The background: mental health in school aged children and young people
A BBC article from the beginning of the academic year highlighted the long waits that children who have been referred to Child and Adolescent Mental Health Services (“CAMHS”) across the country are having to endure. The article quotes information obtained by the BBC under the Freedom of Information Act from 46 of England’s CAMHS services (half of the total) covering just over 250,000 under 18s showing that the data from April 2020 to March 2021 revealed:
- Half of those who were seen waited longer than four weeks
- A fifth waited more than 12 weeks
- The average wait was more than two months – although in some areas it was more than eight
Schools are often the first referrers of children into services such as CAMHS and social care, and the Covid-19 pandemic has exacerbated the need for such support. It is clear from NHS data published in September 2021 that the mental health of young people has deteriorated during the course of the pandemic. Rates of probable mental disorders have increased since 2017: it is now estimated that 1 in 6 children aged 6 to 16 (and the same proportion of 17 to 19 year olds) are affected by a mental disorder, representing an increase of roughly 6% since 2017. These children and young people were likely to also experience problems with sleep, eating disorders and to have missed more school than their peers who do not have mental disorders.
Ofsted’s review of the academic year 2020-21
The Ofsted Annual Report published on 7 December 2021 concluded that, particularly in mainstream schools, “pupils with SEND have been disproportionately affected by the pandemic”. Specialist support was difficult to arrange and deliver during the early lockdowns, with external professionals being limited as to how they could assess or work directly with pupils, and some therapists being redeployed to other areas and settings to support the Covid pandemic response.
Pupils with Education, Health and Care Plans (“EHCPs”) were encouraged to attend school during the periods of lockdown, but school attendance was not an option for those pupils who had SEND but no EHCP. Of the pupils that were able to attend school, many did not due to a variety of factors such as the anxiety of the pupils themselves and/or their parents, difficulty accessing transport, a lack of support and access to specialist services in school, and high rates of Covid-related staff absence. Provision of remote education during lockdown varied significantly, and the Ofsted report states that:
“In our remote education work, we found that 59% of parents of a pupil with SEND said that their child had disengaged from remote education (20 percentage points more than those without SEND)”
The uncertainty of GCSE and A Level exams meant that pupils in Years 11, 12 and 13 were more anxious and stressed than previous classes at the same stage in their education[1].
In addition, local area SEND provision has long been a real challenge since the introduction of the 2014 SEND reforms, with just over half of the local authority areas inspected showing significant weaknesses and being required to produce a written statement of action (“WSoA”). 7 out of 8 local areas inspected by Ofsted and the Care Quality Commission during the last year required a WSoA. As a result of the pandemic many in-person services were cancelled or reduced, having a detrimental effect on families. The Ofsted report notes that:
“As a result, some parents and carers reported that children had regressed in communication skills and wider learning. In several areas, access to child and adolescent mental health services was a particular concern. The lack of services overall left some parents and carers feeling isolated, exhausted or unable to fill gaps in support. Without access to their usual services, some children and young people with SEND were left in pain, immobile or unable to communicate properly.”
Where does this leave schools?
The effects of Covid have been far reaching for children and young people, particularly those with SEND. As the NHS data and Ofsted report have shown, the mental health of young people after nearly two years of turbulent education and extended periods of school closure is of particular concern. This can manifest in pupils in a variety of ways, for example increased anxiety, absenteeism, challenging behaviour, and communication difficulties. Schools should be familiar with the Department for Education’s guidance on Mental Health and Behaviour in Schools and the whole school approach to promoting mental health and wellbeing strategy produced by Public Health England and the Department for Education.
Alongside trying to secure external support, advice and appropriate provision for pupils with mental health needs, schools need to be aware of their responsibilities both in terms of managing SEND but also their duties under the Equality Act 2010 as well. This is often overlooked when school staff and leadership teams are focussed on managing incidences such as challenging behaviour and persistent absence, yet school leaders should keep in mind that pupils who are excluded as a result of their behaviour are very likely to have some degree of SEND, whether or not this has been recognised and/or diagnosed[2]. It is very clear in both the SEND Code of Practice and the Department for Education’s Exclusion Guidance that schools have a duty to consider whether there is any underlying SEND in cases where a pupil repeatedly displays challenging behaviour. There is a very real threat of schools receiving disability discrimination claims if parents believe that a disabled pupil has been unfavourably treated as a result of their disability.
We have advised on a significant number of exclusions in all settings since the start of the year. In addition, many primary schools are grappling with issues linked to behaviour and SEND on a scale many of them have not encountered before. Please do reach out to our SEND experts for support if this is an issue affecting your school.
Schools are also often faced with situations where staff are concerned about the wellbeing of a pupil in the context of potential mental health and wellbeing needs of parents and carers. In these circumstances, it is important for all school staff (regardless of whether they have direct contact with children or not) to be aware of their safeguarding obligations set out in Keeping Children Safe in Education and to follow the school’s safeguarding policies and procedures.
Post lockdown, we have also seen a marked increase in the level of complaints being made to schools by parents and carers, particularly over issues related to Covid mitigation measures such as mask-wearing and the use of hand sanitiser. It is important for schools to foster good relationships with the parent community, but also to recognise when it is appropriate to deal with issues such as complaints in a more formal, structured manner in line with the school’s policies and procedures.
For further advice and support in managing SEND, safeguarding or parental complaints, please contact the School Support Service at schoolsupport@wslaw.co.uk or on 0345 070 7437
[1] Teacher Tapp research, March 2021, as quoted in the Ofsted annual report
[2] See our previous article on SEND and exclusions