Spotting Mental Health Needs in School

Teachers and support staff see pupils every day, often for longer than anyone outside the family. That puts school staff in a good position to notice when something changes. It does not make them mental health professionals, and this article does not ask you to become one.

What follows is practical guidance for noticing, listening and passing concerns on through your school’s systems in England. It is not clinical advice. If you are worried about a pupil, follow your school’s procedures and speak to the relevant lead.

What your role is, and is not

Keeping children safe in education, the DfE’s statutory safeguarding guidance, says that only appropriately trained professionals should attempt to make a diagnosis of a mental health problem. It also notes that school staff are well placed to notice changes in behaviour that might point to a mental health problem, or to a risk of developing one.

Your role is to notice, to listen, to record what you see and to pass it on. Labels such as “depressed”, “anxious” or “has an eating disorder” are for clinicians. In your notes and conversations, describe what you have observed.

The same guidance makes a link between mental health and safeguarding. Where a mental health concern is also a safeguarding concern, act on it immediately, following your school’s safeguarding policy and speaking to the Designated Safeguarding Lead.

Early signs to notice

No single sign means a pupil has a mental health need. What matters most is change, and patterns over time. Things staff often notice include:

• withdrawal from friends, or a change in friendship group
• loss of interest in things the pupil used to enjoy
• tiredness, or comments about not sleeping
• a drop in the quality of work, or difficulty concentrating
• more frequent absence, lateness or requests to leave lessons
• irritability, tearfulness or outbursts that seem out of character
• changes in eating, or in appearance and self-care
• comments about feeling worthless, hopeless or a burden
• physical complaints such as headaches or stomach aches with no clear cause

Some pupils hide distress well. A pupil who is always cheerful and helpful can still be struggling. Pupils with SEND, including autistic pupils, may show distress in different ways, and their usual presentation may already differ from that of their peers. Knowing the pupil’s baseline helps, which is one reason form tutors and TAs who see a pupil often are so valuable.

In a computing lesson you might notice a pupil who used to finish tasks quickly now staring at a blank screen, or someone who keeps their camera or screen turned away from others. Record observations like these even if they seem minor.

Listening well

If a pupil comes to you, or you decide to check in, a short and calm conversation can help a great deal.

Choose the moment

Find somewhere private but visible, not a locked room. Side-by-side conversations, such as walking somewhere together or tidying the classroom, can feel less intense than sitting face to face.

Open the door

Keep it simple and low pressure:

• “I’ve noticed you seem a bit quieter this week. How are things?”
• “You don’t have to talk about it, but I’m here if you want to.”

Listen more than you speak

Let the pupil finish. Silences are fine. Reflect back what you hear (“It sounds like things at home have been really tough”) and avoid rushing to fix the problem or minimise it. Phrases like “Everyone feels like that sometimes” are meant kindly but can make a pupil feel they have not been heard.

Be honest about what happens next

Do not promise to keep what they tell you secret. If what they share raises a safeguarding concern, you will need to pass it on, and it is better that they know this from the start. Explain who you will talk to and why.

Write it down

Afterwards, record the conversation using your school’s system, with the date, what you observed and the pupil’s own words where possible.

Making a referral through your school’s pathway

Each school organises mental health support differently, so learn your own school’s pathway. It usually starts with the form tutor, head of year or pastoral lead, and may involve the SENCO, the school nurse, a counsellor, or the senior mental health lead.

The senior mental health lead

The 2017 green paper “Transforming Children and Young People’s Mental Health Provision” proposed that schools and colleges in England be encouraged to identify and train a designated senior lead for mental health. The DfE has since funded training for this role. The senior mental health lead oversees the school’s whole-school approach to mental health and wellbeing and coordinates support and referrals. They are not usually a clinician, and they will not diagnose.

Mental Health Support Teams

The same green paper proposed Mental Health Support Teams (MHSTs), which are now in place in many schools and colleges in England. They are linked to NHS children and young people’s mental health services and often include education mental health practitioners. MHSTs offer early support for children and young people with mild to moderate needs, such as some anxiety and low mood, and help schools build their whole-school approach. Referrals usually go through the school’s mental health lead.

Not every school has an MHST, and what each team offers varies by area. Your senior mental health lead or pastoral team will know what is available locally and when a referral to specialist NHS services, usually via a GP or the local children and young people’s mental health service, is more appropriate.

If you think a pupil is at immediate risk

If a pupil talks about suicide or self-harm, or you believe they are at immediate risk, do not leave them alone and get help straight away from the DSL or a senior colleague, following your school’s procedures. In an emergency, call 999.

Looking after yourself

Supporting pupils through difficult times can affect the adults around them too. It is common to carry worries home, especially after a hard conversation.

Some things that help:

• Talk to the DSL, mental health lead or your line manager after a difficult disclosure. You should not carry it alone.
• Keep to your role. You can care deeply about a pupil without being the person who solves everything.
• Notice your own signs of stress: poor sleep, irritability, dread on Sunday evenings.
• Use the support your school offers, such as supervision or an employee assistance programme.

Education Support is a UK charity that supports the mental health and wellbeing of teachers and education staff. It runs a free, confidential helpline that is open 24 hours a day. If you are worried about your own mental health, your GP is also a good place to start.

Further reading

• Department for Education. Keeping children safe in education (current edition).
• Department of Health and Department for Education (2017). Transforming Children and Young People’s Mental Health Provision: a Green Paper.
• Education Support (educationsupport.org.uk): helpline and resources for education staff.