Frances Mathews, Tamsin Ford and colleagues have performed a secondary analysis of the 2004 British Child and Adolescent Mental Health Survey, to understand how accurately teacher concern predicts the presence of a mental disorder in school children. They found that teacher concern was only moderately predictive and sensitive, but a lack of teacher concern was highly predictive and specific. Even though teacher concern did identify children with poorer mental health, it did not accurately differentiate between those with a clinically impairing disorder and those with subclinical levels of mental health difficulties.
“Teachers seem to accurately identify children who are mentally healthy, but they can also correctly identify children whose mental health is poorer than average”, explains Ford. “Their concerns, however, identify a broader spectrum of children than those with impairing mental health conditions”. Therefore, teacher concern alone identifies children whose needs do not meet the threshold for CAMHS, as well as those who do. However, if both teacher and parents were concerned, the child was much more likely to have a disorder, suggesting that corroboration of teacher concerns may help to identify those most in need of CAMHS support.
As children spend a great deal of their time within school, checking how a child’s attainment, behaviour and peer relationships compare to others constitutes a vital part of a mental health assessment. “This information can tell you a lot about how a child is functioning”, says Ford. “If a teacher is not concerned, then our data suggest that it is very unlikely that a child has a significant problem”.
The researchers welcome the current emphasis of policy on a closer collaboration between schools and mental health services. However, they explain that this emphasis will only extend to a third of the country in the next few years. Going forward, we need to understand how best to support teachers and school mental health practitioners such that affected children receive the appropriate level of support that they need. Longitudinal research is also warranted to determine how teacher-identified children with poor mental health fare over time. Ford et al. explain that if these children continue to struggle or even deteriorate, then this might suggest the potential gains of early intervention.
Mathews, F., Newlove-Delgado, T., Finning, K., Boyle, C., Hayes, R., Johnston, P. & Ford, T. (2020), Teachers’ concerns about pupils’ mental health in a cross-sectional survey of a population sample of British school children. Child Adolesc. Ment. Health. doi: 10.111/camh.12390.
Department of Health and Social Care & Department for Education, 2017. “Transforming children and young people’s mental health provision: A green paper.” Retrieved from: https:// www.gov.uk/government/consultations/transforming-children-and-young-peoples-mental-health-provision-a-greenpaper
Mental health of children and young people in Great Britain, 2017. Retrieved from: https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-of-children-and-young-people-in-england/2017/2017