As a member of the REACH Project Steering Group, a Kings College Study into Teenage Mental Health in Ethnic populations and a member or the McPin Foundation Priority Setting Partnership ‘Right People, Right Questions’ group, working to raise awareness in young people on the issue of mental health, I would argue that as a school we are ahead of the curve in not only our awareness of teenage mental health but how we manage it and support our vulnerable young people.
But the last 2 weeks have made me realise that teenage mental health in our schools is akin to the historic sexual abuse of children scandal, or the Rochdale grooming ring, in both its scale and catastrophic ‘knowing the problem is massive but an unwillingness or inability to know how to tackle or address it’. The statistics are staggering, 1 in 5 young people suffer from a mental illness, that’s 20 percent of our population but yet only about 4 percent of the total health care budget is spent on our mental health.
I don’t want to get into a political rant, as we all know that mental health in schools is appearing in soundbite form in manifestos. Similarly, this is not an attack on CAMHS or Social Services – we are all in this together but merely an off-load, a cathartic sharing to raise awareness of the realities that schools face day in and day out.
‘Young people need adults who notice them’
I was greeted on Monday, a fortnight ago buy a Year 9 student who we have referred to CAMHS for chronic self-harm, who is seen by the school counsellor, known to Social Services, you get my drift! She presented with a very specific suicide note, outlining her desire to end her life, at a train station on Tuesday.
Naturally, safeguarding systems kicked in and we attempted to triage the situation, informed the ‘Team Around the Child’ and invited parents in to collect her and agreed that they would take her to CAHMS via A&E as we felt this was an escalation and there was a real danger to her life.
She appeared in school the next day, as if everything was fine and on talking to her we discovered that her parents just took her home. We contacted CAMHS and Social Worker (why hadn’t parents done as we agreed and I am not convinced that the home is the trigger for the self-harm) as it was Tuesday and she was still very clear that she would end her life today. The self-harm increased during the school morning, despite colleagues being aware of the safety factors that needed to happen to safeguard her but with arms and legs bleeding she ended up in the care of our school nurse, who sat with her and contacted her CAMHS worker to seek advice.
At this point, she absconds and I now have a potentially suicidal, self-harming student, who has made a very clear threat to her own life, now non-communicative, hiding in a large building. Major problem. Fortunately, she was very quickly located as she is a creature of habit and secured.
Parents, CAMHS and Social Services were all called, as was my Safer Schools Officer and an Ambulance. We had a suicidal young lady making very real and visible threats to life. It was only midday. Ironically, the REACH Study were in school researching with student groups for the study and were shocked by the reality that schools face.
Eventually, ambulance service and police convene and we talk through the situation. A stand-off as no colleague wanted to entertain the discussion of ‘sectioning’ a 13 year old, self-harming, suicidal girl. I expressed concern about discharging to parents because of suspected abuse in the home and the fact that they didn’t engage with the care plan from the day before. The Social Worker was happy that this wasn’t the case. Stand-off.
In the middle of this, said Year 9 is non-communicative and scared. It was agreed that at 13, she didn’t need to have her parents travel in the ambulance with her, so a colleague did, because there was a trusting relationship, (after all, that’s we all do for our students) and she was taken to an CAMHS A&E appointment and I informed parents, who followed the ambulance.
Some days later, with a very bland care plan, further updating to risk assessment, NFA from Social Services and a future appointment later with CAMHS, the problem was solved!
A week later, a different student, self-harmer with a specific penchant to iron the inside of her legs, erupts with another student and potential fight ensues. Myself and colleagues were very quick to the scene and able to dissipate it but I have a very angry and strong young lady, completely out of control and harming herself and anything that got in her way, that I needed to safeguard.
Despite numerous warnings, I and another colleague take the decision to restrain for her own safety, as the damage she was doing to herself and the wall was escalating. At this point, slow motion and visions of 2 careers going down the drain but at least she was safe. We manage to calm and talk her out of the rage and ball of destruction that she was in. Other colleagues who have a caring relationship with her come and support and the scene ends in tears and a full break down.
I inform her mum, who we have been working with closely and she arrives and our fantastic school nurse tries to get hold of her CAMHS worker. A quick phone assessment later, she too is fixed and we put them both in a taxi home.
Now my point here, is that this is increasingly becoming the norm and not the exception. This isn’t because of a lack of in school services because as I said, we are ahead of the curve in our wellbeing provision. This is just what colleagues like me are doing day in and day out in our schools, because we ‘notice’ and we care.
This is why I liken this to the historic sexual abuse cases; everybody in every school knows that there is a mental health epidemic bubbling under the surface but there isn’t a strategy to tackle it. I don’t have the answer but I can tell you what it isn’t.
It isn’t just a money thing. Throwing money at CAMHS and Social Services isn’t going to solve the problem. Young people need people/adults to ‘notice’ them. They need adults who will commit and work with them and their families in enduring relationships.
They need continuity in their care and support. That is why we can hold it all together like ‘glue’ in our schools.
It is about building and sustaining enduring relationships and connections. It is about breaking down barriers and fear and building non-judgmental, trusting relationships with professionals that last and endure.
If we get this right, then maybe we can build a support network that will make a lasting difference. In the meantime, we just need to make sure that we keep ‘noticing’ and running through walls for our young people.