of CAMHS was "very much" a barrier to accessing specialist mental health support, while 17 per cent said capacity affected access "quite a lot". Funding was also cited as a barrier - 61 per cent of staff said lack of funding affected access "quite a lot" or "very much", while the same proportion blamed the unavailability of specialists. But links between different agencies were not cited as a strong barrier to accessing support services and neither were general attitudes to mental health. Overall, 84 per cent of staff thought specialist services employed by the school had helped, 64 per cent thought services provided by the private and voluntary sector had helped and 57 per cent thought CAMHS had helped.


The fact secondary schools reported a greater availability of specialist services than primary schools may reflect the fact mental health issues tend to increase at adolescence. But there is evidence that support in primary schools may be more effective than in later years. The fact schools did not think stigma around mental health was a barrier to accessing support may reflect the success of recent campaigns such as Time to Change. The report authors say there is need for initiatives to increase the capacity of CAMHS since schools identified lack of capacity as the key barrier to accessing specialist support.


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