This is a plain English summary of an original research article. The views expressed are those of the author(s) and reviewer(s) at the time of publication.
Researchers evaluated the roll out of the first wave of the mental health programme based in schools, the Children and Young People’s Mental Health Implementation programme, and explored how it can be improved.
They found:
- general satisfaction with the programme among schools, colleges and the young people who accessed support
- variation in the approach and support provided at different institutions
- staff shortages.
This early evaluation may inform the next wave of the programme, and encourage schools to engage with pupils, parents and carers about what support is most necessary.
More information about child mental health can be found on the NHS website.
The issue: supporting mental health in schools
The Children and Young People’s Mental Health Implementation programme was launched in 2018 to improve mental health in those aged 5 – 18 years. This Government-led programme funds mental health support teams and mental health leads in schools and further education colleges (not universities).
In the first wave of the programme, 58 mental health support teams were set up. They served 1050 schools in 25 ‘Trailblazer’ areas in England. The teams directly support children with mild to moderate mental health problems, and help schools promote wellbeing for everyone. They give advice to teachers and liaise with external specialist services to help pupils get the right support and remain in education. A new role – education mental health practitioner – was created for the programme.
Researchers explored people's experiences of setting up and running these mental health support teams in the first wave of the programme.
What’s new?
The researchers evaluated 599 survey responses from people involved in rolling out the programme between 2020 and 2021. They interviewed 71 people (including staff from mental health support teams and school leaders) from 5 areas, plus 52 clinical commissioning group leads and 21 people involved in the design and delivery of the national programme. They held 5 online focus groups with 32 pupils from schools recruited into the programme.
Overall, the programme had made good progress. The study found:
- schools were generally satisfied; they welcomed the additional mental health support, valued the support teams and said the programme increased staff confidence in talking to pupils about mental health
- support teams were positive about working with schools
- young people who had accessed support were universally positive; others were unaware of the programme.
The programme strengthened relationships and collaboration between education settings, mental health services and other local partners. However, challenges included:
- the workload involved in setting up the programme, including recruitment and training of staff, and engaging stakeholders in designing local services
- variation in the support provided because national guidance did not specify whether teams could work beyond mild to moderate problems; this led to gaps in provision for those with more severe problems who did not meet the threshold for specialist help
- prioritisation of support for individuals by some teams; others spent more time promoting whole-school wellbeing
- unmet needs among some groups of children, including those with special educational needs or challenging family circumstances, and those from ethnic minority backgrounds
- staff shortages; high workloads and a lack of career opportunities within teams made staff retention difficult
- the lack of involvement of young people, parents and carers in deciding on the support provided; these groups had some involvement in half of the schools, but full involvement was rare.
Why is this important?
A national roll-out could improve youth mental health in schools and ease the burden on specialist mental health services. Schools and mental health support teams worked well together, the project found.
Pupils need to be more aware of the programme, the authors say; they also call for young people, parents and carers to be more involved in the design and delivery of the support. Diverse groups, including children with special educational needs and disabilities, need more tailored provision.
The programme’s implementation was challenging because of its scale and complexity. A system-wide approach may be beneficial for future waves of the programme, to embed it into existing partnerships. All case study sites found the set-up chaotic. They reflected that structure and guidance would have been helpful in advance, as long as it was sufficiently flexible for them to be able to tailor provision to local needs.
During the pandemic, support teams adapted their service to provide remote support, for example. But challenges included the delayed introduction of wellbeing activities for the whole school.
Children in the first 25 areas of the programme may be better supported than those in other areas. Survey responses were low and some groups such as school staff were not well-represented in the interviews.
What’s next?
This early evaluation provided further evidence to support workforce development initiatives already underway across the programme. These include training of junior practitioners and more opportunities for career progression. There is a drive to improve recruitment, and to emphasise equality, diversity and inclusion both in the workforce and in access to services.
Longer-term evaluation of the programme by the same research team started in summer 2023. It will explore outcomes for all stakeholders, including staff retention and other workforce issues.
Many schools have invested in mental health support since joining the programme, either because of the programme or, for instance, the ongoing effect of the pandemic.
You may be interested to read
This is a summary of: Ellins J, and others. Early evaluation of the Children and Young People's Mental Health Trailblazer programme: a rapid mixed-methods study. Health and Social Care Delivery Research 2023; 11: 8.
An animation summarising the study.
Funding: This study was funded by the NIHR Health and Social Care Delivery Research Programme.
Conflicts of Interest: No relevant conflicts were declared. Full disclosures are available on the original paper.
Disclaimer: Summaries on NIHR Evidence are not a substitute for professional medical advice. They provide information about research which is funded or supported by the NIHR. Please note that the views expressed are those of the author(s) and reviewer(s) at the time of publication. They do not necessarily reflect the views of the NHS, the NIHR or the Department of Health and Social Care.
