Ms Sarah Stockham:

On behalf of Dorset HealthCare University and the Dorset Mental Health Support Teams in Schools, I am pleased to have been invited to make this opening statement to the members regarding the mental health support teams in schools, MHST, service we offer.

MHSTs involve a jointly funded approach through Health Education England, the Department of Education and NHS England to offer mental health support for all children in education, as well as supporting school and teaching staff through a whole-school approach. The teams were set up originally following the publication in 2017 of Transforming Children and Young People's Mental Health Provision: a Green Paper.

We know that, in England, one in six children or young people aged from five to 16 was identified as having a probable mental health problem, which is an increase over the previous estimate from 2017, namely one in eight. We also know that, based on data from 2018-19, 16% of 17-year-olds reported experiencing high levels of psychological distress, 24% reported self-harming, and 7% reported self-harming with suicidal intent. In a tutor group of 32, this equates to approximately five or six pupils per class who potentially could be open to services that fall under the wider child and adult mental health services umbrella.

There are currently just over 9 million children in education in England, which is an increase of 88,000 over the number in 2021. Some 3.5 million children and young people are accessing secondary education in state-funded schools. Based on the figures from NHS Digital in 2021, one in six of those children probably has a mental health problem. Therefore, approximately 595,000 children in English state schools meet this criterion.

MHSTs comprise a national project and are currently in their third year of roll-out. In the south west, of which Dorset is part, we have established teams across the region, and further expansions will be happening. We work with school-age children from reception years right up to 18 years.

The MHST has three specific core functions set out by the national team. These are to provide evidence-based interventions for mild to moderate emotional and mental health issues using low-intensity approaches in a one-to-one setting with children, young people or their parents or carers; to support the designated mental health lead in each school to introduce and develop a whole-school approach to emotional well-being; and to give timely advice to school and college staff, signposting and liaising with specialist services to help children and young people get the right help and support at the right time.

Each service we have in Dorset has a clinical or service lead; a team lead; a supervisor practitioner; a counsellor; a mental health practitioner in a core profession such as nursing, occupational therapy or social work; and education mental health practitioners. Depending on the sizes of the teams, the numbers vary, but the expectation is that each team of four education mental health practitioners and one supervisor will cover a population of approximately 7,500 children.

The benefit of the programme is that it is developing a new and skilled workforce from people who may not have traditionally entered healthcare work. To qualify as an education mental health practitioner, people must complete a year-long course run by one of the accredited universities in the UK. The prerequisites are that they need to have evidence that they have studied previously at degree level and evidence of having worked with children and young people. In the south west, this training is provided by the University of Exeter, where the education mental health practitioners qualify with a postgraduate diploma in mental health practice in education settings. They attend university full-time for the first three months. Then they spend two days in practice and the remainder at university. Over the remaining year, the time spent being taught is reduced such that by the end of the course, the students are working within the services full time and are completing assignments based on competencies.

The mental health practitioners are supervised weekly in both individual and group settings, and this is key to the model. They are supported by dedicated supervisor practitioners who have also completed a further year of specific supervisor training at university to ensure they can support these practitioners. All other practitioners are supervised monthly in line with their professional registrations.

This qualification enables the mental health practitioners to practise low-intensity cognitive behavioural therapy interventions for children or young people, or their parents, to address mild to moderate mental health needs, such as low mood, anxiety or panic. The aim of the service is to provide preventative support at the first sign of a young person displaying a change in his or her emotional state. Education mental health practitioners work within a model of the child and young person that recognises both the effects of adversity on children and the limits of their autonomy.

We offer core interventions such as psychoeducation. This is to be able to provide evidence-based information and psychoeducation to young people, parents, carers and education staff. Also offered are peer mentoring, which focuses on interpersonal relationships and well-being in respect of mental health; training others, the objective being to support structured workshops and training, based on principles of cognitive behaviour therapy, to help children, young people, parents and carers; and classroom skills. We also offer consultation to education staff, which relates to common problems children and young people experience, group work, and parenting groups.

The whole-school approach is an integral part of the MHST model and moves away from providing only one-to-one interventions. This improves the accessibility of mental health, emotional and well-being supports in a universal manner. The approach enables many more children and young people to access mental health information and support.

Within the whole-school approach, we also offer consultation or signposting; whole-class interventions; staff stop-and-think sessions, which entail individual reflective space using a cognitive behavioural therapy framework for teachers to access support; staff training; and support in developing well-being or behaviour policies.

We also offer an audit and resources.

The educational mental health practitioner, EMHP, title, along with other qualifications, will soon be accredited with a registered body, thereby giving these staff a protected title. In order to be accredited, completion of a recognised and registered course will be required, as will key performance indicators, a required number of clinical hours and ongoing continuing professional development. This is due to be launched in January 2023.

I am excited that this model to support the mental health of children and young people is being considered as a possible approach within Ireland. I thank the committee for inviting me to appear before it. I will be happy to take any questions.