New mental health support teams in schools and colleges have achieved a great deal, but gaps in children's mental health provision remain
The BRACE Rapid Evaluation Centre and Policy Innovation and Evaluation Research Unit – both funded by the National Institute for Health Research (NIHR) – have published initial findings from an early evaluation of the government’s Children and Young People’s Mental Health Implementation Programme.
The Programme was launched in December 2018 to improve mental health prevention and early intervention for children and young people with mild to moderate mental health problems. Led by the Department of Health and Social Care, Department for Education and NHS England and Improvement, the programme is funding the creation of mental health support teams, which work with staff in schools and further education colleges to promote mental health, and provide support to children and young people in their place of education. The early evaluation is following the experiences of the initial group of mental health support teams, which are based in 25 areas across England (called Trailblazers) and work with more than 1000 schools and colleges.
Survey and interview data collected between November 2020 and March 2021 showed that mental health support teams had been well received by schools and colleges, many of which reported that they were seeing an increase in mental health problems – among pupils, parents and staff – as a result of the Covid-19 pandemic. As seen across children and young people’s mental health services generally, there was a sharp reduction in referrals to the teams in the early months of the pandemic. Teams quickly adapted to the challenges presented by Covid-19, primarily by switching to supporting children and young people remotely via the telephone, internet or digital platforms. The study findings suggest that mental health support teams will continue to provide some support remotely after the pandemic, but alongside face-to-face consultations.
Practical problems were also described. Some schools and colleges reported that the mental health support teams were not able to help some of their children and young people who were most in need of support. This particularly related to children whose needs were greater than ‘mild to moderate’ (the group that the teams were designed to serve) but still not deemed serious enough to meet the referral criteria for specialist mental health services. Schools and colleges raised concerns about this group of children and young people falling between gaps in local provision.
The Programme introduces a new role in the mental health workforce, the education mental health practitioner. The education mental health practitioner role and national training programme were popular, but retaining staff once in post was more challenging. The early findings suggest that the education mental health practitioner role might be seen as a stepping stone to other jobs in mental health and that more attention needs to be given to creating career development opportunities within the teams to avoid high staff turnover.
The lead researcher, Dr Jo Ellins from the University of Birmingham, commented: “Mental health support teams have had to establish themselves and start building relationships with schools and colleges, and children and young people, in the most challenging of circumstances. Our initial findings identify a widespread view that they have achieved a great deal in a relatively short space of time. However, our early findings suggest that the types of support that teams are typically providing may not be effective for all children and circumstances. This is something we want to explore further in the next stage of fieldwork.”
Professor Nicholas Mays from the London School of Hygiene & Tropical Medicine, a co-author of the report, commented that: “Our findings suggest that mental health support teams are already having some early positive impacts. Many Trailblazer sites told us that local partnership working was improving, and that relationships were being built or strengthened between the NHS and education system in their areas. Schools and colleges also reported some positive impacts already including staff feeling more confident talking to children and young people about mental health issues; being able to access advice about mental health issues more easily; and quicker access to support for children and young people with mental health problems.”
A final report from the evaluation will be published in the summer of 2022. This will include the findings from in-depth interviews with mental health support team staff and focus groups with children and young people in Trailblazer sites.
The authors of this study are Jo Ellins, Kelly Singh, Mustafa Al-Haboubi, Jenny Newbould, Lucy Hocking, Jenny Bousfield, Gemma McKenna, Sarah-Jane Fenton and Nicholas Mays.
Read the full report
Read a summary of key findings
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More information on the Children and Young People’s Mental Health Implementation Programme and details of the 25 Trailblazer sites (and the areas involved in later waves) can be found on the NHS website.
The University of Birmingham is ranked amongst the world’s top 100 institutions. Its work brings people from across the world to Birmingham, including researchers, teachers and more than 6,500 international students from over 150 countries.
The Birmingham, RAND and Cambridge Evaluation (BRACE) Centre is funded by the National Institute for Health Research’s (NIHR) Health Services and Delivery Programme to conduct rapid evaluations of promising new services and innovations in health and social care. It is a collaboration between the University of Birmingham, RAND Europe, the University of Cambridge and National Voices.
The Policy Evaluation and Innovation Research Unit (PIRU) is a collaboration between the London School of Hygiene & Tropical Medicine, the Care Policy and Evaluation Centre (formerly PSSRU) at the London School of Economics and Political Science, and Imperial College London Business School. It is funded by the NIHR's Policy Research Programme principally to evaluate innovative policies and programmes across health services, social care and public health in England.
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