In 2017, the Government published its Green Paper for Transforming children and young people’s mental health, which detailed proposals for expanding access to mental health care for children and young people, building on the national NHS transformation programme which was already underway.

The proposals were focused on providing additional support through schools and colleges and reducing waiting times for treatment. Following a 13-week public consultation, during which the Government received more than 2,700 responses, the Department of Health and Social Care and the Department for Education published its Response to the Children and Young People’s Mental Health Green Paper Consultation.

These core commitments are delivered through a joint and collaborative programme led by the Department of Health and Social Care, Department for Education and NHS England, with support from Health Education England and Public Health England and the Office for Health Improvement and Disparities.

Supported by these partners, NHS England is leading the delivery of two of the programme’s main commitments:

• Establishing Mental Health Support Teams (MHSTs) in education settings, jointly delivered with the Department for Education. As part of the MHST workforce structure, new roles called Educational Mental Health Practitioners have been created and are being trained in evidence-based interventions. The teams will act as a link with local children and young people’s mental health (CYPMH) services and be supervised by NHS staff;
• Between 2018- 2022, NHS England funded 14 pilot sites. Pilot sites worked with NHS England to build consensus on the approach to defining and measuring waiting times. The piloting phase concluded in March 2022 and the work of pilots informed the definition of the waiting time metric that was outlined in the Clinical Review of Standards consultation feedback. NHS England will continue to support systems to transform to improve access, outcomes and experience.

The programme’s other commitments include the training of Senior Mental Health Leads in schools and colleges, and good progress has been made on the commitment to offer senior mental health lead training to all eligible state-funded schools and colleges in England by 2025.

In March 2021, the government announced £79 million to boost mental health support for children and young people in England. The new funding was part of the £500 million already announced for mental health support during the 2020 Spending Review. Over the course of  2021/22, it will be used to expand the support available to children and young people, including increasing the number of MHSTs in schools and colleges and improving access and reducing waiting times for community mental health support.

Mental Health Support Teams (MHSTs)

MHSTs have three core functions:

• to deliver evidence-based interventions for mild-to-moderate mental health issues;
• support the senior mental health lead (where established) in each school or college to introduce or develop whole school or college approach and;
• give timely advice to school and college staff, and liaise with external specialist service to help children and young people to get the right support and stay in education.

In 2018/19, the first wave of MHSTs was commissioned – 58 ‘Trailblazer’ teams – followed by a further 125 MHSTs in 2019/20 and 104 MHSTs in 20/21. By Spring 2022 MHSTs covered 26% of pupils in schools and learners in Further Education achieving the NHS Long Term Plan coverage ambition a year early. Since then, a further 111 MHSTs have been established and as of Spring 2023, 398 teams are operational covering 6,800 schools and colleges and 35% of pupils in schools and learners in Further Education. Additional to this, 100 more teams undertook training during 22/23. We therefore expect approximately 500 MHST to be up and running by 2024. A further 109 teams have been commissioned for 2023/24 (Waves 9 and 10).

Early evaluation of the Trailblazer programme can be found on the University of Birmingham’s website.

MHST site selection process

NHS England regional teams are leading local areas through the further rollout of MHSTs, working with regional teams from the Department for Education and the Office for Health Improvement and Disparities. This includes development of multi-year plans for MHST site selection (incorporating 2021/22 to 2023/24).  Taking a multi-year approach improves strategic planning abilities for both regions and MHSTs and is underpinned by the principles of achieving equitable MHST coverage across England and focusing on placing MHSTs where there are higher levels of need, inequality and disadvantage.

As part the approach, each Integrated Care System (ICS) is allocated a share of the MHSTs in each year based upon their local population of children and young people.  Integrated Care Systems are expected to work in collaboration with health and wider local system partners to determine where the new teams will be located within their area.

As regions and ICSs determine where MHSTs will be placed, they will consider:

• reducing health inequalities and promoting equality of access to services, specifically considering how MHSTs will reach those children and young people with high level of need and most at risk of poor outcomes.
• how an MHST will add to the emotional and mental health support already in place.
• the ‘state of readiness’ within a local area, for example if a local health provider is ready to recruit and employ staff or if an education setting is ready to host the MHST or needs more time to prepare.

Each MHST is expected to provide sufficient capacity to deliver services to a population of c.7000 to 8000 pupils, or between 10 and 20 education settings.

Education settings who are interested in learning more about MHST delivery in their local area are encouraged to contact the lead in their Local Authority who is responsible for the education portfolio or their local ICS.

MHSTs will contribute to the NHS Long Term Plan’s ambition that at least an additional 345,000 children and young people aged 0-25 will be able to access NHS-funded mental health services by 2023/24.

The table below summarises the number of operational and mobilising Mental Health Support Teams, as of May 2023. Precise numbers may be subject to slight variation due to local mergers, as well recruitment in the case of later waves.

North East and Yorkshire

Total for the region: 92

North West

Total for the region: 68

East of England

Total for the region: 72

Midlands

Total for the region: 121

London

Total for the region: 99

South East

Total for the region: 97

South West

Total for the region: 58