Where are the EPs? Theresa May, mental health and schools
The focus on schools and the workplace is much needed, as is the attention to addressing stigma and the transformation of attitudes to mental health conditions…Educational psychologists are best placed to assist the government in delivering its aspirations in this regard
Professor Peter Kinderman, President of the BPS
Theresa May’s speech at the Charity Commission Annual Lecture has made headlines across the UK today. Her speech to the Commission praised the fantastic work that many of the UK’s charities carry out for the betterment of many sections of our society. Much of Mrs May’s speech for my own part, was met with scepticism – there was the predictable references to ‘making society work for everyone’, developing a ‘modern industrial strategy’ and even explicitly to ‘building a great meritocracy’ – you can find the full text of the speech here. The purpose of this short blog post however is not to examine Mrs May’s political rhetoric.
What has attracted most media attention today has been the ‘announcements’ designed to quell the ‘burning injustice of mental and inadequate treatment’. To summarise, Mrs May suggests:
- Piloting new approaches such as offering mental health first aid training for teachers and staff to help them identify and assist children experiencing mental health problems
- Trialling approaches to ensure schools and colleges work closer together will local NHS services to provide dedicated children and young people’s mental health services
- The Care Quality Commission and OFSTED leading a thematic review looking at services for children and teenagers across the county to find out what is working, and what is not
- Publishing a Green Paper on Children and Young People’s Mental Health to transform services in education and for families
- Ensuring that by 2021, no child will be sent away from their local area to be treated for a general mental health condition
- Capitalising on the crucial role that civil society has to play in helping young people build resilience
I have been unsurprised as EPs have taken to twitter, Facebook and EPNET today to ask ‘Where are the EPs’. While Mrs May explicitly refers to CAMHS and the NHS there was seemingly no recognition of the role that EPs already play, daily, in supporting the social, emotional and mental wellbeing of teachers, families, children and young people. Perhaps this is to be expected though as a contributor to EPNET today observed that the latest SEN Code of Practice mentions educational psychologists only a handful of times in its 292 pages. I find it much more concerning that in the March 2016 DfE guidance ‘Mental Health and Behaviour in Schools’, educational psychologists are mentioned once.
So beyond the glaring question ‘Where are the EPs’ a number of issues seem to have arisen for EPs today – many of which throw up more questions than answers.
Medicalisation, reductionism and within-child views
Understandably there are concerns about the apparent continuing dominance of within-child, medicalised views of those experiences that are variously defined as ‘mental ill-health’. These views have as their focus, the unit of ‘the child’. These views have naturalised the understanding of mental health as belonging to the child or young person and so this seems the most obvious place for ‘treatment’ to occur.
EPs in various discussions have highlighted the importance of understanding mental wellbeing issues as connected to the processes and products of wider systemic influences. Seeing children as people within families, schools and communities enables us to understand the multiple factors that may be contributing to experiences of distress – you’ve got to ‘up stream’.
Within this systemic understanding however there seems to be an awareness and readiness by EPs to engage in what another contributor to EPNET today termed ‘reactive approaches’. Variously these might be considered as the range of approaches, strategies or interventions that might be offered and/or delivered to a child or young person facing difficulty, designed to reduce their distressing experiences and help them learn to cope.
Certainly with the range and depth of initial training and the continuing professional development that EPs undertake, EPs seem more than capable in rising to this challenge. Within my own practice I encounter colleagues who offer CBT, solution focused group/individual work, sand tray work, lego work, therapeutic story writing, and narrative work among others.
The problem with ‘mental health first aid’?
Michael Billig, in his book ‘Ideological Dilemmas’, suggests”
‘…the appreciation of good health depends, in no small way, upon an understanding of what it means to be a sick person’ (pg. 86).
Herein lies the inherent problem of conceptualising mental experiences through the lens of ‘health’. You have the measles or you do not. You have influenza or you do not. It is not possible to suggest that you have mental health or you do not. The variability and variety of mental and emotional experiences makes common sense understandings of ‘health’ and ‘illness’ redundant when we think about the social, emotional and mental wellbeing of children and young people.
My worry is that the idea that mental wellbeing can be thought of as binary, 0 or 1, good or bad, will be reinforced by the proliferation of terms such as ‘mental health first aid’. First aid is usually basic help or care given to someone as a result of an injury, often by someone who is not a trained medic, until medical help arrives. It works well under the framework of emergency response where ‘the problem’ is often embodied – but I’m not sure the use of ‘first aid’ is so easily translated to the context of mental wellbeing for young people.
Many EPs have raised questioned about the skill base of those trained in MHFA. Currently there is a two day training that qualifies an individual as a Mental Health First Aider. EPs understandably have questions about the content of such training and are sensibly asking the question ‘Who is delivering this training?’. My sense is that the question ‘who?’ refers as much, if not more, to the ‘philosophical’ orientations of such people, and the psychological perspectives that guide their approach.
EP visibility – shout louder?
Returning to the initial question – ‘Where are the EPs?’ – there has been some discussion today about the visibility of EPs as professionals working with children and families in schools, and the profession as a whole. There have been calls for Facebook groups or working parties to be established to address the issue of ensuring those with the power to make decisions understand the important role EPs can play in this discussion. This is great – EPs galvanising and working together for a cause they are passionate about…but how do we move beyond the echo chamber? What can we do to really get our voices heard when we say ‘the current approach isn’t working, but we have some ideas…’?
Well, within the last few months the DECP Committee has put out a call for EPs to add their names to a list to help with responses to the numerous government consultations that the division is asked to submit evidence for. Earlier today the Health Committee’s Inquiry in to the role of education with respect to children and young people’s mental health, was referenced on EPNET along with an invitation to submit evidence. These are incredibly valuable, though perhaps less exciting, ways of making an impact.
Aside from responding to formal calls for evidence – there must be so many great things happening in local authorities around the country where EP services are being commissioned to support the wellbeing of children and families. You must be doing so much to make this a reality, because this is something that many EPs clearly feel so strongly about, and as a bunch, I know we’re not likely to be sitting around and not making an impact on a local level. So thinking about having a space to consider these ideas – to share, to brainstorm and to come together – please do use the comments section below to begin a conversation or alternatively use twitter @edpsyuk or #EPvisibility