Health Needs – Mental Health
We are seeing an increasing number of children and young people with mental health needs that are impacting on their ability to access school and on their learning. Even where there is no known existing condition, anxiety can be a significant barrier to their learning and accessing their school environment.
Whilst this page touches on what can be done to support mental health issues in general, our main focus will be within the context of ‘school attendance’ and therefore whose duty it is to offer support and what this might look like.
Is Mental Health covered under SEN – Recap.
As we saw on our linked page Medical Needs – Physical and Mental Health, a child or young person’s mental health could meet the criteria for disability under the Equality Act 2010 or perhaps, if their need requires special educational provision, then it would meet the criteria for SEN (under the SEMH area of need). Either way the school and LA have certain duties to make sure suitable support is in place (even if that is through reasonable adjustments, SEN Support, alternative provision or through the request of an EHC needs assessment).
Even where a child’s mental health does not meet with SEN or disability criteria, there is still an expectation on schools to offer support as set out in the non-statutory guidance ‘Summary of responsibilities where a mental health issue is affecting attendance‘. It is worth noting that this guidance applies to any pupils displaying any social, emotional or mental health issues that are affecting their attendance, not just those who have a diagnosed mental disorder, a disability or a special educational need.
We would suggest checking whether your child’s or young person’s mental health meet the criteria for either SEN, Disability or both. If both, then go in the direction of seeking SEN Support (but remind schools and LA of their duty to support disabilities).
So where do we start?
Mental health issues can be very complex and can be as a result of differing factors. Often families and schools are taken by surprise at how quickly the situation has deteriorated and it is therefore vital that as soon as you are aware of any difficulties and issues, concerns are raised and help is sought.
Sometimes it can be obvious why a child or young person cannot attend school (for example, they are needing treatment) but sometimes it may be that a child or young person does not want to go to school and there is no seemingly, obvious reason. Most of the advice for the first example is in our Medical Needs – Physical and Mental Health page.
However where a child or young person is avoiding school on a regular basis, this is generally known as generally known as EBSA. Please look at our EBSA page for more information around this.
Responsibilities
As well as health professionals there are 3 main groups of people who will have some responsibilities where attendance at school is being affected. Lets take a look.
As we highlighted in our School Attendance page, parent/carers have a duty, under section 7 of the Education Act 1996, to ensure that their child of compulsory school age (5 to 16) receives an efficient full-time education either by attendance at school or otherwise. They share in the responsibility of ensuring good and regular attendance.
As soon as you think there may be an issue with your child or young person with attendance, arrange to speak with the school and share your concerns.
Guidance says that parents/carers and schools should be encouraged to be open and work together to create a plan for attendance that fits with the needs of the child. Schools need to work with parent/carers and pupils to understand the barriers to their attendance and, where appropriate, make reasonable adjustments to overcome those specific barriers in an effective way of building confidence and reducing anxiety about attending.
Only medical professionals can make a formal diagnosis of a mental health condition. However, children or their parent/carers can inform the school of a suspected mental health difficulty. They do not necessarily need to have a particular condition but you can explain that they have experienced a series of symptoms that you feel is affecting their quality of life. Where possible is it is helpful for the child or young person to voice their experiences themselves.
On the flip side parent/carers should engage with support offered by the school, and will be reminded of the importance of regular attendance and the emotional and mental wellbeing benefits of attending school for children and young people. You should feel reassured that the school has a plan for your child, and parent/carers should feel supported in their responsibility of ensuring the child’s regular attendance at school.
Any reasonable adjustments or support put in place by schools should ensure that the time the child or young person spends in school is prioritised as much as is possible, always considering their particular needs.
In some instances, parent/carers themselves might be living with mental health problems or experiencing wider vulnerabilities or challenging life circumstances. This may affect their ability to provide support and care, and so it is important to recognise the need for practical, whole-family support and/or early help support where necessary, in order to try to address the causes of poor attendance. For example, where applicable, the family’s support worker might act as an instigator or organiser of any additional support offered and is a key party to join any conversations about a child’s attendance.
The DfE guidance “Working together to improve attendance” outlines the expectations of school in regards to attendance and state schools should, for all pupils:
- Develop and maintain a whole school culture that promotes the benefits of high attendance.
- Have dedicated senior leaders championing attendance.
- Have a clear school attendance policy which all staff, pupils and parents understand.
- Accurately complete admission and attendance registers and have effective day to day processes to follow-up absence.
- Share information and work collaboratively with other schools in the area, local authorities, and other partners when absence is at risk of becoming persistent or severe.
School staff are not expected to diagnose mental health conditions or perform mental health interventions, but they are expected to work to ensure regular attendance for every child, as per this guidance. This means schools have a responsibility to look at the barriers to attendance, make suitable adjustments where needed, and review these regularly. This is more than just telling a parent that their child or young person must be in school and leaving the duty solely with the parents to sort out.
Teachers within schools are well placed to observe children day-to-day and identify behaviour which suggests that the child may be suffering from a mental health problem or be at risk of developing one. Although the government is seeking to educate teachers on mental health difficulties in children and young adults; teachers are not professional psychologists so teachers are not under a duty to identify mental health difficulties.
Broadly speaking, the role of school staff is to ensure that the school is a calm, safe, and supportive environment where all pupils want to be and are keen and ready to learn, which is the foundation of securing good attendance.
Generally, schools will achieve this by promoting children and young people’s mental health and wellbeing through a whole-school approach to pupil mental health, and by developing a trusted relationship with parents/carers and families that involves them in the conversation about the school’s ethos, and emphasises the importance of supporting mental health and regular attendance.
The Department for Education (DfE) encourages schools to identify a senior mental health lead who will have strategic oversight of their setting’s whole school approach to mental health and wellbeing.
In developing a plan to support attendance through reasonable adjustments, school staff will need to take into account the individual circumstances of the child, being mindful of safeguarding responsibilities as set out in the ‘Keeping children safe in education’ 2022 guidance.
Where support is offered but parent carers and/or pupil has not engaged with it, or where all other options have been exhausted or deemed inappropriate, schools should work with LAs to consider whether to formalise support or to enforce attendance through legal intervention in the normal way under their existing powers.
Again, this should not be a case of ‘you haven’t agreed with what we have offered so now we will just fine you’ but exhausting all other options first.
Summary of responsibilities where a mental health issue is affecting attendance (Feb 2023) Support for pupils where mental health is affecting attendance: effective practice examples
According to the DfE’s Summary of responsibilities where a mental health issue is affecting attendance (Feb 2023):
- Schools should inform the LA where pupils are likely to miss more than 15 days.
- Schools should work with the family to provide educational provision (whilst determining with the LA whether alternative provision should be provided under section 19 of the Education Act 1996, as outlined in statutory guidance).
- LAs must not follow an inflexible policy of requiring medical evidence before making their decision about alternative education.
- LAs must look at the evidence for each individual case, even when there is no medical evidence, and make their own decision about alternative education.
- No pupil should be left without educational provision.
Parents/carers may submit a complaint to the Department for Education where they do not feel the LA has acted in accordance with the School Attendance Parental Responsibility measures guidance.
The Local Government and Social Care Ombudsman (LGSCO) are seeing increasing numbers of cases where children are unable to attend school because of anxiety. Often, these cases involve children with Special Educational Needs (SEN) which have yet to be fully understood. There may be little, or even conflicting evidence about the child’s needs. Nevertheless, the Ombudsman is clear in saying councils must assess the available evidence and decide for themselves whether they have a statutory duty to make other arrangements for the child’s education.
Remember: Where a child or young person is not able to attend school because of their health needs (mental or physical) it is the local authority which has the duty to arrange alternative education, not the school Even though in reality, this may mean that the LA request the school to arrange and fund it.
If your child is out of school because they are unable to attend due to health needs such as illness or anxiety, then you can request the LA arrange alternative education.
Education must be provided as soon as it is clear that your child will be away from school for 15 days or more (whether these days have occurred one after the other, or at separate points over the school year), and at the latest by the sixth day of the absence.
If you are not sure whether your child or young person should be learning in person or remotely, you should discuss this as soon as possible with the medical professionals involved and the setting.
IPSEA have a very helpful letter template that you can use to do this. Click on this link and go to model letter 22b.
Further Information
Mental Health UK – advice for parents/carers.Advice for parents and guardians – Mental Health UK (mentalhealth-uk.org)
Reaching Families is a well established parent support group in Worthing, their details are here, if you’d like to see what they can offer: https://www.reachingfamilies.org.uk/
Hope Charity Project – The HOPE Charity Project has been set up to help families in Sussex and surrounding areas, who are worried or struggling to support their children suffering with their emotional health. We offer a very real, compassionate approach to providing advice, support, and comfort to the children, parents and siblings who are all affected by this growing nationwide problem. https://www.hopecharityproject.org/
The SID Youth – wellbeing mentors and workshops covering the Worthing, Adur and surrounding areashttps://www.thesidyouth.co.uk/services-we-offer-and-why
The Listening Ear Service by CONTACT – Emotional support, advice or ideas to help you cope. Appointments are free, confidential and over the phone with a family support adviser. The Listening Ear Service has daytime, evening and weekend appointments available, bookable online. https://contact.org.uk/help-for-families/listening-ear/
Anna Freud – https://www.annafreud.org/parents-and-carers/afc-crisis-messenger/ free text support but also a section for Parent/ Carers that may be helpful. Should we also include the link to spoon feed? Parents and Carers | Advice and Guidance | Anna Freud Centre
Well At School website – www.wellatschool.org Helping Children and Young People with Medical or Mental Health Conditions get the Best out of School
Not Fine In School is a parent/carer-led organisation set up in response to the growing number of children and young people who struggle with school attendance. – https://www.teamsquarepeg.org/not-fine-in-school
They Are The Future website , training and resources – https://www.theyarethefuture.co.uk/parenting-courses/
Minded is a free educational resource on children and young people’s mental health for adults, but can also be really useful for teenagers. It covers a wide range of topics including school refusal. www.minded.org.uk
Relate gives specific advice for different types of worries and problems aimed at young people including school refusal. www.relate.org.uk/relationship-help/help-children-and-young-people
Other Pages
For more information please click on the following page titles.
A look at EBSA including school and LA duties and various resources.
A look at what support could and should be offered and by whom.
The most frequently asked questions around mental health