Children’s mental health needs to be at the heart of school policy

Half of lifetime mental illness starts by the age of 14, so emotional well-being is important to have in schools. www.shutterstock.com/Tom Wang

Support for emotional health in schools is increasingly being recognised as less of a nice add-on and more of an essential practice. Research shows that school-based activities have a big role to play in supporting the mental health of primary school children, and that emotional well-being and academic achievement go hand in hand.

Statistics now show that one in ten children have a clinically diagnosed mental health or behavioural problem and that half of lifetime mental illness starts by the age of 14. So the case for school-based activity in this area is mounting. This research is starting to feed through into education policy, as schools begin to understand their role in delivering a broad range of practice – beyond the focus on the cognitive side of education which has taken precedence in the past.

However, trials which have attempted to roll out well-being programmes in schools have demonstrated that supporting young people’s emotional health is a more complex task than first thought.

Mixed results

School-based programmes to support child emotional health range from targeted help for individual pupils with identified difficulties – such as cognitive behavioural therapy – to approaches that aim to improve social and emotional learning for all, such as the PATHS (Promoting Alternative Thinking Strategies) programme.

Various studies and some schools have reported promising results from these types of programmes yet, overall, school-based cognitive behavioural therapy trials and other similar interventions have failed to show sustained positive effects on symptoms of anxiety and depression among children.

Likewise, two recent trials of the highly acclaimed PATHS programme – which promotes emotional and social competencies and aims to reduce aggression and behaviour problems at the same time as enhancing educational progress in the classroom – have arrived at disappointing conclusions in large numbers of UK schools. One found no evidence of sustained effects on behaviour or well-being, while another showed a somewhat mixed pattern, sometimes in favour of PATHS schools but sometimes in favour of the control schools.

Mental healthcare in schools needs to come from an integrated approach rather than be an afterthought. www.shutterstock.com/Sergey Nivens

Given the current evidence, it appears there is no guarantee that introducing programmes such as these will generate positive and sustained impacts for children. But what then can be done to help our children grow into emotionally healthy adults? The answer lies in an integrated, embedded approach to learning.

A question of implementation

There are a range of factors that could influence when, and in what contexts, programmes to support emotional health are likely to be most successful. The main issue here seems to be implementation: to roll out and scale up even theoretically sound and well-researched programmes to large numbers of schools is already a challenge, and even more so in the face of the everyday constraints and pressures in education.

Our latest report into supporting the emotional health of children in primary schools highlights that while school programmes can sometimes be effective, school systems need to be strongly connected with each other in order to translate research evidence into sustained positive impacts. A large number of programmes are now available to schools, but the real-world success of intervention and prevention efforts cannot be attributed to any given programme per se – success is found in the way a programme is put into place within this integrated school systems approach.

To put it simply, emotional health needs to become a core part of all school matters, and not be just another competing priority.

This is easier said than done, however. At present, there is no established evidence base to inform practitioners and policy makers about how well-being programmes, the curriculum, staff and external professionals are coordinated to maximise the emotional health of primary school children. If efforts to support child well-being are connected with wider school visions then work on emotional health must be viewed as lying at the core of effective teaching and learning in the future.

Our report calls for exploratory work with small numbers of schools, working with expert support and national level support to test a framework that could inform activity across the school system as a whole. Only then can we really begin to address how to best support the emotional health of our children in schools.