Mental health support in schools and colleges

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 and NHS Improvement, with support from Health Education England and Public Health England and the Office for Health Improvement and Disparities.

Supported by these partners, NHS England and NHS Improvement 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;
  • Pilot sites worked with NHS England and NHS Improvement to build consensus on the approach to defining and measuring waiting times. The piloting phase concluded in March 2022. NHS England and NHS Improvement will now work to introduce the approach to measuring waiting times as outlined in the Clinical Review of Standards consultation feedback, and 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 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 advise 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. As of Spring 2022, 287 teams are now operational covering over 4,700 schools and colleges and 26% of pupils in schools and learners in Further Education.  This means that MHSTs have achieved their NHS Long Term Plan coverage ambition a year early.

More teams are on the way; 112 teams were commissioned and began training in 2021/22, with a further 104 to commence training during 22/23. This means that over 500 MHSTs will be up and running by 2024.

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

MHST site selection process

NHS England and NHS Improvement regional teams are leading local areas through the further rollout of MHSTs, working with regional teams from Health Education England, 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 2022. Precise numbers may be subject to slight variation due to local mergers, as well recruitment in the case of Wave 7 and Wave 8 teams.

North East and Yorkshire

ICS

Number of MHSTs, by year

2018/19
Trailblazer
2019/20
Wave 1 and 2
2020/21
Wave 3 and 4
2021/22
Wave 5 and 6
2022/23
Wave 7 and 8
North East and North Cumbria 7 6 4 4 5
Humber, Coast and Vale 0 4 3 4 3
South Yorkshire and Bassetlaw 4 2 3 2 2
West Yorkshire and Harrogate 2 6 4 6 4

Total for the region: 75

North West

ICS

Number of MHSTs, by year

2018/19
Trailblazer
2019/20
Wave 1 and 2
2020/21
Wave 3 and 4
2021/22
Wave 5 and 6
2022/23
Wave 7 and 8
Cheshire and Merseyside 3 8 8 5 1
Lancashire and South Cumbria 0 4 6 6 1
Greater Manchester 2 2 2 4 6

Total for the region: 58

East of England

ICS

Number of MHSTs, by year

2018/19
Trailblazer
2019/20
Wave 1 and 2
2020/21
Wave 3 and 4
2021/22
Wave 5 and 6
2022/23
Wave 7 and 8
Hertfordshire and West Essex 2 2 2 3 4
Bedfordshire, Luton and Milton Keynes 0 3 1 3 2
Mid and South Essex 0 3 3 2 3
Suffolk and North East Essex 0 3 3 2 1
Norfolk and Waveney 0 2 2 2 2
Cambridgeshire and Peterborough 0 2 2 2 2

Total for the region: 58

Midlands

ICS

Number of MHSTs, by year

2018/19
Trailblazer
2019/20
Wave 1 and 2
2020/21
Wave 3 and 4
2021/22
Wave 5 and 6
2022/23
Wave 7 and 8
Nottingham and Nottinghamshire 2 3 2 1 2
Staffordshire and Stoke-on-Trent 4 2 1 1 2
Coventry and Warwickshire 2 2 0 2 2
The Black Country 0 4 2 3 4
Derbyshire 0 4 2 0 3
Lincolnshire 0 2 2 0 3
Birmingham and Solihull 0 2 0 2 6
Shropshire, Telford and Wrekin 0 2 0 1 1
Herefordshire and Worcestershire 0 0 4 0 2
Leicester, Leicestershire and Rutland 0 0 3 2 3
Northamptonshire 0 0 2 3 2

Total for the region: 92

London

ICS

Number of MHSTs, by year

2018/19
Trailblazer
2019/20
Wave 1 and 2
2020/21
Wave 3 and 4
2021/22
Wave 5 and 6
2022/23
Wave 7 and 8
North East London 2 2 6 5 4
North Central London 4 8 1 1 2
North West London 4 5 5 3 2
South West London 3 7 3 3 0
South East London 2 4 4 4 3

Total for the region: 87

South East

ICS

Number of MHSTs, by year

2018/19
Trailblazer
2019/20
Wave 1 and 2
2020/21
Wave 3 and 4
2021/22
Wave 5 and 6
2022/23
Wave 7 and 8
Buckinghamshire, Oxfordshire and Berkshire West 6 3 0 3 4
Frimley Health 0 1 3 3 0
Surrey Heartlands 0 0 2 2 4
Sussex 0 6 0 3 4
Hampshire and Isle of Wight 0 6 5 3 4
Kent and Medway 2 2 4 4 5

Total for the region: 79

South West

ICS

Number of MHSTs, by year

2018/19
Trailblazer
2019/20
Wave 1 and 2
2020/21
Wave 3 and 4
2021/22
Wave 5 and 6
2022/23
Wave 7 and 8
Gloucestershire 4 0 0 2 1
Bath and North East Somerset, Swindon and Wiltshire 3 3 2 2 0
Devon 0 3 1 3 2
Cornwall and Isles of Scilly 0 2 2 2 0
Somerset 0 2 2 2 0
Dorset 0 3 0 4 1
Bristol, North Somerset and South Gloucestershire 0 0 3 3 2

Total for the region: 54

Totals

  • 2018/19 Trailblazer: 58
  • 2019/20 Wave 1 and 2: 125
  • 2020/21 Wave 3 and 4: 104
  • 2021/22 Wave 5 and 6: 112
  • 2022/23 Wave  7 and 8: 104
  • Total: 503