Policy

Today, nurtureuk publishes its guide to implementing the Department for Education in England’s advice document regarding mental health and behaviour in schools.

In November 2018 the Department for Education in England (DfE) published its advice document Mental health and behaviour in schools. This guidance for English schools is just as relevant in other parts of the UK and in other countries because it directly confronts one of the most pressing issues in education today.

As evidence from the Boxall Childhood Project (BCP)2 clearly shows, the social, emotional mental health (SEMH) and behavioural difficulties that children and young people are experiencing has reached epidemic proportions. From the 6,800 pupils who were assessed from the primary schools that took part in the Boxall Childhood Project, the evidence shows 10% of pupils are presenting with high levels of SEMH needs, and 26% with moderate needs.

Boys in primary schools are three times more likely to experience high levels of SEMH needs. It is small wonder that teachers are experiencing what they sometimes describe as a ‘tsunami’ of mental health needs in the classroom.

The challenging behaviour this mental health tsunami produces has resulted in rocketing exclusion rates that have in turn been cited as a principle driver of anti-social behaviour, leading to violent crime, and in particular – knife crime.

The need to address these issues has never been more pressing, and implementing the advice in the Mental health and behaviour in schools White Paper can have a significant impact as the evidence shows. In this publication we look at how this guidance can be effectively implemented in the school setting and the benefits not just for the children, young people and schools, but also for society as a whole.

You can download and read the nurtureuk‘s guide to mental health and behaviour in schools in full HERE

Commenting on the Initial Teacher Training (ITT) Core Content Framework, nurtureuk chief executive Kevin Kibble said: “At a time when the Department for Education (DfE) is highlighting the issues of mental health & behaviour in schools, the newly-published Initial Teacher Training (ITT) Core Content Framework does little to help teachers address these needs.”

“This was an ideal opportunity to bring ITT into the 21st century, equipping new teachers with the skills, or at least the methodology to obtain them, to identify and tackle the mushrooming prevalence of social, emotional, mental health & behavioural needs of the most vulnerable pupils. Nowhere is there reference to what we now know about brain development and how it impacts on a child’s ability to learn. Where is the overwhelming evidence of the adverse effects on child development of early childhood trauma and how our knowledge is evidenced by neuroscience? And what about attachment awareness or the importance of the teacher-pupil relationship in building secure attachments?”

“This feels like a ‘business as usual’ approach and misses the chance to really step forward in ITT. It’s no wonder we fail to hold on to so many of our new teachers for more than a few years.”

If you’d like to find out more about how the Boxall Profile® can be used to respond to the SEMH needs of children and young people, please contact nurtureuk‘s Boxall Profile® team on [email protected].

On the 25th September Jayne Bryant, Labour Welsh Assembly Member (AM) for Newport West, tabled a debate on “Wales’s whole school approach: Supporting all children to flourish, learn and succeed in schools” in the Welsh Assembly.

Opening the debate, Bryant spoke about the importance of early experiences in a person’s life, saying that “attitudes, beliefs and behaviours learnt during these very early years are often carried into adulthood”. She then highlighted the mounting evidence that “if we get things right early on” this will have a “a positive impact on not only the individual, but on society as a whole.”

She also pointed to the conclusion that the Welsh Assembly’s Children, Young People and Education Committee came to in their ‘Mind over Matter’ report that “school settings are key to promoting emotional well-being and good mental health”.

Bryant then highlighted excellent whole-school approaches in her own constituency including Pillgwenlly Primary School, which opened its first nurture group in 2004, and Malpas Court Primary School which has been on the National Nurturing Schools Programme for one year and recently opened its first nurture group.

Our National Nurturing Schools Programme supports schools to apply the principles which have underpinned nurture groups for 50 years across their whole-school.

Bryant also praised nurture approaches for helping the most disadvantaged children and noted that nurture approaches have now been running for 50 years.

Hefin David, Labour AM for Caerphilly, then raised another school which takes a whole-school approach to nurture: Nant-y-Parc in the Aber Valley. At the school, teachers make “daily efforts to understand the emotional needs of pupils” as well as running emotional literacy groups and offering support for staff well-being. He quoted a staff member who said that: “Placing a high emphasis on well-being allows staff and pupils to feel valued. It’s allowed me to form positive working relationships and I feel motivated to give to pupils as I feel appreciated.”

Ysgol Ty Ffynnon, the first school in Wales to complete the two-year National Nurturing Schools Programme, was then praised by Jack Sargeant, Labour AM for Alyn and Deeside. Sargeant endorsed the programme for other schools and described how “the whole school has embraced the six principles of nurture” and “how nurture group sessions allow their pupils to take part in activities that develop self-awareness, build self-esteem, perseverance and positive thinking.”

Following on from this, John Griffiths, Labour AM for Newport East spoke about how important it was for children to get the best start in life and spoke about how “none of us know what life may throw at us” which means “developing that emotional resilience is so important for the whole of  our life course.”

He then said how Somerton Primary, one of his local primary schools had been recognised by Estyn for their excellent nurture approach. He said that “the staff there believe it’s made a real, positive difference to the pupils in that school” and quoted a staff member who had said, “it has really helped a significant change for the better, with growing confidence and self-esteem, sharing and co-operating, and producing better strategies to cope in different social situations. Behaviour and attitudes to learning have all improved.”

Mark Isherwood, Welsh Conservative AM for North Wales region praised not only Ysgol Ty Ffynnon but also Ysgol Maesincla in Caernarfon. Isherwood has previously noted the issue of exclusions and how these affect pupils with additional learning needs and pointed to how Ysgol Maesincla has seen a reduction in exclusions since it opened its nurture groups and adopted a whole-school approach to nurture.

Finally, Education Minister and Liberal Democrat AM for Brecon and Radnorshire Kirsty Williams responded to the points raised by AMs. The minister noted that more and more schools were recognising nurture groups as a “proven means” to support both primary and secondary pupils. The minister then went on to highlight how nurture groups are effective in supporting children who’ve experienced trauma and how they can help build bridges with parents to support children’s learning, especially when those parents may not have had positive experiences of school themselves.

We were delighted to see so many AMs from different political parties praise nurture schools in their constituencies. Nurture teachers work hard to deliver the best outcomes for their pupils and we were very pleased to see their work recognised in this way.

We have welcomed much of the progress made in Wales in recent years to promote pupil-wellbeing. Wales’s new curriculum emphasizes the importance of wellbeing and the principles of the National Nurturing Schools Programme supports many of the curriculum’s elements. The Children, Young People and Education Committee, chaired by Lynne Neagle AM has been a champion of children’s social, emotional and mental wellbeing, particularly through its ‘Mind Over Matter’ report. This debate was a welcome confirmation of the Welsh Government and Welsh Assembly’s commitment to whole-school approaches to wellbeing and AMs appreciation of nurture’s role within this.

Responding to leaked government proposals for England which include plans to back headteachers to use temporary and permanent exclusions to “promote good behaviour”, Chief Executive of nurtureuk Kevin Kibble said:

“If these proposals are genuine we would be deeply concerned. Exclusions do not improve behaviour and take a harsh toll, both on the excluded child’s education and on society. Excluded young people are more likely to go to prison, be unemployed and develop severe mental health issues. Rather than see exclusions as a tool, we need to actively address the underlying causes and work to reduce them.

“Current rates of exclusion are unnecessary and unfair. We know that we can reduce difficult behaviour through understanding the underlying needs that cause behavioural difficulties, and using interventions based on assessment of needs we can be much more effective at reducing exclusions. We also know that exclusions disproportionately affect the most disadvantaged children. In cases where poor behaviour is directly linked to trauma and adverse experiences like separation from family, exposure to family conflict, parental substance abuse exposure and maternal depression, to then exclude a pupil simply confounds the problem and isolates them further.

“Exclusions have been climbing since 2012 and increasingly affect younger children. Currently, almost 6,000 pupils between the ages of five and ten are in pupil referral units or alternative provision in England, a massive increase of 85 per cent since 2011.

“It’s not just us who thinks we need to tackle exclusions: the independent review of school exclusions led by Edward Timpson called for schools to be equipped to address the social and emotional needs underlying difficult behaviour while the House of Commons Education Committee says schools should not rush to exclude and should instead be ‘bastions of inclusion’.

“We cannot repeat the approaches that have failed in the past and have led to appallingly high levels of exclusions. Instead of doubling down on failed approaches, we urge the government to support measures that will ensure every child gets the education they deserve.”

Nurtureuk welcomes much of the content of the new draft curriculum. We hope the Welsh Government will prioritise resources to help empower teachers to make the most of the changes.

Last week, the Welsh Government finished its consultation on the draft proposals for the new Welsh curriculum. From September 2022 all maintained schools and settings in Wales will use this curriculum.

The curriculum is composed of six areas of learning: Languages, Literacy and Communication, Mathematics and Numeracy, Science and Technology, Expressive Arts and Health and Well-being.

We welcome that the planned curriculum places health and wellbeing on par with more academic areas in this way. Given we know that poor social and emotional wellbeing has a detrimental impact on learning, prioritising support for children’s social and emotional needs will support their ability to learn.

The principles behind, and practical application of, nurtureuk’s whole-school approach supports the delivery of the health and wellbeing elements of the new curriculum. The National Nurturing Schools Programme (NNSP) is a whole-school approach that upskills teachers and other school staff to embed a nurturing culture to improve the mental health and wellbeing of all pupils and staff in a school. With one in 10 school children in the UK suffering from a mental health problems and worrying levels of stress and exhaustion among teaching staff, whole-school approaches like the NNSP offers schools a way to develop a happier, more resilient and more successful school community.

The health and wellbeing aspects of the new curriculum also include ways that progression will be measured, including children’s ability to self-regulate. Many criteria and principles laid down in the curriculum around progression are similar to the strands measured through the Boxall Profile. The Boxall Profile is a tool teachers use to help understand the social, emotional and mental health needs of their pupils. Our Now You See Us report into using it to assess the social and emotional wellbeing of all pupils found that it helped even experienced nurture teachers identify children with needs they may not have identified before, as they presented in a non-evident manner. By helping teachers understand their pupils needs, using the Boxall Profile can also support early intervention for emotional wellbeing, a focus of the Welsh Assembly’s Children and Young People Committee’s Mind Over Matter report.

We therefore believe that the new draft curriculum could be an excellent framework to help schools support their pupil’s social, emotional and mental wellbeing.

However, the Welsh Assembly’s Children and Young People’s Committee noted in their report on school funding that:

“Stakeholders, including teaching unions and local authorities have expressed real concern that insufficient provision for school budgets could inhibit the delivery of the Welsh Government’s education reform agenda and key objectives of the Education in Wales: Our National Mission action plan, including school improvement, the new curriculum and teachers’ professional learning and pupil wellbeing (including the whole school approach to emotional and mental health).”

Speaking to Welsh Assembly Members in 2017 Professor Graham Donaldson, who played a key role in designing the curriculum, noted that recognising the need to support teachers in order to enable them to effectively teach the curriculum was a key lesson from the implementation of a similar curriculum in Scotland.

To ensure Wales fully grasps the opportunities in the new curriculum, we would welcome more resources and funding in order to help schools support the whole-school approaches to health and wellbeing proposed in the curriculum.

Estyn, the Welsh Assembly and the Welsh Government have all increasingly acknowledged the importance of social and emotional wellbeing, and specifically of nurture, in education over the last few years. If properly resourced, the new curriculum could effectively support children with social, emotional and mental health needs and remove key barriers to learning for these children, giving them the education they deserve.

Responding to Ofsted’s announcement of new joint targeted area inspections examining the extent to which local services respond to children’s mental health, Dr Florence Ruby, lead researcher on nurtureuk’s Now you see us report, released the following statement:

“The acknowledgement of the vital role that schools play in identifying social, emotional, and mental health (SEMH) issues among children and young people is welcome, as is its commitment to ensuring inspectors take into account efforts taken by schools to consider the support provided by schools to children with SEMH needs.

Whilst the inspections will focus on particular children such as those who are subject to a child in need or child protection plan or are looked after children, we believe this is an important step forward and is in line with our goal of all schools being properly resourced and recognised for their efforts to understand and support pupil’s SEMH needs.

We particularly welcome Ofsted’s recognition that frontline practitioners have a role in identifying mental ill health.

In our response to Ofsted’s recent consultation into its new framework, we called for “a stronger focus on what schools are doing to gain an understanding of the SEMH needs of learners, and what they are doing to address them” in their inspections. This would serve to recognise the efforts being made by teachers to understand and support their pupil’s SEMH.

The measures announced by Ofsted in its joint targeted area inspections (JTAIs) represent a welcome step towards this, however in order for them to be effective it is crucial that participating schools are able to identify to SEMH among their students.

The Boxall Profile is already the most used tool in schools to understand the wellbeing and support needs of their pupils (Department for Education, 2017, Supporting mental health in schools and colleges: Quantitative survey) and was recently highlighted in the Department for Education’s 2018 Mental health and behaviour in schools advice.

In our recent Now you see us report, we shared the findings of piloting the use of the Boxall Profile with every child in school, conducted across four terms in 25 primary schools in England. Teachers in the pilot used the Boxall Profile to assess the SEMH needs of more than 6,800 pupils, and 92% of schools that successfully assessed all their pupils using the Boxall Profile found it very valuable and would recommend other schools do the same.

Once SEMH needs are identified, it is equally crucial that schools are given the resources to put in place the support needed. Now you see us found that when support was put in place following a Boxall Profile assessment, there was a 23% increase in the number of pupils who had no apparent SEMH needs after five months had passed.

Recent figures have shown that in a primary school setting, as many as one in 10 five to 10 year olds have a diagnosable mental health disorder (Sadler et al, 2018) and our research shows that addressing the social and emotional needs of children early on benefitted their SEMH, academic success, and could prevent them from experience more serious mental health and wellbeing issues in adolescence and later in life.

The JTAI package is currently aimed at young people between the ages of 10-15. Rolling out the measures further to reach children between 5 to 10 years old would have clear evidential benefits as this would support early intervention and would help prevent SEMH needs becoming more embedded.”

Deputy First Minister of Scotland John Swinney and nurtureuk CEO Kevin Kibble last week presented the National Nurturing School Award to St Mary’s Primary School in Edinburgh, the first school in Edinburgh to receive the award.

The National Nurturing School Award is presented to schools that have successfully completed a two-year programme aimed at embedding a whole-school approach to mental health and wellbeing for all pupils and staff. Teachers are trained to focus on emotional needs and development as well as the academic learning of all pupils, and to embed the six principles of nurture throughout the policies and practices of a school. This enhances teaching and learning and promotes healthy outcomes for children, young people and the staff in the school. Teachers are also trained to use the Boxall Profile, the educational psychologist designed tool to identify children and young people who need additional, more focused support or interventions.

The importance of nurturing interventions has been recognised by the Scottish Government and Education Scotland. A nurturing approach is promoted as an effective intervention to reduce school exclusions and support positive relationships and behaviour in the Scottish Government’s flagship strategy Included, Engaged and Involved. Education Scotland has also published guidance and good practice examples for nurturing approaches, citing the benefits of nurturing interventions for attainment and behaviour, especially for young people who have experienced Adverse Childhood Experiences (ACEs).

We were delighted that the Deputy First Minister attended the award presentation to show his support for whole-school nurturing interventions as a key part of the Scottish Government’s developing national approach to young people’s wellbeing.

You can read more about our work in Scotland by downloading our policy briefing here.

The newly released NHS Long Term Plan sets out commitments to expanding mental health services for children and young people in a dedicated section on children and young people’s mental health (CAMHS). The plan includes the welcome promise that funding for CAMHS will grow faster than both overall NHS funding and total mental health spending. It also promises that an estimated 345,000 more children and young people will be treated via NHS funded mental health services and school or college-based mental health support teams over the next five years.

This follows a period of significant public outcry over the state of CAMHS services across the country. A series of reports on CAMHS from the Care Quality Commission in 2017 and 2018 found that many children are unable to access timely and appropriate support, quality of care was often poor, and structure, commissioning, and oversight of CAMHS services is often ineffective. Around a quarter of children who are assessed are turned down for treatment, often on the grounds that their problems are “not serious enough”.

The new NHS Long Term plan also commits to embedding mental health support in schools and colleges, including funding and support for new Mental Health Support Teams working in schools and colleges. This is part of a package of measures proposed in the green paper “Transforming children and young people’s mental health provision”, which includes a strong focus on whole-school approaches to mental health and wellbeing.

While the ambition to create mental health support teams in every school is welcome, educational leaders have expressed fears that they will not be provided with the necessary resources for the new teams to work effectively, including staff time, training, and support for implementation. Concerns have also been raised about whether challenges specific to areas of significant socioeconomic disadvantage were being sufficiently taken into account in preparing to introduce the new regulations. Planned implementation of the green paper will leave many areas of the country waiting years for improvements, as the proposals are due to be in place in only ‘a fifth to a quarter’ of the country by the end of 2022/23.

More broadly, while many ambitions for improved health outcomes contained in the NHS Long Term Plan have been welcomed by experts and practitioners, questions are being asked over whether the allocated funding will be enough to deliver them. The plan also does not mention staffing, an issue which will be key to delivering improvements, with staffing shortages already posing a significant challenge and expected to cause even greater disruption after Brexit. In her response to the plan, the Children’s Commissioner has also called for an NHS-funded counsellor in every school, highlighting that more will need to be done for children with minor conditions and to improve the system as a whole.

Nurtureuk welcomes the commitment to grow CAMHS as a proportion of health services contained within the Long Term Plan, and calls on the government to further expand provision based on need, as well as ensure the promised improvements to outcomes are backed up by investment and resources.