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Access to school mental health services improving, but challenges remain

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Published: 09 February 2023

The 'Trailblazer' programme, which aims to support children and young people’s mental health, has had a positive impact. That's according to a newly-published study funded by the NIHR.

Trailblazer funds the creation of mental health support teams (MHSTs) for schools and colleges. A national programme, it aims to improve early intervention and access to support. It also promotes good mental health and wellbeing for all children and young people. It is jointly led by the Department of Health and Social Care, the Department for Education and NHS England.

The first MHSTs began delivering services in England in January 2020. They work in schools and colleges, helping staff promote emotional wellbeing for pupils. Their work helps them to build resilience and learn coping techniques and strategies. 

They also support young people with mild to moderate mental health problems. This may be through tailored one-to-one and group activities. By April 2023 the aim is to have created around 400 teams. They will support approximately 3 million 5- 18-year-olds.

The new study covered Trailblazer’s first 3 years. Researchers examined the set up and delivery of MHSTs in the first 25 areas set-up across England. Their analysis, published in the NIHR Journals Library, includes:

  • survey data from close to 300 schools and colleges 
  • interviews with 132 people involved in implementing MHSTs 
  • focus groups with children and young people

It showed staff felt more confident talking to young people about mental health. Advice and support was much easier and quicker to access. It also led to stronger relationships between staff from different settings. This helped to speed up referrals and the ease of arranging multi-agency meetings. 

Children and young people expressed how important they felt having someone to talk to about mental health was. They highlighted how they felt their concerns were listened to and staff would be able to help them. They mentioned how learning techniques helped them cope with stressful situations. They also highlighted how this helped them manage difficult experiences and feelings.

Concerns for some individuals and conditions

The study also highlighted challenges in Trailblazer's first 3 years. These included supporting children with more specialist needs and staff retention. 

Concerns were raised about the suitability of cognitive behaviour therapy approaches for some individuals and conditions. Cultural and language barriers were among the challenges highlighted with this type of treatment. Schools and colleges welcomed investment in ‘in-house’ mental health support. Some felt frustrated MHSTs focused only on ‘mild to moderate’ mental health issues. 

Another challenge was achieving a balance in the different types of service offered. Researchers found practitioners often spent most time supporting children with mental health problems. This was as opposed to working with colleagues to promote good emotional health. 

Commenting on the analysis of Trailblazer’s first 3 years, lead researcher Dr Jo Ellins, from the University of Birmingham, said: “Overall, children and young people who had contact with an MHST reported an overwhelmingly positive experience. Mental health services in schools and colleges are facing increased pressure, particularly following the pandemic, and the programme has significant potential. But teams may find it difficult to sustain activities focusing on promoting wellbeing, given the increasing demand for mental health support.”  

Professor Nicholas Mays from the London School of Hygiene & Tropical Medicine, a co-author of the report, added that: “Our findings suggest that the gap between the support that MHSTs are providing and the criteria for accessing specialist help may be widening as a result of the Covid-19 pandemic. Schools and colleges in particular were concerned about the lack of available support for children and young people whose mental health needs fell between these services.” 

Mental Health Minister Maria Caulfield said: “It’s encouraging to see that Mental Health Support Teams are having a positive impact in schools, giving staff more confidence, improving access to advice and support, and strengthening relationships between schools and mental health services.

“This research shows there is room for improvement which I hope will be taken onboard as the number of Mental Health Support Teams will increase to almost 400 by April 2023. These will cover three million children and young people – part of an extra £2.3 billion a year investment into mental health services.”

The analysis of the Trailblazer programme was funded by the NIHR’s Health and Social Care Delivery Research Programme. The study was undertaken by the Birmingham, Research and Development (RAND) and Cambridge Evaluation (BRACE) Centre. Also involved were the Policy Innovation Research Unit (PIRU). Other partners included:

  • London School of Hygiene & Tropical Medicine
  • RAND Europe
  • The Primary Care Unit, University of Cambridge.

For more information about the study, please visit the NIHR website.

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