On May 8th 2018 I attended a Westminster Education Forum seminar where the topic of discussion was: ‘Next steps for child mental health in England – developing a multi-agency approach and provision in schools’. Attendees were invited to submit a short written contribution to be included in the seminar transcript publication. Here is my submission:
‘School refusal’ is a term commonly used to describe the reaction of children who experience severe anxiety and distress in relation to attending school, often resulting in prolonged absences. Children experience a range of psychological and physical symptoms, and in severe cases suffer with depression, self-harm and sometimes attempt suicide. School refusal is acknowledged as a multi-dimensional, dynamic and diverse emotional reaction, meaning each case is individual and complex to resolve.
All over the UK, families are struggling with children and young people who are severely anxious about school. Their anxiety often relates to the constant academic pressure of current education assessment policies; of reaching expected attainment levels; or to a lack of effective provision for special educational needs – all creating school cultures and environments that damage mental wellbeing.
Thousands of children are missing out on both an education, and treatment for their mental health difficulties. They become depressed, self-harm and sometimes suicidal, yet schools, local authorities and CAMHS ignore them.
Families are in crisis because they cannot access help, and as a consequence they are being fined, prosecuted and referred to social services for non-attendance at school.
What needs to change?
My PhD research considers the lived experience of parents who have children suffering with anxiety-based school refusal. Enmeshed within these experiences are numerous emotional, behavioural, and attitudinal reactions expressed by people in different roles. My study recognises the importance of acknowledging and understanding the ways these reactions are constructed because they affect how school refusing children and their families are viewed, treated and supported.
Parents are reporting a widespread lack of recognition of mental health difficulties in schools, a lack of training, a lack of empathy, and a general unwillingness to admit that current practices are creating and exacerbating mental health problems. As a consequence children and parents are being blamed for these difficulties and denied support.
Alternative provision for children experiencing difficulties at school varies greatly at a local level. It is generally extremely difficult to access because schools and local authorities ignore relevant existing government guidelines. Equally, government has neglected to investigate these issues, or act, for far too long.
Current attendance policies create a situation where parents face intense daily pressure to force severely distressed child to attend school, or to provide the school with medical evidence demanded to authorise absence. This medical evidence is almost impossible to obtain quickly because families become stuck in an endless cycle of CAMHS waiting lists, rejections or inaction.
Schools are given little option to offer any flexibility or empathy because they fear OFSTED scrutiny and criticism. So, instead they force attendance, issue fines and refer parents for prosecution. This makes an extremely difficult situation much, much worse. Moreover, there is no evidence that legal action improves or resolves mental health related non-attendance (indicating the only benefit is protecting school data).
Trapped in this ‘no-mans-land’ of support, some families are even referred to Social Services under accusations of ‘educational neglect’ or even Fabricating or Inducing Illness. This seems to be a tactic used in growing regularity and reported by 20% of parents who completed our recent school refusal survey. This tactic is seemingly being used to deter families from demanding expensive SEND or alternative provision, or from highlighting the deficiencies within the education system.
Many families have children who are diagnosed or suspected of having learning needs and differences such as Autism, ADHD and Dyslexia. Parents often spend months, or years, struggling to navigate the SEND system to obtain any type of diagnosis or provision. A lack of training and funding cuts mean schools do not assess or provide for SEND, while Local Authorities do their utmost to delay or avoid assessing for EHCPs to save money.
Day after day, we hear from parents desperately worried that children are not coping with academic pressure relating to testing, exams and achievement expectations.
The discussions during the Education Forum on May 8th focused upon the provision of new services or school-based therapies. Frustratingly, there was little recognition of the need to address the UNDERLYING CAUSES of mental health difficulties in schools.
Please consider that once children access educational environments that do not place unreasonable academic demands and pressure on them; Provision that does recognise and support their individual needs, they often recover – given time, empathy and understanding. These features are missing from current provision, and furthermore, there is absolutely no accountability when children are left unsupported – these are all factors where change is desperately needed.