Mental health and wellbeing: whole school approach: framework

E. Eight principles of a whole school approach to support mental health and wellbeing

A whole school approach to mental health and wellbeing incorporates eight key principles that emphasise a health-promotion and preventative approach. The eight principles outlined here are largely adapted from those first identified by Public Health England/National Children's Bureau and outline what a whole school approach will look like in practice.^[6]

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GIRFEC → Transition and Recovery Plan → Curriculum for Excellence → UNCRC

Whole School Approach to Positive Mental Health and Wellbeing

• Targeted support and appropriate pathways to the right support
• Collegiate leadership and management that supports mental health and wellbeing across the school
• A collegiate ethos and environment that promotes positive and respectful relationships and values diversity
• Identifying need and monitoring impact of interventions
• Supporting staff professional learning and development in order to ensure their own and others’ wellbeing
• Enabling children and young people’s voices and participation to influence decisions
• Working with parents, carers, and the wider community
• Effective curriculum, learning, and teaching

1. Leadership and management that supports mental health and wellbeing across the school

Effective leadership can ensure that this strong commitment to mental health and wellbeing is visible within the school community, and well communicated to all stakeholders. As a result, staff, children and young people, parents, carers and partners are included and valued in the school and form a key part of developing the whole school vision and approach to support mental health and wellbeing. Creating a clear sense of ownership and autonomy where individual and collective contributions are valued.

School leaders have a critical role in creating the conditions for, and delivering a whole school approach to supporting mental health and wellbeing. Effective leadership should be supported at all levels, ensuring that health and wellbeing is supported by all, and that the key components of a whole school approach, outlined here, are in place.^[7] Where staff have more formal roles and responsibilities in this area, these should be made clear to colleagues, children and young people, and parents and carers, and support the delivery of the whole school approach. Distributive leadership and collegiate decision making is essential in taking this approach forward.

A clear vision for whole school mental health and wellbeing should be evident and will be expressed through school values and practices.^[8] The vision should be co-constructed with staff, key partners and include children and young people and their families. Leaders should also model these values in their interactions with the wider school community. Shared aspirations and high expectations relating to mental health and wellbeing outcomes are communicated and demonstrated by leaders and are agreed and accepted by all. Staff should be supported and challenged, as required, to drive changes in knowledge, attitudes and behaviours in relation to mental health and wellbeing. This will be evident in School Improvement Plans and approaches to quality assurance and self-evaluation.

Positive leadership will ensure that the importance of mental health and wellbeing is agreed, accepted and embedded by the whole school community. This is based on a shared understanding of the clear link between mental health and wellbeing, attainment, achievement and life chances for children and young people. Leadership will be encouraged at all levels including providing opportunities for staff, children and young people, and parents and carers to lead on aspects of supporting mental health and wellbeing.

Strong leadership of change requires a clear implementation plan which has an accurate understanding of the challenges and the responses required in supporting the mental health and wellbeing of children, young people and their families, based on a thorough self-evaluation (see Appendix 4). Leaders should consider their current priorities, processes and systems to ensure they are aligned with this approach and use their existing data and evidence to determine where any gaps lie. Staff may find the Framework for Implementation (see Appendix 3) helpful in these considerations. Additionally, this process can be informed by the self-evaluation framework (see Appendix 4). School leaders should support their wider staff teams in developing a clear understanding of what is required in terms of next steps at a whole school level and with partners to develop mental health and wellbeing as well as an understanding of how changes and improvements will be supported and sustained.

As part of a whole school approach, leaders should ensure that there is an agreed and robust policy framework which promotes mental health and wellbeing across the life of the school. Mental health and wellbeing should be reflected in the wider school policies, such as Promoting Positive Relationships, Anti-Bullying and Equalities, and consideration should also be given to whether a specific policy on mental health and wellbeing is required.

Policies should be up to date, and clearly define responsibilities and expectations. Robust and ongoing self-evaluation will ensure that policy inform practice. Thorough consideration will be needed to ensure each is coherent with an approach that promotes positive wellbeing and ensures stigma-free support for mental health for the whole school community.

2. An ethos and environment that promotes positive and respectful relationships and values diversity

School ethos and environment are key determinants in promoting mental health and wellbeing for everyone within the school community. Everyone within the school setting and its wider community, whatever their contact with children and young people may be, share the responsibility for creating a positive ethos and climate of respect and trust. One in which everyone can make a positive contribution to the wellbeing of each individual within the school and wider community.^[9]

Evidence has consistently suggested that the strong connections we make throughout our lives can help buffer the impact of additional stressors and risk factors and the impact of adverse childhood experiences. A school ethos and environment that best supports mental health and wellbeing is underpinned by relational approaches such as whole school nurture and restorative approaches that promote positive relationships.^[10] A relational approach enhances a sense of belonging, connectedness to school, and helps build resilience for all. Positive relationships at all levels, including peer-to-peer, teacher-to-pupil, teacher-to-teacher and parent-to-teacher relationships can impact positively on mental health and wellbeing for all.

A whole school nurturing approach is often seen as synonymous with a relational approach and can provide schools with a blueprint of how to promote positive relationships throughout the school community.^[11] Nurturing approaches focus on a balance of care and challenge, incorporating attunement, warmth and connection alongside structure, high expectations and a focus on achievement and attainment. Supporting mental health and wellbeing will require both warmth and support alongside clear expectations and structures to allow children and young people to thrive. A nurturing ethos emphasises modelling positive behaviour which promotes mental health and wellbeing, such as kindness, compassion, and giving, where children and young people are communicating emotional distress through their behaviours and interactions and ensures that they are given the right support.

The school climate and ethos will also be underpinned by a shared commitment to and understanding of Children's Rights and the Human Rights of adults working in schools, where children, young people, and staff feel included, respected, safe and secure, and where their achievements and contributions are valued and celebrated.

Diversity and difference are welcomed and celebrated by the school community, with a clear link being made between equity, equality and the promotion of mental health. In particular, school staff recognise the importance of providing additional support and understanding for vulnerable groups such as those living in poverty and those who might experience prejudice or prejudice-based bullying.^[12] While it is important not to stereotype particular groups, it is important to recognise the challenges that some groups of children and young people may face. Data about the need for support and the results of monitoring can be used to ensure that the ethos and environment is one that promotes positive and respectful relationships, and values diversity.

The key to achieving an ethos and environment able to support mental health and wellbeing is ensuring that everyone within the school community recognises that we all have mental health, and everyone is at different points on that continuum at various points in their lives.^[13] It is vital that anyone experiencing concerns with their mental health is treated in a non-stigmatising and discriminatory way and is provided with the support they require. It is important to recognise cultural sensitivities and to ensure that all children, young people, and their families are aware of the support available. Expressing feelings and showing emotional vulnerability should be seen as positive attributes and children and young people should be encouraged to open up to others when they require support.

3. Effective curriculum and learning and teaching to promote resilience and support mental, emotional, social and physical wellbeing and learning

Curriculum for Excellence already places health and wellbeing at the heart of the curriculum and this will be further emphasised within a whole school approach to mental health and wellbeing.^[14] COVID-19 Educational recovery guidance similarly emphasises mental health and wellbeing within the curriculum.^[15] Learning across the whole curriculum as outlined within Health & Wellbeing Responsibility of All should ensure that children and young people develop the knowledge, understanding, skills, capabilities and attributes they need for mental, emotional, social and physical wellbeing. Well-chosen and evidence-informed programmes may complement curriculum delivery, and will be most effective when they are well integrated into the day-to-day curriculum.

Curricular approaches which focus on promoting resilience can be adapted to reflect the current, local context and ensure their relevance to children and young people. Learning and teaching should also take account of prior knowledge and understanding as well as respond to and act upon what the children and young people want to learn about. As well as building resilience there should be opportunities for children and young people to develop mental. emotional, social and physical skills, problem-solving, coping, and relationship management skills. Enabling children and young people to learn that there are a range of strategies available to enhance mental health and wellbeing. The importance of outdoor activities to support and maintain mental health and wellbeing should also be emphasised.

The school will provide children and young people with meaningful opportunities to contribute to, influence and lead on aspects of their learning within health and wellbeing. Where possible, children and young people should take ownership of their learning and progression within health and wellbeing, and help co-design and deliver core components of the HWB curriculum as well as wider aspects of school life.^[16]

Scotland's curriculum promotes the engagement of children and young people in the delivery of learning in our schools. Young people can be provided with learning opportunities, including peer led opportunities, to develop activities for other children and young people with support from school staff. These can raise awareness of the continuum of mental health, the extent to which we all lie along this continuum, and how we can promote better mental health and wellbeing for ourselves and others. Young people can use this knowledge to work alongside school staff and third sector partner agencies to ensure that there is a culture and ethos that is non-stigmatising. Opportunities for peer leadership, mentoring and support should be encouraged.

School approaches to learning and teaching should engage children and young people fully in the learning process and promote their resilience and wellbeing, aligned to the ethos of the school. Schools can support classroom organisation and management which is consistent with an approach that supports wellbeing and promotes pedagogy that is suited to their pupils' needs. This should be in keeping with guidance on COVID-19 recovery.

There should be clear tracking and monitoring approaches in place to ensure children and young people make progress, based on the Health and Wellbeing Experiences and Outcomes. This includes evaluating progress within Responsibility of All, which can link to the wellbeing indicators as well as assessing progress of PSE, using the Benchmarks. This should be in keeping with Local Negotiating Committee for Teachers guidance.

Schools should also support a clear balance between academic, attainment based subjects and opportunities for vocational and wider achievement. Schools will already recognise the links between positive mental health and wellbeing and achievement. Schools should continue to provide children and young people with strategies and opportunities to manage times when their positive mental health and wellbeing may be challenged, such as in exam periods or in periods of isolation, to support their resilience and overall mental wellbeing.

4. Enabling children's and young people's voices and participation to influence decisions

A children's rights-based approach across the school emphasises their entitlement to be kept fully informed and right be included in decisions regarding all aspects of school life. We know that many children and young people have been negatively impacted by the COVID-19 pandemic and this makes it even more vital that they are supported to have their voices heard with regard to the appropriate ongoing support that is required.

Authentic and supported involvement in decisions that affect their own lives enhances children and young people's sense of autonomy and belonging and is a significant protective factor that supports mental health and wellbeing. It is important not only to enable and listen to and act on views, but to ensure these views influence decisions across the school community and that young people are aware of the impact sharing their views have had.^[17]

There will be a wide range of areas of the life of the school community that will benefit from children and young people's participation in decision making, including key policy development; curriculum; learning and teaching; clubs and committees and the design of targeted supports and interventions for mental health and wellbeing. They should also be involved in shaping the whole school vision and values on how to support mental health and wellbeing. Children and young people have much to contribute in terms of what supports their own mental health and wellbeing and what is likely to impact negatively upon it and it is essential that their views and experiences are fully heard and acted upon where possible. Children and young people should be encouraged to support schools in their self-evaluation processes using tools such as How Good is Our School?^[18] (HGIOS 4).

Children's views are vital within individual planning as part of staged intervention and GIRFEC planning processes, and children and young people should be empowered to express their views regarding their needs, supports and services.^[19] It is also important that children and young people are aware of the advocacy arrangements that are in place to support them. A whole school approach should try to ensure that wherever possible children and young people are comfortable seeking help from adults when needed, whilst recognising that children and young people may also value peer support to better support mental health and wellbeing. Children and young people can make significant contributions by acting as peer educators and mentors, delivering mental health and wellbeing messages to their peers and providing credible role models. They can also build the capacity of schools to deliver health and wellbeing experiences and outcomes in a highly relevant, meaningful and sustainable way.

5. Supporting staff professional learning and development in order to ensure their own and others' wellbeing

Professional learning and development can be key factors in empowering staff to effectively support children and young people's wellbeing as well as their own wellbeing. Staff may benefit from being afforded opportunities to develop their knowledge, skills and attitudes so that they can positively impact on the wellbeing of others. Schools may want to consider the specific needs of staff with regard to professional learning , reflecting on the 'practice levels' of informed, skilled and enhanced from Knowledge and Skills Framework for Children and Young People's Mental Health and Wellbeing (NES)^[20]

• The Informed Practice level describes the baseline knowledge and skills required by everyone who works with children and young people in the Scottish workforce (Support for All)
• The Skilled Practice level describes the knowledge and skills required by all workers who have direct and/or substantial contact with children and young people who may be experiencing mental health challenges (Early Support)
• The Enhanced Practice level details the knowledge and skills required by workers who have more regular and intense contact with children and young people who are known to have difficulties with their mental health, and who provide specific supports or interventions and/or who direct or manage services. (Additional Support)
• The Specialist Practice Level details the knowledge and skills required by staff involved in specialist assessment and interventions. This level will not be applicable to school staff.

The leadership team can support this by promoting continuous high-quality professional learning opportunities to ensure that all staff are enabled to promote the mental health and wellbeing of all children and young people across the life of the school and community and recognise and respond to need effectively. Learning opportunities should be individualised to staffs' own development needs and reflect the needs of the school population and local community. It is also essential as the world responds to the COVID-19 pandemic for some time to come, that learning opportunities reflect the needs that have emerged as a result of this.

The GTCS standards for registration states as part of the professional values and personal commitments, 'promoting health and wellbeing of self, colleagues and the children and young people in my care' and 'understanding health and wellbeing and the importance of positive and purposeful relationships to provide and ensure a safe and secure environment for all learners and colleagues within a caring and compassionate ethos.'^[21] Opportunities for professional learning in mental health and wellbeing could be made available as part of teacher's probation period as well as part of career-long professional learning. Schools should also consider how they can be flexible in order to best include all support staff in development opportunities in this area.

As part of a wider focus on mental health and wellbeing, staff development opportunities for wider staff might include:

• Child development
• Attachment and trauma
• Promoting positive relationships
• Resilience
• Understanding of the mental health continuum and specific areas of mental health
• Recognising, responding to and supporting needs within mental health
• Additional interventions
• Curricular approaches to supporting wellbeing
• Prevention of suicide and self-harm.

A range of partners can provide support for staff development opportunities, including Educational Psychology Services and Education Scotland.

An online professional learning resource entitled 'Children and young people's mental health and wellbeing: A learning resource for all school staff, has been developed by the Scottish Government.^[22] The resource takes a whole school approach centred around prevention and early intervention to promote positive mental health and wellbeing for everyone in the school community. It aims to provide school staff with knowledge and understanding of mental health and wellbeing in schools and a range of opportunities to learn about experiences and advice from practitioners and young people. There are four main sections which include: An overview of mental health and wellbeing; Factors influencing mental health and wellbeing; Applying prevention based approaches to mental health and wellbeing in schools, and; School staff wellbeing.

Promoting staff wellbeing is also a core component of a whole school approach and should be given the priority and importance required in a school. Professional learning should not just focus on how staff support children and young people's mental health and wellbeing but how they can support their own and colleagues' wellbeing needs.^[23] It is vital for its own sake but will also ensure staff are best supported to work with children and young people experiencing distress and support them appropriately.

At a leadership level the understanding of the factors that affect staff mental health and wellbeing in the workplace is essential; including organisational, job-related and individualised factors. A range of embedded supports and structures that can assist and reassure them in their day-to-day roles should be available and made known to staff. These should specifically promote positive mental health and wellbeing, and provide a specific support for mental health and wellbeing needs as required. Leaders at all levels should be mindful of the pressures on staff and of conditions of service.

Ongoing staff development and support may involve mentoring, coaching, check-ins, debriefing and peer and management support. School staff may call upon staff in the wider local authority and partners to be involved in this support. Educational Psychology Services will have a key role to play in this. Staff should be encouraged to seek support when needed and there should be no stigma around this as part of a whole school approach to addressing mental health and wellbeing.

As part of the overall culture and ethos of the school on mental health and wellbeing, it should be clear that it is okay not to be okay, for staff, and there should be clear pathways for those needing more personalised support.

Staff feedback, including for example, gathering views and more formal wellbeing surveys, could be used to capture staff experience and inform approaches and next steps. When formal 'measures' of wellbeing are used, these should be used with sensitivity and appropriate safeguards should be in place. The approaches to supporting staff mental health and wellbeing include staff working at all levels, including senior leaders.

6. Identifying need and monitoring impact of interventions

If taking a whole school approach to mental health and wellbeing, schools should consider having effective arrangements in place to ensure they identify need at the whole school, group and individual level.

Identification of individual pupil wellbeing needs is a key aspect of the Getting it right for every child approach in Scottish schools, alongside Health and Wellbeing Responsibility for All within the Curriculum for Excellence, and inform a whole school approach to addressing mental health and wellbeing needs. The national health and wellbeing census will support the monitoring of need and next steps in schools and education authorities.^[24]

The overall school approach to identifying need and monitoring impact will be built on existing robust self-evaluation approaches which take into account a broad range of data and evidence, including robust stakeholder engagement and consultation with children and young people to gather their views. This engagement should include identifying school staff needs and monitoring the impact of interventions to support the mental health and wellbeing of staff. Schools should ensure that their self-evaluation and quality assurance processes take into account mental health and wellbeing needs explicitly and includes relevant data and evidence in this area to inform next steps. How Good Is Our School? 4 has a range of quality indicators which can support this and Applying Nurture as a Whole School Approach can also help to further inform evaluation and reflection on practice in this area.^[25] Additionally, the self-evaluation framework at Appendix 4 can further support in identifying improvement priorities.

In terms of identifying the children and young people's invididual needs, the most effective way of monitoring impact is via quality relationships and being attuned to young people and present for them. This will be further supported by schools ensuring that they have robust systems in place to evaluate progress in Health and Wellbeing underpinned by a shared understanding of Experiences and Outcomes within Responsibility for All and the GIRFEC wellbeing indicators. Holistic assessment of individual wellbeing needs includes children's and young people's views and those of parents and carers and information from wider professionals as appropriate.

Arrangements for identifying children who need targeted support for their mental health will be informed by shared understanding of how to recognise a child who is distressed. It is important that a wider holistic and contextual view of needs is taken into account and that all behaviour is understood as communication.

In understanding the wider contextual factors that can impact on mental health and wellbeing, schools may be able to take an early intervention and preventative approach to alleviate further concerns. This should take account of the wider contextual, environmental and structural factors within a school that may be barriers to wellbeing. Where appropriate, additional wellbeing assessments (examples in Appendix 2) can be considered, to identify children and young people who are distressed and in need of further support. This should be outlined as part of staged intervention processes and planning cycle and may be supported through further consultation and advice from visiting specialists such as the Educational Psychological Service or the school counselling service where appropriate. When carrying out individualised assessment and support, it is vital that mental health and wellbeing is recognised as being impacted upon by wider environmental factors and not as a within-child difficulty.

It is important that when implementing interventions to support mental health and wellbeing, such as nurture groups, school counselling, resilience, HWB programmes and anxiety based supports such as Lets Introduce Anxiety Management (LIAM), there are also robust evaluations in place to evaluate the efficacy of such interventions.^[26] Whilst many of these interventions may be evidence-based, the impact may be attributable to implementation factors. Schools may wish to use an Implementation Science approach (see Appendix 3) to help them to consider the factors that contribute to successful implementation. When utilising the Framework within Scottish schools, leaders will need to be mindful of LNCT agreements on workload, school improvement planning, and classroom observation.

7. Working with parents, carers and the wider community

Parents and carers are instrumental in supporting their children's mental health and wellbeing and learning and are key to building an effective and inclusive whole school approach to mental health and wellbeing.

Parents, and carers, positive relationships with their children are a powerful protective factor for their mental health and wellbeing. They have unique knowledge about their children and diverse experiences and skills that can contribute to the whole school approach to mental health and wellbeing. The needs of children and young people who are care experienced will require particular attention.

Strong school, family and community partnerships can also greatly enhance the impact of actions to support positive outcomes. Schools should foster a positive environment where relationships and partnership working are strong and communication is effective.

Effective partnership working in this area will be underpinned by understanding that some families may feel blame and stigma, for themselves and for their children and young people where there are mental health issues. They may have fears about reaching out for support and will need a compassionate response and personalised approaches to help overcome this. Any approach to supporting mental health and wellbeing should ensure that all parents and carers, including those who are harder to engage, have their voices heard. This reflects the work of The Promise, which emphasises the need for families to be given support to overcome some of the difficulties that get in their way.^[27] Parents and carers should also be helped to feel confident that their child is getting the right support for mental health and wellbeing at both a universal and targeted level. There should be a recognition of the importance of cultural values and beliefs and how they impact on the way that mental health and wellbeing is perceived in families and a culturally responsive approach to addressing the needs of children and young people which promotes positive mental health for all.

Parents and carers should also be involved in discussions about key developments within the school and contribute to the vision and values around whole school mental health and wellbeing.

Parent Councils have an important role to play and are well placed to support schools and head teachers in developing school policies, and advising on how best to engage with the wider parent body. Schools should endeavour to capture the views and experiences of the wider parent bodies in creative and innovative ways to ensure that even the most vulnerable families have their voices heard. Efforts to engage parents and carers should also take into account cultural needs and language barriers. Schools are best placed to understand the needs of their school community and respond to these appropriately. This might include: breakfast blethers; mental health and wellbeing workshops; parent-led events. Other communications to parents such as social media approaches can also help share positive messages with parents about mental health and wellbeing and signpost them to supports. Overall, strong partnership working in this area will mean that parents will feel more open to support and advice with regards to supporting their child and seeking appropriate external support for their own mental health and wellbeing where required.

As part of a whole school approach, appropriate support for parents will be well signposted and the approaches taken by the school can have a positive impact on parental mental health and wellbeing. Effective engagement with parents will support the school to understand and provide support at a universal or targeted level that enhances knowledge and understanding of mental health and wellbeing for example by providing an input to parents and carers on managing formal assessment and exam stress, sleep, distressed behaviour, understanding and responding to the teenage brain, or having regular supportive conversations about emotions and wellbeing.

The wider school community will include connections with local groups such as community groups, sports and leisure facilities, business and enterprise, cultural venues and civic groups. Strong partnerships with the third sector will greatly enhance the whole school approach. Community Learning and Development Services will also have a significant role to play and can include collaborative approaches to youth work, family learning and early intervention work.

New and enhanced community mental health services, to complement existing local provision are also currently being developed and delivered by local authorities to provide support for children and young people around emotional support and distress. These are aligned to a Children and Young People Mental Health and Wellbeing Supports and Services Framework and are intended to provide support upstream of CAMHS services. Additional services provided by or enhanced through this framework will complement current universal and targeted services provided by a whole school approach.

Family – school - community partnership can ensure an integrated approach to support children, young people and families, and communities can provide schools with a context and environment that can reinforce the work of the school in general and in supporting mental health and wellbeing. It can extend the physical, cultural, social and vocational opportunities for children and young people and enhance their wellbeing and connection to community, and social capital.

Appropriate consultation and participation with these wider stakeholders enhances the health-promoting school and provides learners and staff with a context and support for their actions.

8. Targeted support and appropriate pathways to the right support

Targeted support within the school builds upon effective universal support offered as part of a whole school approach that includes staff accepting that mental health and wellbeing is the responsibility of all staff and it is a key part of the curriculum. This approach also builds upon the key principles of Getting it Right for Every Child which includes being child focused, based on an understanding of the wellbeing of a child in their current situation; requires joined up working and is based on tackling needs early. Effective universal support will ensure a minimally intrusive approach is in place, and that when targeted support is sought it is appropriate and timely.

Pastoral care teams within schools should have clear and effective structures and systems that ensure that they are able to identify the children and young people who require additional support. This should involve; regular dialogue between staff with pastoral responsibilities and wider school staff, effective assessment, referral processes, and ongoing professional learning and support for relevant staff so that they can identify children and young people who are in distress and require more intensive support.

A range of school supports can also be accessed which offers targeted support for mental health and wellbeing, including access to counselling through schools for children and young people of 10 years and over. Educational psychologists can also offer ongoing consultation, advice and support for staff, children and young people and their families. School nursing also have a key role to play in supporting school-age children with emotional health and wellbeing. These additional services are intended to complement a whole school approach to wellbeing. There may be times, however, when maintaining and extending the support from a key adult is a more appropriate alternative to a child starting counselling.

Joined-up partnership working is a fundamental aspect of the whole school approach; where children, young people, parents and carers, and the services they need all work together in a co-ordinated way to meet specific needs and improve the child or young person's wellbeing. This should involve partnerships across the local authority, with health and social care partners, and with third sector partners. Multi-agency teams working with schools to support wellbeing will need to remain mindful of any relevant public health advice.

In order to ensure the right support is offered at the right time, there is a need for good understanding of local pathways and the role of agencies across the local community and beyond. School staff should have a good awareness of the role and scope of supports such as school counsellors, educational psychology, community mental health services, CAMHS and the third sector.