Broader community services
Schools are in an ideal position to identify children who need early help. They can de-escalate emerging mental health problems and provide early support to those who are struggling, through school-based assistance or counselling.They can also work in partnership with other local organisations as well as with specialist CAMHS to reduce the risks to children’s mental health and wellbeing.
When considering help for children with mental health difficulties, schools need to think more broadly than specialist CAMHS (Child & Adolescent Mental Health Services) who are typically only able to meet the needs of 2% of children. It is this broader local landscape of support that this section of the site focuses on.
Getting to know your broader local community services
How services are provided to support children’s mental health in a local area will vary a great deal. It is therefore difficult to provide clear and prescriptive advice on what range of services schools might expect to find.
However, understanding and mapping your local service landscape is an important factor in planning and improving children’s access to support. Our section on carrying out an audit of services provides further information.
How one team introduced ‘speed dating’ to help schools understand the patchwork of local community services.
The school mental health and wellbeing team in North Lincolnshire organised a school ‘speed dating’ event between primary and secondary schools and a range of local statutory and voluntary sector organisations. This involved members of school staff joining tables hosted by local community-based organisations for five minutes to hear about what services did, how school staff might access them, how services might best support children in school, and even troubleshooting barriers to access. Community-based organisations who attended the event included local bereavement services, school nursing, specialist CAMHS, support for children with health problems, educational psychology, early help services, eating disorder services, local voluntary sector support, counselling, coaching, complex behaviour teams, parent and family-based support etc. This event helped schools understand their referral options better and created a central bank of information of local organisations who might support children’s mental health, wellbeing and learning in school.
Understanding your local landscape of support – some starting points
It’s important to consider the range of health, social and voluntary sector service providers.
- Is there a local central gateway (e.g. a single point of access) through which you refer all children if you have mental health concerns? These arrangements can help schools understand and build up knowledge on who locally might support different levels of need.
- Does your local area already have a directory of services supporting children’s mental health and wellbeing? Some do, but not all schools know about these listings.
- You should also refer to your local Transformation Plan (see our section on influencing commissioning for more information) as it provides an overview of children’s needs, of local priorities, plans for improvement and of how needs will be met. Schools should know how they can influence their local Transformation Plan and make sure that their data and local knowledge of gaps feeds into the process.
Understanding your local landscape of support – other services to consider
- The Youth Wellbeing Directory: a national database that provides a list of local organisations supporting mental health and wellbeing for anyone up to the age of 25. Contact details are provided as well as the age range the service caters for. If you know of services that are not listed, let your local commissioners know so that they can keep it up-to-date.
- The local SEND offer: a lot of the work completed by your local authority and by schools on the local SEND offer will also be relevant for mapping and understanding support services for children and young people’s mental health. Make sure you build on the information you have already collected.
- School nursing health profiles: as part of the action plan produced by school nurses to support local needs, they are required to ‘provide a comprehensive overview of services provided locally for children and young people’. This overview offers a useful building block for schools to map, update and understand local support services and pathways.
- School-based mental health teams: some local areas have introduced new school-based wellbeing workers as a result of local ‘transformation’ improvements (see our case study on school involvement in a local needs assessment). If you have these teams in your local area, they should be a useful resource for meeting children’s needs in your school as well as a reference point for helping to navigate the system. The recent (2017) government green paper ('transforming children and young people's mental health provision') has recommended testing out the introduction of mental health workers in schools to improve support for those who need help.
- This website: includes a range of national support helplines and resources to help school staff, children and families get the help they need. Helplines provide short-term advice, signposting and support which can help a worried parent/carer or child develop strategies and think about what to do next. There are key resources for children and families at the end of each section in both risk and protective factors and mental health needs.
- Parent support: find out who delivers evidence-based parenting support in your local area (e.g. Triple P, Incredible Years or FAST). On the whole this type of service, rather than school counselling, will have the best chance of facilitating change when children have severe and persistent behavioural difficulties in some areas, these programmes are also used as a first-line response for families of younger children with suspected or diagnosed ADHD. There is no national database of provision but health visitors are most likely to know about provision in your local area.
- Community paediatricians: these are patchily available across the country. Are there any in your local area? If so, what age range do they engage with and how do you access them (usually via school nurses)? These professionals can advise and support primary school-aged children with a range of difficulties including ADHD or autistic spectrum disorders.
- Early help teams: is there one in place? What they do varies from area to area but generally it involves providing earlier, coordinated and effective support to children, young people and their families to help them with problems when they start and before they become a serious issue. Find out how you can refer children for support and how you might best promote a family’s engagement (perhaps via your local authority children and family services, GPs, school nurses, CAMHS liaison worker or the troubled families team).
- Voluntary sector/charities: what other support do you have in your local area for children facing multiple or increasing risk factors (e.g. peer mentoring, young carers groups, community counselling, bereavement support etc.)?
- Parent/carer mental health: do you have clear referral pathways to local adult mental health services to support parent/carer mental health?
- Online counselling:
- Do you have online counselling available in your local area? (e.g. organisations such as Kooth – these services are mainly targeted at children in KS3 and beyond).
- Do you know about national helplines and self-help tools (e.g. Childline, YoungMind’s parent helpline) for children and for their families? These are not long-term solutions for children’s and families’ needs but can offer advice, self-management strategies and help children while they are waiting to access local support. Details of these services are included in the resources below.
- Specialist eating disorder services: Local Transformation activity has also led to the development of specialist eating disorder services for children and young people who have an escalating risk of an eating disorder. While young men and women aged 13 to 17 are most at risk, eating disorders can develop at any age, including in childhood.
Deciding which services to approach
School leaders and school staff often struggle to decide which service might best support a child needing help. School leaders should not make these decisions alone.
In areas where there is a single point of access (a specialist CAMHS advice line or a school-based mental health worker who can complete an initial screen of children’s needs), you can get important advice and support from a professional trained in identifying the right help for children and families. But such resources don’t exist in all areas.
It is also worth remembering that even when a child is deemed unsuitable for specialist CAMHS it is best practice, if a child does not meet their criteria, for the CAMHS team to make suggestions about who else might be able to help.
If a child is struggling, it is useful to work in partnership with parents/carers to problem-solve what support might best meet a child’s and family’s needs. This could be done by encouraging parents/carers to complete a Strengths and Difficulties questionnaire. This is not a diagnostic tool but can help pinpoint where there are difficulties and how severe a child’s problems might be. It provides useful additional information to draw together, in combination with school staff, child and parent/carer observations, to make sense of how children might be struggling.
This may then indicate what might have the best chance of helping a child move forward: e.g. parenting strategies (if difficulties are based around behaviour) or school counselling or community support for emotional difficulties, or a referral to specialist CAMHS where problems appear complex, severe and numerous. A completed SDQ also creates evidence and a shared language with other professionals which can support the referral process.
Integrating local activity
Because children’s mental health is seen as ‘everyone’s business’, the landscape supporting children’s mental health and wellbeing often involves a very wide range of support services and can feel confusing to navigate and fragmented for parents/carers, children and non-mental health specialists. There have been many attempts to create an overarching framework to more effectively describe how the system works and to identify the different roles and responsibilities of all organisations working to support children’s mental health. Some of these different approaches are explained in more detail in our guide to whole-system frameworks.