Les Lawrence, Chair, Children’s Quarter Board, Birmingham ‘To what extent will positive mental health, economic and emotional wellbeing of families, and children and young people, be considered in the re-opening of schools?’
This was a live webinar recorded on Wednesday 8 July 2020 for ACAMH West Midlands Branch as part of the ‘Return to school: the impact of COVID’.
Accompanying slides are available to download, and a transcript is below.
Other talks included;
Professor Tamsin Ford CBE – ‘Supporting children’s mental health as schools re-open’
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Les LawrenceLes Lawrence is the Chair of the Children’s Quarter Board. Children’s Quarter is a co-operative of groups committed to creating inclusive opportunities for children, young people and their families, currently socially isolated by their experience of being disabled, or of mental ill-health or of any other reason. Former roles include; Heart of England NHS FT Chair, Royal Orthopaedic Hospital NHS Trust Chair, and Birmingham City Councillor – serving as Cabinet Member for CYP and families for 8 years. Les also served as the Chair of the CYP Board of the LGA.
This presentation is based around a series of national surveys, studies and reports and, in addition, the specific work in Birmingham by the Mental Health and Emotional Well-being Steering Group, which has members from health, mental health services, local authority, which includes, of course, education, social care, public health, NGOs and charities, and is part of the Birmingham Education Partnership. I would like you all to keep these in your mind as we go through the presentation.
Mental health has always been a subject that dare not speak its name for a very long time, but is now becoming a subject that is now receiving a great deal of support and consideration. But insufficient resources, irrespective of the initiative launched by the DfE and the Department of Health back in 2018.
Covid-19 will be with us for a considerable period of time, as will its consequences. Therefore there is no short-term fix in that regard. May I also suggest that we need to adopt to real-time methodology in planning, responding and adapting to circumstances as they emerge. Not easy for public services and especially governments. We need to forget boundaries and have multi-skilled teams working across sectors. Our staff are our most important resource and we need to develop their skills, capabilities and competencies to enable the real-time flexibility I’ve just stressed to occur. Also building confidence, trust and resilience back into our systems will require, at school level, may I suggest, curricular change. And in other areas practice change and cross-sectoral participation.
What I want to do is just to provide a degree of context as to what has been happening over the past few months. Around 40 per cent of adults are reluctant to venture out. A new word has being coined, coronaphobia. Around 68 per cent of non-disabled siblings are providing extra care in the household which they have not done in the past. A significant number of families, to varying and worrying degrees of emotional and mental health issues. 39 per cent of families have seen a reduction in incomes and 61 per cent of families have seen increased costs, with 21 per cent saying that they will definitely go into debt.
Parents are reporting significant increases in behavioural problems, for example, tantrums and disobedience amongst four to ten year olds. But interestingly, and conversely, less so in 11 to 16 year olds. A third of all age groups have indicated increased stress, loneliness and anxiety. And homelessness is likely to rise once rent protection is removed in August.
People in general, also, are losing trust in government, institutions and, to a lesser degree, experts. Not trusting or believing what they are being told or asked to do. In the great miasma of facts, factoids and misinformation how are parents and their children to weigh up the odds? Is it a wonder that many have opted to keep their children home and have expressed considerable concerns in returning to September despite the latest DfE guidance? In Birmingham, our Director of Public Health has coined the phrase ‘hokey-cokey world’ and that is what he thinks children and young people will be facing. The in, out, shake it all about syndrome.
Previous studies have shown that young people often get from school secure relationships, including those with teachers, build self-worth and esteem, stability, create a sense of meaning, and see that they have a purpose. Now, whilst many families, together with their children, will adjust to school restarting, a significant number will not. Some of those who will find it difficult to adjust will have identified special needs, including some with the HCPs, Child Protection Plans or Children in Need Plans. However, many will have had no previously identified need and will require considerable support initially and, in some cases, support on a long-term basis.
Over the past few months, via surveys, studies, helplines, work done, some by Kooth, a young person’s mental health charity, not only nationally but it is now working in Birmingham, together with the NCB Disabled Children’s Partnership, amongst others, have produced evidence of children and young people suffering increasingly, to varying degrees, anxiety, sadness, fear of change, depression, suicide tendencies, social isolation, or combination thereof. What this has allowed to be done is to put these attributes into characteristics.
First, the afraid to leave home. Those who have withdrawn from the social world, become disconnected, found the long period at home hard to manage, have become or show tendencies around emotionally-based school avoidance. The next three categories can be described as containing pupils with learning difficulties or have pre-existing mental health or serious health difficulties or are in low-income households without the technology. Many of these have become disaffected with school or awaiting placement due to exclusion. But one thing is very noticeable. They have become increasingly frustrated and depressed.
The happier at home. Those have enjoyed a secure and safe environment at home, have found their learning has been enhanced because the kind of distraction and avoidance of trouble has been removed. They do not want to return to school.
The re-engaged. Those who have found large classes difficult, were at risk of permanent exclusion, but often they have continued their education but have found that small group working, one-to-one support has seen their behaviour improve. Adopt a more positive view of education. They do not want to return to normal in terms of how their school is.
Interestingly, in Birmingham, Kooth found that black, Asian and minority ethnic families have been hardest hit, with family relationships often highlighted. And interestingly, across all the age groups, irrespective of their background, more females than males coming forward to discuss their individual circumstances. Further, many have also expressed a view homeschooling may have the unintended consequence of challenging the parent-child relationship, especially where the parent is juggling work from home with the homeschooling role. I’ve included two quotes from mothers, which I think exemplify the situations faced with which support will required going forward, as it’s known as pressure cooker families.
The conditions created by Covid-19 have increased the likelihood that both stressers and vulnerability will increase at a time when the protective services we normally rely on have been weakened and families have reduced social support and connections to rely on. Young people with digital access are spending more time using social media and online resources.
I seem to… Sorry about that, I seem to have rolled past. Let me just go back.
Right. Sorry about that. Added to this, children may be receiving less protection within their home if their parents are overburdened and standards of supervision have fallen. Many may be susceptible to grooming if they feel lonely or uncared for. And almost certainly they will have reduced access to protection from trusted adults outside the home.
Though child and domestic abuse concerns have seen helplines busier, it has become more problematic to both refer cases or have the ability to assist by gaining access to the home or to provide a safe refuge to support the young person or family members subject to the abusive environment. The most recent report indicates that calls to the UK’s National Domestic Abuse Helpline have reportedly risen by 66 per cent during lockdown and visits to its website increased by 950 per cent. Demand for beds in refuges has also rocketed. Witnessing domestic violence as a child can have a huge impact on their future and their mental health. Phone interventions can never compensate for home visiting.
This will have created issues for schools, especially when a number of these young people return to school. And one has to wonder whether the social care will have the ability to cope with the increased workload and whether they will be able to support the young people on their return to school. The latest report from the School’s Commissioner makes specific reference to the urgent need for local agencies, Councils, schools, youth workers and police to focus resources on adolescents at risk of becoming invisible to services or who have gone missing under lockdown. This group are easy prey to criminal gangs and abuse, as well as extremely high risk of becoming not in education, employment or training, NEET, or being excluded. It is essential that they are supported to recover from the crisis and have a way of getting back into education, training or work
To address this, the Department for Education, schools, local authorities, police forces and Safeguarding Partnerships need to work together to identify, track, support and ultimately re-engage this vulnerable group. And parents should be supported not fined for this.
The mitigations indicated on this slide are being undertaken to a greater or less degree across Birmingham. But I want to concentrate for a moment is what is happening in Birmingham. Now, bereavement counselling in Birmingham, of course, had to be adaptive in its approach to enable the various religious, cultural and ethnicity dimensions to be considered. And it is being provided equally to both families, young people and school staff, ’cause one forgets that often school staff have themselves lost members of their nearest and dearest.
Work has also been undertaken to identify as many young carers as possible, both those who have had long-term responsibilities and those, because of the pandemic, who have become involved in increased caring responsibilities. This is being done so as to provide support to those young people on an ongoing basis. But equally, and in parallel, to support those parents who are self-isolating and, or especially clinically vulnerable. And also often those young people are looking after other youngsters, other siblings who have special needs. All of this additional support is to ensure that those young carers are fully re-engaged in their education. Unfortunately, this is a situation unlikely to change to any great extent from September, irrespective of government guidance, given the low levels of trust, confidence and resilience currently experienced by individuals or in their communities. Sorry about that.
One group of concern are those who exhibit emotionally-based school avoidance tendencies. Their reluctance to attend school becomes entrenched due to emotional factors. Can I emphasise the use of the word ‘avoidance’, not refusal, as these youngsters often want to go to school but simply feel as though they cannot and are often not in control of their feelings.
In Birmingham, to assist in identifying those in this group, determine the intervention and support requirements, the signs of safety and well-being framework and early help assessment tools are being developed. This work will be undertaken with well-being leads and practitioners in and across schools. This is in addition to supporting schools in their universal approaches with wider statutory and community partners.
Further work has been ongoing to develop a governance and governing board toolkit with regards to positive mental health and emotional well-being, to assist governing boards to meet the duty test and covers such areas as physical, emotional and positive mental health and well-being, protection from harm and neglect, ensures that mental health and well-being represent an integral part of strategic and operational practice, ensure consultation on this issue with the whole school community and it is seen as a collective responsibility. It also wants the impact of all this to be assessed, so that defined outcomes can be determined and improvements and the process refined, as appropriate.
The next two slides indicate how, around the country and in Birmingham, techniques are being developed and lessons learned to begin to encourage children and young people back to school, not only over the last few weeks but for the anticipated return in September. And this is in conjunction with the programme of catch-up tutoring and the associated monies. These initiatives, practices and techniques have and are being discussed, communicated, adapted and developed, depending on the circumstances identified and are being faced in real-time.
One particular aspect that has been given a lot of consideration has been behaviour, given that the emotional well-being of many returning pupils will be at differing levels, together with the parental anxiety levels that themselves will need to be addressed, and the application of traditional behaviour policies which could give rise to a potential explosion in exclusions. Therefore we have to ask, should the punitive zero-tolerance practices be replaced by restorative practices based on consequences? Unfortunately, the Secretary of State implies fines should be levied for non-attendance. Many head teachers feel that this is inappropriate, at least in the autumn term, if not for at least two terms thereafter. Equally, to what extent should schools be allowed to flex the curriculum to encourage the rediscovery of the love and joy of learning, be more open to using the vocational, technical and arts routes to engage, encourage exploration and appreciation of self and each other, rather than just returning to the academic, exam-driven environments? The worry being that young people will find it difficult to re-engage, become distracted and therefore start to not attend, increasing the numbers who may well need to be excluded in the traditional sense.
In Birmingham, work is also being undertaken to support the professional development of school staff in dealing with the consequences of the pandemic. Also to provide consultation opportunities for both school staff and parents to ensure that parents have the confidence and the resilience to allow their youngsters to come back into school and to understand that the environment will be safe, for example. Also to assist [inaudible – 0:18:56-0:18:59]
schools are being encouraged to identify members of staff with additional training to enable them to be ones who can be approached, for example, by anxious pupils, or can assist in providing a safe place where a young person can go if needed or to identify and even assist where whole family support is required.
What has also become noticeable as schools have moved to post-pandemic working is the way, depending on the methodologies used, the ease of transition that has been achieved, irrespective of the type of community served. Many of those who have tried a top-down approach, treating staff, for example, without reference to their levels of vulnerabilities, have faced considerable logistical difficulties. Similarly, depending on the level of communication with families in the wider community, this has often had a direct effect on the levels of participation. Those schools which have utilised an holistic approach have seen increased participation at every level, with many in the wider community assisting as well.
Also, many schools, as part of this approach, have sought to ensure that young people are included in the decisions involving their well-being, have listened to their views and worked with them to design policies that, for example, promote good behaviour and discipline. Equally important, by building social and emotional skills into the learning life of the school, resilience, structure and confidence can be rediscovered, developed and entrenched in young people.
The last comment in this regard, each school is very different and no one-size-fits-all approach will ever be sufficient. It does require the flexibility of approach I suggested at the beginning.
Some final thoughts. Many of the issues that I have raised could, I suggest, a few years ago have been addressed through facilities that we once had. I’m sure many of you can remember Children Centres, the Family Nursery Hub in many communities. Professional help on hand, often with a youth unit for excluded young people. Can you remember Extended Schools which used to have wraparound care, from breakfast to tea with homework clubs? And I’m sure many of you can remember the numerous youth centres which were available to engage and to ensure that youngsters had activities that were appropriate to their age. Almost all of this has been stripped away through austerity, leaving services stretched and schools often having to pick up the pieces. Should we be seeking to reintroduce?
Budgets are stretched. Needs will be greater, as will the support required. But will it be available at the point it is most needed? Yes, services are being brought back in, especially in the health service, but do they have the level of provision, do they have the resources and the staff to be able to provide that support at the point it is most needed? One thing that we will have to do, I would suggest, is to change working practices. We will have to pool more resources. We will have to create multi-skilled teams of professionals. But above all, to address the changed environments, it must be recognised that there has to be a programme of investment in services for families, children and young people.
Thank you all for listening.