Green Paper: Transforming Children and Young People’s Mental Health Provision

This week has seen the close of the consultation on the Green Paper: Transforming Children and Young People’s Mental Health Provision.

Transforming is a strong word (to transform – to make a marked change in the form, nature or appearance of).

The title and the three pillars put forward in this Green Paper relate to specific matters of access for schools to refer children and young people more easily for mental health interventions. Other parts of the Green Paper refer to wider matters, without any detail re how these link to the remit of the paper.

To transform, that is to make a marked change in the nature of the mental and emotional health of our young and therefore of our future society in this country, we need to be bold, brave and courageous. We need to listen and learn from the wisdom of the research in this area, plus the fascinating advances in the understanding of how our brains develop and continue to grow.

The First 1001 Critical Days

Our brains are at their most “plastic” during the first two years of life and during adolescence. It makes sense therefore to put as much support as possible into those early years, supporting parents and families with those crucial 1001 days (

Sadly and inexplicably, the Green Paper missed out any reference to children aged 0-2 years. Supporting the emotional health of parents during this challenging time is surely the place to start. (It would also benefit the workplace, as we inevitably carry our family selves to work).

Parenting Programmes in Schools

Parenting Programmes which link parents into the approaches taken at school as their child grows and develops, can lead to a real partnership and create a feeling of safety and containment for a child/ young person and their family. Boundaries can become clearer, communication strengthened, emotions and difficult feelings heard, self-regulation supported.

This is also more likely to lead to any early concerns about a child being followed up and addressed. If parents feel like partners in their child’s education, feel less judged, have an open communication with key people in the school, then school and home can form a protective circle around that child/ young person.

A Proactive Approach to Good Mental and Emotional Health

A universal approach to emotional health is a proactive model. If we are trying to transform the emotional and mental health of our next generation, then doing something about the relational cultures they grow up in is surely the place to focus our greatest energy.

Of course it matters that we continue to try to find ways to support those who are experiencing mental health challenges, but the transformation is unlikely to come from this.

Being transformative about the relational cultures in our families, schools, colleges and workplaces would benefit society as a whole and would constitute a much-needed long term strategy for developing emotional health and resilience in our young.

“Resilience is more than an individual trait. It is a capacity which arises through interactions between people within organisational contexts.”

Day et al, 2011:3

Challenges and threats to a healthy culture will of course appear regularly and so listening carefully and reflecting on the lived experience of those around us will help with learning from such difficult patches. This is surely a more cost-effective approach too, requiring a different way of doing our daily business, weaving a healthy relational culture throughout the school community/ workplace.

Mental Health Leads in Schools and Colleges

We welcome the whole school approach to supporting good mental health, and would like to suggest that the proposal for a Designated Senior Lead for Mental Health be considered on a par with Safeguarding, ie that this is a senior position, with dedicated time during the working day.

The best practice in Safeguarding within schools and colleges has led to:

  • The setting up of well-trained safeguarding teams, led by the DSL who is part of the senior leadership team.

  • Training for the safeguarding leads is regularly updated

  • Safeguarding is seen as everyone’s job and is recognized as being a responsibility for everyone in the school/college community

  • Training at a basic level is provided for everyone and updated regularly

  • Good relationships are fostered with external agencies

  • Parent partnerships are supportive and strong.

There is much to be gained from the Leads for Mental Health and Safeguarding working closely together, however they should not be the same person as safeguarding teams are already overstretched. (The model of best practice for Mental Health leads could look very similar to that of Safeguarding Leads as bullet points above).

Strong senior leadership, including governors should understand fully and promote a positive relational culture of emotional health throughout the school/college community.

This needs to involve training for all adults and PSHE (including RSE) as a statutory aspect of the curriculum; school policies and practices must also reflect and promote this healthy relational culture.

Parenting Programmes delivered in school, with a shared language and approach, can support a non-judgmental, healthy and supportive working partnership between school and home.

Mental Health Support Teams

In the meantime, we welcome the Green Paper’s call for Health and Education to work more closely together, with the formation of Mental Health Support Teams.

This has the possibility of working well if both the MHSTs and the School Staff are given time within their working weeks to reflect and communicate well together.

The best outcomes for children and young people with mild and moderate Mental Health difficulties are likely to come from the access to specialist support alongside an emotionally healthy, nurturing daily environment at school.

With such a wide age range of children and young people, the MHSTs will need to be staffed by people with a varied experience, so that there are appropriate people to work with young children as well as with adolescents. Again, for best practice, there will also need to be a stability in this workforce so that good working relationships can be developed.

Waiting Time Standards

Waiting times will need to be monitored carefully, as it will be important that the four week target is for a suitable intervention for a child or young person, and not just for a one-off or defined short series of sessions.

We welcome:

  • The opportunity to contribute to the ongoing discussions following on from Future in Mind

  • The wide -ranging conversations this Green Paper has prompted between organizations with a rich experience of supporting the emotional and mental health of children and young people

  • The collaborative approach between Health and Education put forward in many of the Green Paper’s proposals

  • The needs of 16-25 year olds specifically mentioned in this Paper

  • The consultation opportunities with representatives from the Department of Health and the Department for Education

We would like to propose:

  • That the “first 1001 days” are prioritized in the transformational long-term strategy and therefore included in this Paper

  • Investment in a universal approach to Emotional Health, as a proactive approach to good Mental Health

  • That there should be a Designated Senior Lead for Infant Mental Health, (working with families, Health Visitors, Children’s Centres and Voluntary Sector) as well as for Early Years settings, for Primary Schools, for Secondary Schools, for Colleges and Universities. This role to be on a par with the Safeguarding senior lead in each setting, to work closely with them to lead and maintain a safe and healthy culture, (but to be a distinct and separate role.)

  • That Family Support workers/Home-School link teachers in schools are trained to facilitate well-evaluated Parenting Programmes which share a language and approach between school and home and support effective partnership with parents/carers so that learning can flourish.

Mary Taylor

Head of Programmes

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