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2 Promoting mental health and emotional well-being through school ethos and environment
Introduction
The school environment, its structure and ethos constitute the first axis of the health promoting school, around which we organise the material of this chapter. The international context for mental health promotion in schools is provided by the World Health Organisation that supports the development of 'child-friendly schools'.
A child-friendly school encourages tolerance and equality between boys and girls and different ethnic, religious and social groups. It promotes active involvement and cooperation, avoids the use of physical punishment and does not tolerate bullying. It is also a supportive and nurturing environment; providing education which responds to the reality of the children's lives. Finally it helps to establish connections between school and family life, encourages creativity as well as academic abilities, and promotes the self-esteem and self-confidence of children. (World Health Organisation 2001)
The 'child-friendly school' promotes development of a 'positive psychosocial environment'.
In this chapter we examine in section A what existing studies tell us about ethos/environment issues. We do this in a layered way. Firstly we examine the school's relationship to the community in which it is embedded (and particularly to parents); secondly, we explore the school's internal structures and their potential impact; and finally we discuss the relationships (between pupils and teachers and between pupils themselves) that are symptomatic of the deepest values espoused within the school. We then move on in section B to look at empirical findings from our own work undertaken for this study. The chapter concludes with a brief summary.
Section A: Evidence from literature
A wide range of factors both within and outside school impact on the mental health and emotional well-being of all those who form part of the school community. The issue is a complex one in which schools need to recognise and respond to mental health problems whether these are understood as being created (or exacerbated) by school structures and culture, or by other social factors (including long-term disadvantage or shorter-term adverse psychological events) experienced by members of the school community outwith the school. Within this review we start first by looking at the environment or catchment within which the school is situated and the way in which the school interacts with that catchment. This may be key in defining relations of the school with parents, and, in turn, may affect the ability of parents to support children. The review then turns to look at aspects of the whole school's operation as manifested in structures and operating policies, before telescoping down to the minutiae of teacher-pupil interactions in the classroom and around the school.
The school in its catchment: partnership with parents
How well do school staff understand the problems that children and young people may bring on site each day? In the past when mobility was lower teachers might well have lived and worked in the same area in which their pupils were growing up. Indeed they may have grown up there themselves in many cases. That situation is now much less likely - cities in particular have become socially more disaggregated and, in areas of social disadvantage in particular, teachers may be quite unfamiliar with the area and the sorts of problems it contains. As Lupton (2004: 9) reports, neighbourhoods have a strong impact on schools. Schools in disadvantaged areas are presented with particular challenges in the form of material poverty, a high number of pupils who are 'anxious, traumatised, unhappy, jealous, angry or vulnerable' and poor attendance, together adding up to 'an unpredictable working environment' for school staff.
New social issues like widespread drug misuse, the influx of asylum seekers, the greater proportion of broken homes and reconstituted families all create complex landscapes through which children must navigate their way to adulthood. Some commentators have seen schools as a refuge from such social pressures and from the chaotic conditions which sometimes prevail in young people's lives - a safe zone - but this can only be the case where the problems encountered by children are acknowledged and understood by the school. Allard and McNamara (2004:8) report that a 'common theme' emerging from their study of NCH service users was 'a lack of understanding from teachers about the difficulties they might be experiencing at home and the impact these might have on them in school'. In some cases this amounted to 'extreme insensitivity' on the part of teachers. The study concludes, 'Unfortunately, some NCH service users' experiences of school tend to confirm their own feelings of inadequacy, rather than helping them to feel more positive about themselves and optimistic for the future.' [ NCH was formerly known as National Children's Homes and focuses its work on the needs of looked after children].
Schools must tread a difficult path through this. They may recognise that children's problems in respect of mental wellbeing and discipline may stem in some measure from the family situations in which they are reared. However, they need not to undermine these fragile families even further but rather to enlist the support and maintain the confidence of parents who, in all likelihood, have only negative memories of their own school experience.
A great deal of research has emphasised the importance of schools working with families of children with emotional and behavioural difficulties in order to effect change. Working with families enhances the likelihood of positive outcomes through increasing the involvement of parents with their child's education, sharing expectations of appropriate behaviour across home and school, enhancing parenting skills and increasing likelihood of transfer of social skills from home to school (Durlak and Wells 1997). Of the 25 programmes found to be 'effective' in Catalano et al's (2002) study of programmes for 'positive youth development' 15 included a 'family component.'
Whilst the majority of parents also recognise the importance of close home-school links there are barriers to their involvement. The majority of partnership initiatives are led and dominated by professionals, and are thus controlling rather than enabling or liberating (Vincent and Tomlinson 1997).
The effect of this has undoubtedly been to push the boundary between school and family closer to the home, with a strong normalised expectation now that parents will prepare their children for formal schooling and will support the school's methods and goals through further practice and surveillance of homework activity. It is also clear that the extension of homework (often in considerable amounts) even into primary schools is intended at least in part to harness parents into a form of partnership, whether they are willing or not, and that this 'partnership' is more correctly construed as a form of tutelage - with parents being expected to learn an appropriate set of norms (Martin and Vincent 1999).
The extension of schooling into the home has some profound consequences for relations between children and parents, given that the 'teacherly' role demanded of parents can be emotionally demanding for both parties. Moreover we know too little about the impact of these new demands on the micro-conduct of family life in respect of men's and women's labour market roles.
The demands of homework provide a way of the school monitoring the running of the household, as well as dictating its schedule. It breaks down the public-private divide by bringing the work of the school into the home, with little acknowledgement of its impact on the household. (Standing 1999: 489)
What is clear, however, is that those families under the most stress in economic terms will find it hardest to comply with the new demands made on them by the shifting of this boundary (Shucksmith et al 2005). In single parent families, but also in those homes where men and women work complex and alternating shift patterns in order to maximise income and minimise childcare costs, the strain is felt most clearly. Most debates about school-home partnerships take insufficient account of the divergence of home contexts and familial 'capacity'. The resources families can draw down are hugely diverse and as well as economic constraints there are many families where families are fractured, fathers absent or disengaged; wider kin not available; illness and care burdens. Families are neither equally resourced nor underpinned by similar infrastructures of support. The participation agenda could be one pressure too many, and another source of guilt and perceived failure.
In a survey of parental involvement in their child's education the main barriers cited for non involvement were practical: lack of time due to work commitments and childcare difficulties (Moon and Ivins 2004). While these practical difficulties are real and pressing, research indicates that other barriers are also evident. Thus, Andis et al (2002) in the US cite 'parent blaming' on the part of professionals as a significant barrier to the development of partnerships. In the UK too social policy under New Labour has been accused of being based on 'individualistic strategies that fail to take into account deep-rooted structural inequalities that impact on available choices and values in excluded communities' (Broadhurst et al 2005:106).
Although the boundary has clearly shifted in respect of the school's power to dictate aspects of child rearing, domestic timetables and parenting practices, parents still reserve a space around the boundary, however, where they feel free to demand appropriate standards of care and concern for their child. Issues around bullying or general care for children's health and wellbeing fire even the most reticent parents into action to challenge the school. This may take the form of polite but determined enquiry, but - in parents otherwise disempowered - may result in the sorts of 'storming' behaviour described by Ranson et al (2004), where people feel that the school has intruded too far into the parental domain and yet failed to fulfil its duty 'in loco parentis'.
Ouellette et al (2004) report that parents often feel they are not listened to or that 'schools are condescending'. Parents may also feel that 'communication between parents and schools are for problems regarding their children' (Ouellette et al 2004:304). Thus the school's notion of partnership can be one-sided, with a lack of recognition that parents may hold different educational values or have different goals for their child's education (Hoover-Dempsey et al 2002). Tett (2001:194) argues that,
If parents are to be genuine partners in their children's education then they must be able to share power, responsibility and ownership in ways which show a high degree of mutuality. This becomes problematic if parental knowledge about schools and schools' knowledge about parents is characterised by lack of understanding.
This requires movement away from a perspective of parents as 'problems' to recognising the important contribution that parents can make to the home-school relationship.
The school as a system: structures and culture as constitutive of stress
School systems, comprising structure, organisation and culture operate in complex ways but clearly have the capacity to impact on pupil mental health and emotional well-being - including the construction of the very problems to which they are seeking solutions (Watson 2005). Certainly, symptomatic responses to adverse impact of school structure and culture on pupil well-being can be discerned.
School structure and culture can be considered to be constitutive of stress in pupils (and teachers) in a number of ways. Education has always faced a tension between the delivery of a mass system of education with the specific needs of individual children or small groups. State schools have never been resourced at the levels which allow them the freedom to offer service in ways which are individually tailored for all pupils. Many commentators have noted a decline in the flexibility of the British education system as a key factor in creating structures which induce stress. Target setting, increased levels of testing, prescriptive curricular frameworks and so on are felt to have gradually eroded the freedom of the individual teacher to flex the curriculum to suit the needs of pupils or to even take advantage of serendipitous learning opportunities whose impact might be more immediate. However, in Scotland, policy is shifting to recognise the importance of pupil well-being in a holistic sense. The 'McCrone agreement' places a duty of care on all teachers in 'promoting and safeguarding the health, welfare and safety of pupils' ( SEED 2001b, Annex B).
Thus Connor (2003) discusses the impact on children as 'unwitting victims of current target-setting pressures upon teachers and schools'. In a small-scale study he observed 'tearfulness, attention-seeking behaviour and constant search for reassurance' among 7-year olds sitting standard assessment tasks in Surrey. A survey commissioned by the Professional Association of Teachers, the Secondary Heads Association and the Children's Society (Professional Association of Teachers 2000) indicated that exam pressures caused symptoms of stress in some pupils including panic attacks, problems with sleep and eating disorders. West and Sweeting (2003) also report rising levels of stress among young women related to school work and exams. Homework too (as noted in the previous section) can be a cause of stress. Solomon et al (2002) examined homework policy in England. They concluded that constructs underpinning such policies failed to recognise the impact of homework on the child-parent relationship which for a significant minority of parents 'was dominated by conflict and anxiety.'
The differentiated nature of the school system poses stark contrasts. From primary schools, where children's daily lives are spent in stable groups with single teachers young people are catapulted into secondary schools, vast in size and housed on complex sites, where they must move like nomads from space to space every hour, trailing with them all their clothing and belongings because lockers don't work and cloakrooms are unsafe. Such transitions can be problematic for pupils. Fenzel (2000:94), reviewing literature on transitions, suggests factors contributing to this stress include 'increased academic demands and social comparisons, exposure to unfamiliar peers and teachers, and practices that fail to meet early adolescents' developmental needs for autonomy and self-management.' Such stress impacts negatively on self-worth. Transitions are especially problematic for children who are already at risk in other ways or who are deemed to have emotional and behavioural difficulties.
Lack of flexibility in responding to the needs of certain groups can also lead to problems. This is particularly evident in the case of Gypsy/Traveller children. Jordan (2001) discusses the clash of cultures between Travellers and school that frequently results in Traveller children dropping out of schooling. In particular, she notes that while Travellers expect their children to become independent at an early age, this is not necessarily recognised, valued, or indeed tolerated by schools. She writes, 'Schools verbalised an understanding of the very different Gypsy/Traveller aspirations, of independence, early marriage and family responsibility, of observance of Traveller traditions, yet showed little accommodation to support those.' (Jordan 2001:66). Similarly, Davies and Webb (2000) report on services to support refugee/asylum seeker children in Wales. Cultural differences relating to child-rearing practices created conflict particularly among the boys who had been used to being given greater responsibility in their home country than is usual in the UK. This 'transcultural trauma' resulted in aggressive behaviour at school and inability to conform.
Attempts to offer an education service which did not segregate by social class led from the mid 1960s onwards to the introduction of comprehensive schooling and the development of examination systems that all were to undertake, abolishing the old commercial, technical and vocational streams which prepared a blue collar workforce for the future. Subsequent years have seen the pendulum swing back to a place where policymakers now exercise themselves over how to reintroduce 'vocational' education but in such a manner that it cannot be construed as a second class option. Whilst the solution to this is being sought, many young people still feel intensely frustrated at being made to endure an advisory range of academic subjects to the age of 16 in which they have little interest. Thus in a study for children's charity NCH (Allard and McNamara 2004), the three biggest issues for pupils were respectively: bullying, teachers and particular subjects. With regard to the last of these, many pupils in the survey 'felt they had been forced to study subjects in which they had no interest and to which they could see no point.' ( ibid:4). In some instances the way that the subject was taught, rather than the subject itself, was seen as being the cause of the difficulty. Pupils identified lack of opportunity to be involved actively in learning as at the root of the problem. Such disaffection from school is a widely recognised problem which constitutes a barrier to educational achievement and may be regarded as impacting on well-being in school.
Formal systems and structures within the school can also provide a framework in which mental wellbeing is fostered or jeopardised. In particular we look here at support systems, in respect of learning, discipline and pastoral care.
Support for Learning systems have developed out of the old system of 'remedial' teaching (traces of which still linger in perceptions of the role) and Behaviour Support which has developed more recently. Continued separation of these roles perhaps reduces the extent to which behaviour and learning are understood to be connected. However, the SEED report Better Behaviour Better Learning ( SEED 2001a: 5.1) called for schools to 'consider how existing in-school services can be integrated to support children and young people's learning and pastoral needs…this may include staff who have been given responsibility for learning support, behaviour support and guidance working much more closely under a collective framework of pupil support.' The follow-up report Better Behaviour in Scottish Schools ( SEED 2004b:31) suggests that this is starting to happen. An integrated model of support articulates with the recent move away from the concept of 'special educational needs' in favour of the more inclusive concept of 'additional support needs' ( SEED 2003).
Kane et al (2004) discuss different models of behaviour support operating in 'an authority' in Scotland. They identify three broad models: Type 1 models view Behaviour Support as permeating, involving all teachers and 'embedded in curriculum and wider support schemes'. Schools operating this system 'believed reduction in exclusions would be a by-product of very broad approaches to supporting pupils' learning' ( ibid: 70). They also believed this approach was consistent with the development of inclusive practice and fostered each teacher's competence and confidence in dealing with challenges. 'Type 2' and 'Type 3' models saw behaviour support as a discrete entity. Type 2 models tended to remove pupils to designated areas. Type 3 models tended to use behaviour support staff to work alongside classroom teachers and were 'characterised by their effort to strike a balance, encompassing factors from the other two models'. The three models each have strengths and weaknesses, however all shared an ambivalence as to function, namely 'Is it intended to serve a disciplinary function? Is it primarily to promote the welfare of vulnerable pupils or is it just an uneasy compromise between these two functions?' (Kane et al 2004:73). Their research also suggests that pupils share this doubt, appreciating the help of behaviour support but still perceiving it to be part of the overall system of discipline.
It might be expected that similar ambivalence exists within the guidance role. Howieson and Semple (2000:382) suggest that:
Although guidance staff in Scotland historically had a punitive role in discipline, more recently, virtually all schools have tried to separate the issuing of discipline sanctions from the supportive role that guidance staff should play when behavioural difficulties arise. The guidance teachers in the project schools strongly supported a non-punitive role in discipline cases and felt that they took a neutral and supportive stance with pupils.
Pupils themselves, however, were divided on this and the authors conclude that, 'overall, guidance teachers' view of themselves as being in a supportive role was not generally shared by pupils.' This points to the importance of schools examining and acknowledging the perceptions of pupils. It also suggests a need for the reformulation of the concept of 'care' together with recognition of the role that all teachers have in relation to this in line with HMIe's (2004a:4) observation that 'the principle that pastoral care was a core part of all teachers' duties' is 'not well established in secondary schools.'
The restorative justice model of school discipline (Watchel 1999) seeks to combine discipline with care, rather than to separate the two. Just as effective parenting is often described as authoritative, rather than either permissive or authoritarian, so effective school behaviour management is seen to confront and disapprove of wrongdoing, whilst at the same time supporting the and valuing the wrongdoer. This approach advocates responses in which the child or young person is active, (for example by discussing with the victim and repairing the harm), in preference to the traditional responses in which the child or young person is passive, (for example shouting at them, or subjecting them to detention). This approach is currently being piloted in three Scottish authorities and is undergoing evaluation.
Many authorities have now adopted a new set of structures via the adoption of a staged approach to responding to behaviour difficulties. The HMI document Alternatives to Exclusion ( HMI 2000) sets out four levels. Level one needs are considered to be able to be met in the ordinary mainstream classroom, while level four needs require 'a highly specialised environment'. (While the emphasis in this document is on pupils presenting challenging behaviour, there are parallels with tiered responses to mental health needs, with schools seen as an appropriate site for tier 1 interventions (Gowers et al 2004). This perhaps points to an area in which school/medical discourses could become more closely articulated).
A staged approach to behaviour support is Birmingham City Council's 'Framework for Intervention'. In this case the focus of attention at level one is not the child but the classroom environment and the creation of a classroom climate that promotes learning and emotional well-being (Daniels and Williams 2000; Williams and Daniels 2000). Modified versions of Framework for Intervention have been applied in a number of Scottish authorities including East Ayrshire and in Aberdeenshire where it is known by the acronym ASSIST. Framework for Intervention is a 'no-blame' approach which highlights the contextual nature of behaviour. Any teacher who considers that he/she has a problem in their classroom consults with another designated member of staff (a Behaviour Coordinator or 'BeCo') and, using 'solution focused' techniques, develops a plan for changing some aspect of the classroom environment in order to improve behaviour. This plan runs for six weeks after which it is evaluated. Moves to levels 2 and 3 of the scheme, in which the focus changes to individual children may then follow. The authors state that the scheme offers 'a comprehensive approach to all behaviour problems whether 'disciplinary', ' EBD' or 'psychiatric'. (Daniels and Williams 2000). Although the scheme has been enthusiastically taken up by a number of authorities little formal external evaluation of the approach has been published to date, though a small-scale evaluation by Birmingham University was carried out in 1999 which found 'widespread support' for the scheme. It was viewed as compatible with inclusion and led to reductions in low-level disruption. Key factors in success were given as: support from senior management; support and training for BeCos; and a receptive staff (Framework for Intervention website). During the trial for the project it was noted from questionnaires that a shift in teacher attitude was apparent. Teachers 'were more inclined to believe that teacher behaviour markedly affected the conduct of children in school' (Daniels and Williams 2002). East Ayrshire have incorporated Framework for Intervention into their overall inclusion strategy, evaluated internally in 2004 (East Ayrshire Council 2004). A case study of the ASSIST initiative forms part of this report.
Obviously vulnerable groups often appear well cared for in terms of the establishment of structures within schools, though experience on the ground may fall short of the ideal. Better Behaviour in Scottish Schools ( SEED 2004b) notes good progress towards the appointment of designated supporters for looked after children, for instance. Fletcher-Campbell et al (2003) examined this role in a number of schools in England. Their research indicates that where schools already had 'highly developed structures' to meet the needs of a wide range of pupils they had 'little additional to do to meet the specific needs of children in public care.' The role of designated teacher was seen to be that of a keyworker, having an overview of the child's progress, being an advocate for the child, and ensuring effective liaison with other agencies.
Other vulnerable groups include refugees/asylum seekers. As a result of the UK government's dispersal policy Glasgow has some 1400 young asylum seekers in its schools (Walker 2002). Clearly, schools need to develop inclusive systems which meet the diverse needs of these learners whose education has been inevitably disrupted and for whom English is in all probability an additional language. Walker (2002) discusses Glasgow's model of provision which is based on 'attendance at a Bilingual Base followed by gradual integration into mainstream at the time most appropriate for each individual child.' Ingleby and Watters (2002) outline the Pharos project aimed at developing school-based programmes to support the transition of refugee children into their new country and school. Part of this programme is aimed at supporting teachers for which a need is clearly evident: in Stead et al's (1999: 74) research into Scottish schools the authors found that, 'for many teachers interviewed, experience and knowledge of refugee pupils was either limited or non-existent.'
Alongside these factors are the social and psychological problems associated with refugee status. The role of schools as the primary site for support of refugee children is emphasised by Hodes (2002) and by O'Shea et al (2000) who suggest that 'by working collaboratively with teachers much can be achieved with a population that does not readily access mental health services.'
The school as intersecting relationships
If the inclusive school promotes the mental health and emotional well-being of all members of the school community then an important aspect of this is the development of a positive ethos within the school. The HMI report 'Alternatives to Exclusion' ( HMI 2000) identifies the presence of 'a positive, inclusive school ethos in which all pupils are respected and valued' as a key factor in schools with low levels of exclusion. Ethos is, however, a rather elusive notion. Eisner (1995) defines it as 'a term that refers to the deep structure of a culture, the values that maintain it, that collectively constitute its way of life.' This is important. Too often, initiatives to promote a positive ethos, valuable though these might be, fail to acknowledge or surface the deeply held assumptions about the underlying culture that constitute ethos - the normalising practices which serve to construct gender, race, deviance etc within the school. This may go someway to explaining why efforts to promote a positive ethos often meet only with partial success. Deep level and sustained change requires an understanding of the school as a holistic system. However, Weare and Gray (2003:44) suggest that 'there is still a lack of agreement about what this means in practice. Many examples of so-called 'whole school' approaches are in fact only partial accounts.' They suggest that key factors in a whole school approach that promotes emotional well-being are: 'the fostering of relationships; the encouragement of participation; the development of appropriate levels of autonomy in pupils and teachers; and the pursuit of clarity about rules, boundaries and positive expectations.' ( ibid: 56).
In this section we look at the ways in which the deeper values of the school are transmitted through the relationships within the school at a day to day level, between teachers and pupils and between one set of pupils and another.
Healey (2002) surveyed 400 pupils from 41 London schools about what makes a school healthy. With respect to mental health the issue of most concern was stress, with bullying and racism being seen as the major stressors. Other sources of stress cited were peer pressure, homework overload and exam pressures. Respondents also saw the school environment as contributing significantly to emotional well-being. 'Many highlighted the link between school environment and ability to learn' and 'there were widespread concerns about litter and a lack of basic facilities, such as lockers and clean toilets' ( ibid: 6). Teachers' attitudes and friendliness were also important factors as was pupil involvement in decision-making.
Many studies have shown that the quality of the pupil-teacher relationship lies at the heart of children's experience of schooling and as such is of key importance both to educational achievement and to each individual's sense of worth. This finding is echoed in reports like that from Bancroft et al (2004) who investigated the experiences of children of parents misusing drugs and alcohol. They highlight the importance of teachers offering support - even of noticing that something is wrong with the pupil. Some of these youngsters 'could identify particular teachers who stood out as helpful or concerned for them, for example teachers who would not single them out if they were too sleepy to study, or who would defuse their aggression by inviting them to go outside for a cigarette. ( ibid: 23)'
However, they also note some ambivalence in pupil attitude, 'On the one hand [one young woman] was annoyed with teachers for not noticing her problems, even during a short period when she was drunk at school. On the other, she did not trust teachers to be discreet and feared being treated differently to other students.' (Bancroft et al 2004:22).
Similarly, Wade and Smart (2002) in their report on children of divorced parents say that while schools are often viewed as a 'safe place' providing much needed continuity and stability for children in transition, children themselves were ambivalent about the support available from schools and teachers. The authors suggest that where children did tell their teacher it was 'not so much to enable them to offer support but more so they could take account of any changes in the child's behaviour.' Much of this ambivalence relates to the inherent risk of public disclosure of private information at school or as Wade and Smart (2002) report the 'daunting' aspect for - especially younger- children of approaching a teacher, 'many of them saw their teachers as being too busy, or too impatient to listen to them' ( ibid:32). However, Wade and Smart (2002:32) note 'some exceptions' to this 'notably where there was considerable warmth in the teacher's relationship with their pupils' and where pupils felt they mattered.
The importance of the teacher-pupil relationship is a factor that emerges frequently in the literature on children and young people excluded from school (see, for example Pomeroy 2000 and literature cited therein). Pomeroy's (1999) research with young people excluded from school shows that 'repeatedly interviewees mention certain teachers who knew them, who would talk to and explain things to them, and who would listen. Knowing students in this way implies that the teachers have an ability to assume the student's perspective.' (Pomeroy 1999:477). Ennis and McCaulay (2002) make a similar point in their work on 'hard-to-teach' students in which students valued teachers who 'took the time' to get to know them. Conversely, teachers who shout, ridicule, respond sarcastically etc are seen to be antagonistic by pupils (Pomeroy 2000). The difficulties caused by these teachers is highlighted in research on teachers' perceptions of discipline in Scottish schools, 'a small number of teachers cause a disproportionate number of difficulties. They are small in number but a serious problem.' (Head teacher quoted in Munn et al 2004:4). Head et al (2003) suggest that differential exclusion rates between schools may be explained, in part at least, by the extent to which teachers understand and empathise with their pupils and their 'fundamental values in relation to exclusion.'
While overall classroom climate is clearly of importance in determining pupil experiences of learning, individual responses to pupils mean that every child's experience of school is different. Differential responses to individual children may, to a certain extent, centre on the extent to which the teacher perceives the child as being 'naughty' or 'needy'. The 'disturbed' child is seen as not being in control of their own behaviour and as such may be more deserving of compassion than the 'naughty' child. However, the distinction between the naughty and the needy may be more arbitrary than is commonly assumed. Visser and Stokes (2003) discuss research which indicates that children displaying similar behaviour are excluded from some schools while in others they are referred for assessment. Even within the same school judgements about the behaviour on which such distinctions are made vary:
The available repertoires for being "a good school student" differ between classrooms and from one situation to another within classrooms. They differ between the classroom and the playground. And further they differ from one child to another. Repertoires are highly situation specific.(Laws and Davies 2000:110)
However, in addition to this rather idiosyncratic variation in the nature of relationships between pupils and teachers, more structured differences may also exist, related to factors such as gender and ethnicity.
Boys are over-represented in exclusion figures in Scotland by a factor of 4:1 in primary school and 9:1 in secondary (Munn et al 2001) and socio-economic status is a key factor in this. Research into gender effects also indicates that boys' and girls' experience of classroom life is different. There is a body of research that indicates that patterns of classroom interactions are gendered and that gender is a significant factor in the construction of behaviour difficulties by teachers. Thus, while teachers believe they apply the same rules to boys and girls equally, pupils report things differently:
Pupil groups believed that boys got harsher punishments than girls for the same misdemeanours and that girls were expected to behave better than boys by teachers. (Tinklin et al 2001:9)
The school is a key site for the construction of gendered identities. Haywood and Mac an Ghaill (2003:65) suggest that, 'the curriculum alongside disciplinary procedures, normalising judgements and the examination represents an institutionalised gendered regime or a patterning of gender relations i.e. schools create, through their practices, norms for gender which are then performed by pupils.' Thus schools and teachers, through their gender strategies may contribute to the construction of boys as 'problems'.
Institutional racism is clearly an aspect of school culture that can impact on the emotional well-being of pupils. MacPherson (Home Office 1999: 6.34) defined institutional racism as 'The collective failure of an organisation to provide an appropriate and professional service to people because of their colour, culture or ethnic origin.' As such, institutional racism can be seen to operate in the 'construction of black children as a problem for the education system' resulting in black (male) children being over-represented in provision for children with EBD (Cole 2004:44). While the figures in Scotland are not comparable to those in England (perhaps due to smaller numbers of children of African Caribbean ethnicity in this country) the issues are nevertheless relevant. Jordan (2001) also argues that institutional racism creates barriers to Traveller children's learning and 'undoubtedly contributed to some Gypsy/Travellers' self-exclusion from schools.'
The reasons for the relative failure of African and African Caribbean children in our school system are complex. However differential treatment and the low expectation of teachers are crucial factors. As Tennant (2004:199) remarks, 'It is certainly the case that studies have found that African Caribbean children arrive in school at the age of 5 performing at a very similar level to all other children, only to leave at the age of 16 performing rather worse than most other groups of children, particularly boys.' Pomeroy's (2000) research with excluded youth also highlights perceptions of racial discrimination. She writes, 'teachers' behaviour towards students sends implicit messages to the students about their value in the classroom. Racist teacher behaviour, actual or perceived, will unquestionably have a negative impact on young people's sense of self and self-value. The effect of these tacit messages on young people's esteem should not be underestimated.' (Pomeroy 2000:45).
A major shift in the way in which relationships can be seen to reflect the underlying ethos of the school is in the extent to which there is a focus on building competence, autonomy and self confidence. This is an agenda that affects teachers tasked to take on new roles as much as it affects children. Stressed teachers are less likely to be able to promote the emotional well-being of their pupils, and as Kyriacou (2001:33) notes,
Teacher stress can sometimes undermine teachers' feelings of goodwill towards pupils and lead teachers to direct their hostility towards pupils when pupils produce poor work or misbehave.
Kyriacou suggests that further research is needed to explore the interactions between pupil and teacher stress. A survey of teacher stress in Scotland suggested that the two key issues are workload and pupil behaviour (Johnstone 1993). For teachers who view the pupil-teacher relationship in terms of the need to 'control' pupils, the inability to do this strikes at the sense of self and they may feel unable to admit to a problem. This, combined with lack of confidence in responding to the needs of children with emotional and behavioural difficulties creates stress. There is thus a clear need for management support of staff development in this area.
Pupils themselves can be encouraged to support one another's wellbeing in a school in which the underlying ethos values their competence.
The involvement of pupils in schools is a key theme in the development of inclusive and 'child-friendly' schools. Many schools have developed systems which seek to involve pupils more fully, and especially in the area of peer support. Mentoring and mediation schemes are becoming widely seen as strategies for supporting young people's social and emotional needs not just within the school but in meeting the needs of excluded youth in the wider community too (Philip et al 2004). In schools peer support is seen as being a potentially effective strategy in tackling bullying (Cowie et al 2002) and in promoting race equality (Sumil Puri no date). Such strategies are consistent with the recognition of the importance of involving students more fully in decision-making processes within the school ( SEED 2001a). Case studies produced by the Mental Health Foundation suggest benefits to the peer supporters, to students and to staff.
A peer support scheme as part of a whole school approach helps schools to meet the demands of the citizenship curriculum, to work towards the National Healthy School Standard and to demonstrate their commitment to the social and emotional development of pupils… Peer support projects can play a major role in tackling bullying and can contribute to creating a caring and safe school community that promotes the mental health of all its members.' ( MHF 2002b:5).
In evaluating the case studies MHF drew up a series of recommendations for setting up peer support schemes. Central to this was the notion that peer support schemes form part of a whole school approach to pastoral care that requires commitment from the whole school community. Peer supporters themselves need to be trained carefully and supported to carry out their role. MHF also highlighted the need for peer supporters to be representative of the whole school population, not just the high achievers and the well-behaved. Cowie et al (2002) highlight the continuing difficulty of recruiting and retaining boys as peer supporters as this was seen as conflicting with peer pressure to be "macho".
An evaluation of 14 peer support schemes by Baginsky (2004) highlights issues of sustainability. In this study, the 14 schools had worked closely with the NSPCC in setting up schemes. After 12 months it was found that four were still 'relatively strong', another four were 'limping along' while six had ceased altogether. The 'most positive' schemes were operating in two primary schools and in both of these the commitment of staff time was particularly high. Take up in secondary schools was found to be low and was characterised by a move away from the playground and into more formal counselling settings. This contrasts with findings by Cowie et al (2002) of a move away from such settings, which perhaps has contributed to the relative success of these schemes in the schools reported on by those researchers. Another factor associated with success of peer support schemes was the presence of a school counsellor who was able to offer advice and support to the peer supporters. This highlights the need for schools to work closely with other agencies to develop sustainable programmes with realistic expectations (a key finding of Smith and Watson (2004) in their evaluation of the ChildLine partnership with schools programme). Baginsky (2004: 9) concludes, 'To understand what makes peer-support work more time is needed to observe and interact with all the members of the school communities and the evaluations conducted need to be more rigorous.' Smith (2004) also argues that more evaluation research is needed. Peer support, he suggests, clearly benefits the peer supporters, but 'specific benefits for victims of bullying remains to be proven.' This view is also endorsed by pupils. In a survey of 400 pupils from over 40 London schools Healey (2002) found some ambivalence towards peer support schemes. While many pupils thought peer support was a good idea, some expressed reservations about confidentiality and bias among peer supporters. Healey suggests that in evaluating the effectiveness of such schemes the views of young people should be sought in order to identify barriers preventing pupils from accessing support.
Section B: Evidence from empirical work
Youngsters do have emotional difficulties, but I think by attaching that label sometimes you see them as the ones that have to change. Rather than seeing the actual environmental factors as being equally important and having to be modified as well. (Educational Psychologist)
In this section we explore the complex relationship between the school environment, behaviour and the mental wellbeing of pupils, as it was understood and enacted by the various participants of our surveys and case studies. The links between the school environment and pupil wellbeing were universally acknowledged, but the ways in which this relationship was interpreted and the methods employed by schools to support mental wellbeing were varied. The broader environment of the school as characterised in its catchment and its parent body, the macro structures created by value systems, policies and procedures within the school, and the micro-environment, created by personal interpretations and relationships at a day to day level all had implications for the mental well being of pupils.
The school in its catchment: partnership with parents
In all of the case studies considerable concern was expressed by school staff and their partners in other agencies about the problems which some families in the schools' catchment were facing in terms of, for example, poverty, health, substance abuse and family breakdown and the effect that these circumstances have on the mental and emotional well being of children.
I see the difficulties our families have through poverty, through substance and alcohol misuse, through lack of literacy. And I find it very frustrating that in many schools they don't take account of the background of the children. I just saw the pilot of being a community school as being the way forward, so perhaps I embraced this with open arms in the way that maybe other head teachers may or may not do. (Headteacher, case study school)
There was a reported difference between the types of responses that would operate in more rural areas, where, it was felt, schools could often offer services that were better tailored to their circumstances:
Schools are flexible in how they manage children with high level needs. You can do that with small classrooms and the direct relationships with families and home. (Public health consultant)
In rural areas, the advantages of relatively small numbers of pupils and stronger links within catchment communities were seen as key to early identification of issues, and teacher expertise was central to this:
Teachers tend to have a great deal of knowledge about kids, families and communities - the vast majority have long term relationships with services like the GP, health visitors and the education services, so things get picked up early as someone notices. Families too are likely to see these people as there to help. It allows the network to pick up on things if they see something looming and they can stop things escalating where that can be done. So prevention is really built into it. It isn't all rosy but I think there is something there about the stability of the population. (Public health consultant)
Schools were usually keen that parents should feel able to come forward to discuss the difficulties in their children's lives, and, in some cases, there were structures in place to offer family support through the school. However, the main difficulty faced in achieving this relationship was to break down the barriers that inhibit parents from making that type of contact. One school manager commented on how difficult she found it to build relationships with vulnerable parents:
When it comes to secondary school, particularly in this area our parents are reluctant. I think they feel inhibited or whatever and we've tried a variety of things over the years. It's very, very difficult to get parents involved, by and large. It's a shame, but that's the way of it. (Deputy Head, Glasgow)
Often the response to this was to employ additional workers such as home-school link workers, or family learning co-ordinators, who offered a non threatening point of contact and whom parents were able to contact directly. For example, the team of pupil and family support workers in Clydebank High School was reported by parents to be very approachable and helpful.
A very proactive approach to family involvement in school life was seen in East Renfrewshire, where a family learning co-ordinator ran a community wellbeing programme based largely in the primary school. Family involvement was encouraged through a wide range of inclusive activities, usually run in the school holidays including activity days in school and family outings:
And it involves the whole notion that the family come together to do something so its building….building the family unit. Hopefully it's a resilient unit which can do things for itself but also building a larger unit … sort of community groups. Community in the sense of the community of the school rather than a geographical community. ( ICS integration manager)
The objective of the scheme was to develop the capacity of families to support their children, within the wider context of community wellbeing. But the extensive contact made with parents through this scheme also improved general relationships with the school, making it easier for parents to approach the family learning co-ordinator with respect to children's difficulties. He was seen as extremely accessible and supportive, by parents:
You can always talk to H and get support there. They were very good about my husband. He had a heart bypass two years ago. They were always asking how things were. 'Do you need any help?' And H was going to come by my house and pick my son up and bring him to school. He's always ready to help. And that goes for anybody.
Involvement of pupils and parents, however goes beyond simple accessibility to services, and is also related to the involvement in, and control over the subsequent course of action. Very often children and parents were not included in discussions about the most appropriate response to their difficulties. Typically, Joint Support Team ( JST) meetings would not include parents or children. In some cases parental permission was required before holding a meeting to discuss a child's problems but parents were not invited to the meeting. The outcome of the meeting, in these cases was reported to the parents by a representative of the Joint Support Team. Parental control was limited to the power of initial veto.
In some places consultation with parents had been initiated and considerable effort expended on drawing them into discussion about the health services which should be available to young people. At Newbattle High School, two rounds of consultation had taken place and parents had broadly supported the developments. This gave staff confidence in taking the work forward. At another level a parents support group initiated and supported by the integration team met on a weekly basis in a local community centre. The parents who took part in the group had experienced considerable difficulties in dealing with problems that their children had at school. They viewed the group as a valuable forum for seeking and giving support and this was strongly linked to the work of the integration team.
The school as a system: structures and culture
Whilst recent policy changes in Scottish education have moved away from a narrow focus on attainment to a wider and more inclusive view of the function of schools (eg SEED 2001b, SEED 2005a), placing a responsibility for care on all teachers, current practice in schools does not always reflect these changes. Schools' and teachers'' perceptions of national policy, particularly in regard to educational outcomes were not always in line with current Scottish Executive thinking, and this is evident in some of the attitudes and practices described below. Schools, as indicated above, are highly organised, busy places, with little flexibility in terms of time, staffing or curriculum. In this section we look at the ways in which school structures appeared to be operating to promote or impede wellbeing agendas or respond to discipline issues. This allows us to look at the ways in which schools coped with the dual demands of catering for the needs of the majority whilst also responding to individual need. To achieve this schools have sought to reorganise their pastoral provision in new ways, and/or have brought in new and different skill mixes to give additional support to children. Does the degree and pattern of the integration of such support affect the success of the scheme? What tensions are created by grafting on to the school's ethos and culture additional services operating with very different understandings and premises? The drive for integration and inclusion imposes on schools the need to develop staged systems of response to problems with children's behaviour. We look at some of the ways in which schools are adapting structures to keep children in the classroom.
Teachers, unlike any other group working with children or young people, deal with large numbers simultaneously, and need to juggle sometimes competing agendas. Even when teachers were aware of pupils whose wellbeing was compromised by, for example an inappropriate curriculum, they sometimes expressed significant frustration at not feeling able to respond in a way which met the their needs. This comment refers to an identified group of pupils, who were disruptive in classes, due to, it was felt, the unsuitability of the learning environment:
If you took that group and were able to effectively amend the curriculum to suit them, then teaching through the whole school would improve. But quite often simply because resources..because classes are full, because we are so tight staff-wise and time-wise, and even accommodation-wise….. (Secondary teacher)
Much the same sentiment was expressed by another interviewee at strategic level:
That poses the usual professional dilemma about how flexible you should expect a regular mainstream to be. Getting the balance right between significant customisation around a minority of pupils when the majority might be going along very well thank you. That's a tension that has always been about. (Head of service)
Education authority representatives were well aware of these type of issues faced by classroom teachers, and made frequent reference to the difficulties in reconciling an individualised approach with the structures and expectations of a typical secondary school environment. This was linked to the notion that the main business of the school was about delivering the academic goods to the majority, and that this somehow was in conflict with the notion of prioritising welfare and focusing on individuals and their problems. However, some also challenged the notion that there was conflict:
There are some schools, secondaries who go along the attainment line, focus very much on attainment and don't recognise that there is more than one way of achieving that. If young people feel good about themselves, particularly at times when they are feeling vulnerable, they are more likely to come through unscathed and take advantage of what the curriculum has to offer. It's very much about the awareness of staff. Some are very, very aware, others see it as more challenging. (Education authority, development officer)
Schools found it difficult to put in place additional supporting structures within their existing staffing and budget, although Clydebank High school had interlinked their pastoral care staff, learning support and behaviour support to form an extended support team. The team reported being able to detect problems more easily and to be able to respond more quickly. As a result of this new structure they felt that vulnerable pupils were less likely to slip unnoticed through the pastoral care net.
In the other case studies additional structures had been created within or in connection with the school as a result of collaboration with other agencies. Such partnerships brought considerable benefit by being able to offer flexible individualised support to pupils that was much less restricted by the sorts of constraints of time and curriculum, which were reported by the teaching staff.
However, tensions appear in any system where the support for vulnerable children is seen as separate from the main business of the school. If the objectives of class teachers are seen as different from those who offer pastoral care and support to pupils, then inconsistencies arise for those pupils as they move between the different silos of the school. Paradoxically, these inconsistencies can be most acute in schools where the support system is most highly developed, as there can be a wider gulf between the approaches used in the classroom and the targeted approaches employed by the support workers.
Thus targeted support of children and young people is very much associated with empowerment of the individual to cope with the difficulties they face. Such interventions are very child-centred and based on developing a good understanding of the individual pupil and his or her particular circumstances. In comparison the whole school environment may be at pains to stress the need to conform to norms and standards of behaviour, with curricular pressures and the maintenance of discipline as important drivers. So the tension for the pupils lies between the contrasting approaches they experience as they move around the school. As the intervention to maintain pupils in mainstream school becomes more successful there are inevitably larger numbers of pupils experiencing this disjointed school existence.
At the heart of this complex subject is the question of how to respond to pupils whose behaviour in the school challenges the order and discipline that is required in the classroom for learning to take place. If a pupil disrupts the progress of others, yet that behaviour is triggered by poor mental health what is the appropriate response? Is it a disciplinary matter, it is a matter for pastoral care, or both? What are the consequences of each course of action for the pupil, the teacher and the other pupils in the class? To what extent should a universal system of regulations be modified to accommodate the needs of individuals? Some of the answers to this lie in how the discipline and pastoral care systems operate in the school. In many Scottish secondary schools discipline and guidance systems have been deliberately separated, so that pastoral care can be delivered through supportive, non-punitive methods, while a member of senior management holds the responsibility for dealing with indiscipline and administering sanctions. However, where a divide exists the practice is questionable if we accept that challenging behaviour may be underpinned by emotional problems. For the types of indiscipline that are the focus of this study, the interlinks between these systems are vital to ensure appropriate diagnosis and response to the situation.
Educational psychologists contacted as part of the stakeholder survey were particularly concerned that a misdiagnosis in the classroom would result in the pupils being inappropriately channelled through the discipline system, as was this head of behaviour support:
It's still very difficult for the [teachers] to actually say…..once a kid manifests on a difficult morning…difficult behaviour, for the teacher to stand back and say, 'Ah that's that difficult behaviour.' They often end up in a situation where you know it's….discipline. (Head of behaviour support)
Links between pastoral care and discipline systems at a strategic and operational level could make a significant difference to the outcome for pupils. Such a system was in place in Clydebank High School ( see case study) where by discipline referrals and "guidance alerts" pupil problems were cross referenced as they were received. Similarly Woodfarm High School (part of the East Renfrewshire case study) described their systems as interlinked rather than divergent. The schools were keen to point out that they didn't necessarily let children "off the hook", and that sanctions and support may be simultaneously appropriate:
They might still need to go to deal with certain discipline issues in a disciplinary way, and follow certain procedures, but at the same time offer the support. It shouldn't be seen as an either/or situation. ( ICS Integration Manager)
One teacher suggested that pupils experiencing difficulties might be more in need of strong discipline than other pupils, as their home life could be very disordered, with few clear boundaries.
Many authorities had introduced the sort of system of staged intervention into schools described in the literature section above, which provided a multi-agency framework for responding to all types of challenging behaviour, including withdrawn behaviour which could be the manifestation of poor mental health. If operated sensitively it also provided a means of interlinking issues of mental well being with those of behaviour. Where such systems operated the school was required to manage stage one and stage two internally, though advice and consultation could be sought at these early stages from other agencies, and these could sometimes illuminate difficult issues. Once the difficulty was deemed to reach stage three, a multi-agency meeting would discuss the individual pupils, and at this point differing professional perspectives would certainly be brought to bear, as an appropriate course of action for dealing with the young person was determined.
Tensions could sometimes be seen between the teachers' perceptions of appropriate action and the decisions of those in more strategic positions in the management and pastoral care systems. Teachers' responses to pupils not only took into account the needs of the individual pupil, but also the effect it might have on the behaviour of the wider population of the class, and how it would affect a teacher's own standing in the eyes of the pupils and teachers. Consequently, a punitive response to a miscreant carries a symbolism beyond the incident itself. If the result of a discipline referral is a more compassionate response by senior management, this can be interpreted by teachers as a failure by management to offer staff appropriate support, or even as undermining their individual position, an issue which causes some resentment:
Everybody is complaining that, you know, there are a whole hard core of third year [pupils] who are basically getting away with murder and not being taken to task because they are not being referred up that [discipline] route, so something is going to have to be done about it. (Secondary teacher)
Equally teachers also identified the ambivalence they felt when altering a universal system of rules and regulations to accommodate the needs of an individual pupil, and expressed concerns as to how this might affect the wider population of pupils. This highlights the paradox between offering a service based on mass provision which is held together by a commonly accepted system of rules (even if sometimes flouted), and the need to respond sensitively to individual circumstances. The issue is highlighted by this teacher's feelings about school uniform:
There is one child who is here, and it's like you have got him here but he doesn't wear school uniform. He doesn't just not wear the uniform, he makes a public issue of not wearing the uniform…a very public non school uniform wearer….and you wonder, do other youngsters see that and think "Well he gets away with it, why shouldn't I get away with it?". But then, I don't know, do you just have to say, 'Well uniform is not that important. The boy is here, he's not walking the streets. He's not heading to some kind of oblivion.' I don't know. (Secondary teacher)
At local authority level, there was significant tension in the balance between models of export whereby children and young people were supported by removing them from school, and models of ownership, where schools were supported to work with the young people in their own environment. Whilst education authorities all maintained some facilities outside of the mainstream school system, often in partnership with voluntary sector organisations, there was a nation-wide imperative to minimise these types of intervention. This was driven by the desire to give children better access to opportunities but also by financial considerations and staff shortages. However, there was a marked difference reported in schools' commitment to taking ownership of these difficulties.
This could be seen very strongly in the attitude of a primary school head teacher in one of the case studies, speaking here about three particular pupils:
I don't see exclusion as a place to go. It doesn't improve the situation at all and in fact exclusion for any one of those three would be a recognition of their success in getting the badge of honour of having been excluded so I am not going down that road, and I am not going to give in.
As with other disciplinary issues, there was some conflicting opinion amongst teaching staff who had to work with such pupils on a daily basis, and didn't feel equipped to cope.
And really, I mean, I'm all for inclusion but it's definitely not working on some of these children that are just so disruptive because it's just not fair on the rest of the class. It's having such a detrimental effect on their learning that I think it's completely wrong. …We do have a few children in this school that are just affecting the lives and the learning of so many others and the teachers, that I think they … they really should be removed, and that really is the last option and doesn't seem to be happening. (Primary teacher)
Similar tensions existed between exclusion of pupils from particular lessons, with staff sometimes feeling unwilling or unable to maintain a child in the room, as a result of their behaviour.
Clydebank High school responded to this issue by using their team of pupil and family support workers to create a safe-haven for pupils who were experiencing difficulties managing to cope in mainstream school. Based in "room 43" they worked with a range of pupils including those whose poor mental health might otherwise have led to their exclusion from the school, or the classroom, and also those who might otherwise have excluded themselves. Room 43 was emphatically not a "sin bin", as class teachers did not have the power to send pupils directly; access was governed by senior management and the pastoral care team. The emphasis was very much on providing a supportive environment, with structured targets for those who used the room regularly. Importantly, it allowed difficult situations to be managed with dignity; providing a "cooling off" opportunity for pupils and staff.
What we feel that [Room43] and that whole corridor with the staff … it allows dignity for pupils, and the member of staff is allowed to continue to do the learning and teaching, and the member of staff has not lost face or dignity either. And that is important, and that has been an important thing to begin to try to get over to staff. You know if the child loses […] in your class, goes to the next class, it's virtually impossible that they will have calmed down. So they are better out of the system for an hour or two and then slotted back in. That is not seen as being weak and giving in. That is a very practical thing. (Depute head teacher)
A novel feature of this system was that some pupils who were experiencing particular difficulties were allowed to leave their classroom at any time and elect to go instead to the care of the pupil and family support workers. This allowed the pupils themselves to take ownership of the management of their difficulties, by identifying those situations with which they could not cope, and enabled them to manage their own exit in a non-confrontational manner.
The school as intersecting relationships
The link between a school's value system and its ability to respond to mental health issues was evident throughout the project, as was the variability between schools in this respect. These links were explicitly and repeatedly alluded to by educational psychologists during interview, as in the example below:
Often you find it is two sides of the same coin, in many ways. On the one side is ethos and the other side is the ability to make these connections between behaviour and emotional health. The better one side of the coin, the better the other side. (Educational psychologist)
Another educational psychologist identified the need for an overarching philosophy in the school, to which staff are fully signed up:
Part of the sense of 'who we are as a school' should include responsibility for wellbeing. (Educational psychologist)
The value systems to which these interviewees alluded were built around taking a responsibility for the needs of children as individuals. The same interviewee went on to say that these values should be built into policy and practice in ways which made teachers accountable for their behaviour towards pupils. Just as a positive ethos could be seen to promote well being and support young people with mental health difficulties, some interviewees also acknowledged that a poor school environment could, in some cases be damaging to the mental health of pupils.
The role of the head teacher and senior management was seen to be absolutely critical in determining the attitudes within a school towards the wellbeing of pupils. A commitment at the top of the school could raise the issue on the agenda and drive forward change within the school. This was widely recognised by local authority staff, by teachers and other professionals and by parents, and many comparisons were made between those head teachers who put mental wellbeing at the centre of school ethos (albeit possibly using different terminology), and those whose interests lay elsewhere. This kind of leadership was demonstrated by one of the headteachers in a case study school:
I do firmly believe it is a philosophy and it's an approach. And I think its not going to work if a head teacher is one of these kind of autocratic people where the school is theirs and what goes on during the day is theirs and the best person to educate the children is the teachers. Then you have got a problem I think. If you have got someone who is saying [to other professionals] "come" then things are much easier.
The type of head teacher who was successful in this respect was often described as being welcoming to a wide range of workers coming into the school to support the pupils. Conversely the effect on a school of a less enlightened head teacher was to restrict the responses available when dealing with young people's mental health problems as described in this scenario:
Some schools have a very strong, hierarchical structure, and management [of behaviour] is, if you like, an authoritarian route for discipline, leading ultimately to exclusion. A lot of staff at lower levels can see they [should] have a more pastoral style role. (Pupil support manager)
Many younger teachers will have experienced a different type of training; others will have taken advantage of opportunities available through training courses for specialist teachers (for example guidance, learning and behaviour support) to develop a wider range of responses to their pupils.
The achievements of the head teachers and senior managers who take on a proactive community centred approach are undeniable, but the very fact that they are exceptional is potentially problematic. Firstly, they are more likely to welcome new ideas and initiatives, to pilot new schemes and to attract new funding. So, in effect the schools which already have a commitment to wellbeing are more likely to have the opportunity to further develop that, whilst the head teachers who are uninterested remain unchanged, leading to very uneven provision. And secondly, if the success of an initiative depends on the enthusiasm of one person, it may not be sustainable in the longer term, unless the champion has been successful in winning over the hearts and minds of other staff.
The ability and willingness of teachers to enter into supportive relationships that went beyond the narrow definitions of education was also somewhat variable, both within and between schools. It was generally felt that most primary school teachers saw pastoral care as an integral part of their remit, and were concerned about the wellbeing of pupils in their charge. This was reflected in the way primary children spoke of their teachers in interviews. Very often they described their teachers in very trusting terms, seeing them as the natural person to talk to in the case of difficulty, although some pupils recognised that their teachers were often very busy and not always able to listen fully.
In secondary schools, the structure of the pastoral care system places the responsibility for supporting pupils with identified difficulties in the hands of pastoral care, or guidance staff. The role of the classroom teacher in supporting the general wellbeing of all pupils, or of responding to the needs of particular pupils in the classroom setting, is usually less clearly defined, and there was a marked difference between teachers; a situation which was repeatedly referred to by local authority interviewees. Thus whilst all secondary staff interviewed would have seen it as their role to identify challenging behaviour and refer the pupil onwards to guidance (and some were better than others at making the identification), it was a minority who felt they would get involved in any more direct way with pupils who experienced difficulties.
It appeared that some subjects provided greater opportunities for identifying difficulties and offering support. Both art and PE were identified as subjects in which the pedagogy would allow for expressions of emotions, allowing teachers to view pupils in different ways and giving them greater insights into the difficulties that some young people faced. An art teacher commented:
Sometimes it can be very disturbing to see some of the images that a few of our pupils produce. Some of them are very, very violent. Some of them are very, very dark…..Because I'm a pretty nosy individual who doesn't like to mind his own business, I would tend to say to the youngster, you know, "Can you tell me about this, what's this about?".
A teacher of PE at the same school described how he was able to identify pupils with emotional difficulties:
Well, immediately, you can look at the time it would take them to get down to the PE department from their last class. You can analyse that any way you like. If they're quick, if they're slow, if they're with a group of pals, if they're on their own … they can all be indicators of different things, you know. If someone's wanting to be the last in the PE department, if they've got a problem coming down here, if they've got a problem changing between classes and are anxious about that. If they've got a reason for not wanting to change with other children, or be in before or after the other children, is that reason because they're uncomfortable with their body image, or simply uncomfortable exposing themselves in front of their peers or are they trying to hide something? And obviously all the child protection issues are involved there.
Both teachers whose comments are quoted above had developed strategies to support those pupils through discussion, and appropriate activities, but also stressed the importance of referring issues onwards to draw in appropriate specialist support. Whilst they could see a role for themselves in working to support and promote mental wellbeing they were also quite clear about the boundaries of their expertise.
Young people held clear views about the ways in which they might seek support from teachers if they were experiencing difficulties. Universally, secondary pupils mentioned their guidance teachers, although older pupils expressed much greater reluctance to approach guidance staff than did younger secondary pupils. Older pupils felt they would be more likely to confide primarily in friends, and that guidance staff were there mainly for issues affecting academic performance. Pupils were also rather pessimistic about the ability of guidance staff to help them with issues that originated outside school.
In most cases secondary pupils did not feel it was appropriate to talk to other teachers about personal issues, and in some cases felt that their teachers would not be interested. However, the role of extra-curricular activities in building firm relationships through which pupils could talk more easily to staff was very strongly evident in one of the case study schools. Woodfarm High School (part of East Renfrewshire case study) had an extensive programme of clubs, to which the pupils referred repeatedly. These appeared to offer a range of ways to promote mental wellbeing, one of which was a strong belief generated amongst the pupils that the staff were interested in them beyond the confines of the classroom. Pupils identified the teachers who ran the clubs as possible confidantes in cases of difficulties, as they felt they knew them in different way from other class teachers.
Because you know them slightly better and you like them better. (S2 pupil)
A teacher at this school described how he felt extra curricular activities affected his relationships with children:
I guess I came into teaching because I like people. I like youngsters, you know…. Normally I would be taking a badminton club after school this evening. I like to meet kids socially. I like to play badminton with them, and to cycle and to hear their chat. And yes, I do see my role as being more than a subject, though the subject is very, very important to me, but I like to think of it as more than that.
The slightly less formal relationships that are generated through sharing activities are clearly seen as very beneficial by both teachers and pupils, so it is perhaps not surprising that another type of trusting relationship is very often built up between pupils and the non teaching staff such as auxiliaries and classroom assistants, who have more opportunity to respond to individual need. These types of roles allow closer observation of the behaviour of individual children both in the classroom and in the playground, and these workers are often approached by children who are experiencing problems. Some schools are very aware of this role of their support staff, and encourage them to listen carefully to the issues children raise, valuing their input. However, those who hold these support roles in school would take little responsibility for remediating any problems; they would refer matters immediately to the teaching staff:
Children will quite often come up to us in the playground and tell us things that they haven't told anybody else. Like they'll come up and say, 'Can I talk to you?' And that will be something we will share. We'll go straight to [the headteacher]. (Classroom assistant)
Within those schools in the case studies, a wide range of other professionals could be seen working with children and their families, such as social workers, counsellors, pupil and family support workers, therapists, family learning co-ordinators and school nurses. Whilst all these people had a slightly different remit and professional background, they were more likely to share a person-centred, individualised way of working with pupils or parents (or both). They offered a different kind of relationship based on trust, and in some cases professional 'befriending'.
Critical to the performance of this type of role is the need to build a reputation within the target community of being approachable, non-threatening, responsive, supportive and caring. In multi agency settings workers can bring a range of skills to schools, and have the time to work with the most vulnerable pupils that teachers simply do not have. But is there is a danger in bringing a team of caring professionals into a school, and expecting them to take over the business of pupil welfare if it is seen to relieve other school staff from a responsibility for developing a caring approach to pupils in their charge?
How well do the sorts of relationships that exist in schools allow teachers to identify (and respond to) the link between mental wellbeing and behaviour? Findings from interviews with education, health service and voluntary sector staff suggest that schools are generally becoming more aware of the links between mental wellbeing and behaviour than previously. Health service and local authority representatives argued that in primary schools teachers are more sensitised to these connections, since their initial training includes elements of child development and a holistic approach to their work. Importantly, since most are generalists attached to a single class unit, they also spend more time with a smaller number of pupils over the school year than class teachers in secondary schools where contact with any one pupil in a given week may be more fleeting.
Within secondary schools, the 'medicalisation' of some behavioural problems and their naming as 'conditions' such as ADHD has heightened awareness of the links between mental health and discipline, as have changes in systems of guidance and pastoral care. A degree of consensus was evident that those young people who were disruptive were most likely to be identified and, conversely, that those whose behaviour was withdrawn or passive would be more likely to be overlooked since they posed no immediate threat to classroom order. Within secondary schools there would be gradations in the understanding of the link however. Thus the need to maintain classroom behaviour and deliver the curriculum was clearly uppermost in the minds of many teaching staff. In contrast, guidance staff, some senior staff and those non teaching staff who worked with targeted groups or in behaviour support were more likely to see links between behaviour and mental health as part of their remit, not least because they were dealing regularly with external agencies who specialised in working with schools on these topics.
I don't think they are very good at recognising youngsters with emotional behavioural difficulties at the moment. And I am afraid it's still…a lot of it is still rhetoric, and you know we don't do that very well at all. I mean I am quite categoric on that, we really don't. And I think part of that is actually because they don't know what to look for you know. (education authority representative)
A number of those interviewed were more convinced that teachers were sensitive to the climate but that they lacked the capacity to identify what underpinned this:
I think often what schools do is they recognise that there is an underlying problem but they can't identify it. I think that is what causes teachers concern because they like to know the answers. They know there is something but they don't know the cause of it and that can worry them, or they don't know what it is. (Quality Improvement officer)
An educational psychologist gave a more optimistic perspective on schools with regard to their ability to make the links, but acknowledged teachers' difficulties in building this into any pattern of sustained action:
I think all schools are some way down the road to this. Quite often they'll make the connection. But some of the youngsters that are more challenging, although schools see the connection they don't always acknowledge it. It becomes harder for them to always bear in mind that connection and continue working with that young person if the challenge becomes so great that they feel they are being disrupted. I think our schools are getting much better at being inclusive and that would include children with emotional health difficulties but they are not by any means all the way there. (Educational psychologist)
A health worker with a remit to work in a school cluster felt that the pressures on teaching staff prohibited them standing back and looking at children as individuals:
I don't think teachers can identify the link very well. I have gone to a principal teacher and said, 'Look I don't know him but I think that wee boy has problems. Is there anything going on at home?' Maybe, just maybe, that has alerted them to speak to him or try to find out. I come from a nursing and social work background so that is important to me…Perhaps if they stood back and looked … but they are so fraught with the amount of stuff they have to do and have to get through that all they see is bad behaviour and they don't look at the underlying reasons…I have found that a real struggle… (Health development worker)
There was strong evidence throughout the telephone survey data that respondents felt schools were more likely to identify mental health difficulties in those pupils whose resulting behaviour was disruptive. These pupils were highly visible within the school and the smooth running of the school was compromised by their behaviour. Consequently, their needs were more readily identified and addressed than pupils whose response to difficulties was more covert. This imbalance could be seen in the types of issues which were referred to other agencies. For example The Place2Be staff reported the majority of referrals being related to unmanageable behaviour.
A youth counsellor felt that this was a consequence of the ways in which schools operate:
Um…I think…I think…I think there is something to be said to the argument that the brightest will receive attention, and the most difficult will receive attention, and the ones in the middle might be missed. I perfectly understand why there might be some level of truth to that argument in simply looking at what teachers are expected to do in a classroom. And I have come across young people who perhaps have been sitting in the middle.
For some teachers, withdrawn children were more difficult to identify in class:
Yes, these are the ones that are much, much harder to deal with because in some ways these children are behaving as you would ask them to behave. If you know.. [laughs]… they are being quiet and they are being good and they are appearing to get on with it… These are the ones who the danger is that they may very well slip through the net, that they won't be noticed until again someone asks for a report on a particular child, and you say, 'He's doing fine.' (Secondary teacher)
The gender difference between how boys and girls respond to their difficulties is well documented in the literature, with boys typically "acting out" and girls "acting in", or withdrawing. Consequently, if schools have greater difficulty identifying the needs of very quiet pupils, this may operate to the disadvantage of girls experiencing problems in their lives.
It was clear that divisions existed within schools about work on these topics. For the following speaker this picture was one of awareness and expertise in some quarters which was not being cascaded or shared with the classroom teachers and one where senior management in schools could provide more appropriate forms of support, not least in enabling more contact with other professionals and in communicating more clearly about the needs for sustained work on these issues:
The key people for me are those who have to make decisions about the appropriateness of responses, supports … So I am looking there at probably the senior managers in the primary schools, the guidance staff, and senior managers in the secondary schools. Uh…I mean I have a lot of…a lot of contact with our social work colleagues and the key people [in schools] I would say - on a scale of 1 to 10 - the key people they probably operate around about…I would say about an 8 or 9. I think there is a much higher level of awareness. [But] if you go into the classrooms, you sometimes think, ' It's just not happening here.' (Inclusion and support manager)
As noted in the literature review, the wellbeing of teachers themselves (not least connected to their sense of competence) has implications for the ways in which they respond to the children and young people in their charge, and has an effect upon the overall ethos of the school. A collegial and supportive climate for teachers is essential for ensuring improvement in services for young people. One speaker, for instance, commented on the fact that a great deal of what teachers were being asked to do in respect of mental wellbeing and discipline represented new and relatively uncharted territory for some teachers:
I think …there are a whole range of reasons …I mean for younger teachers I think our teacher training is not yet up to scratch. I think that for older teachers, it's the…it can be simply because they've never really had to consider emotional well being. Although its now embedded in law, it's a requirement that they must consider the whole needs of the child effectively, they are in their classroom to teach a subject or to impart learning, so there are barriers…
Interviewer: They haven't changed their view of what they are there for?
No, they haven't changed their view and they don't intend to change their view. And you have got the vast majority who are I think in the middle. And they are the ones who are still open, but because of the nature of the work they do, they are not really encouraged to think holistically, because by and large kids are compliant. Most youngsters are compliant, they come into the school, they will sit down on their seat, they will have a bit of a laugh, and they will get on with their work and get up and go home and have their tea. And that is the experience of most teachers, so…their attention therefore is not really drawn to the fact that oh Johnny looks a wee bit withdrawn today, he's a bit white, is there something going on? (Inclusion and support manager)
It is precisely this fact (the novelty of the responsibility) that was identified by teachers in the case study interviews as a cause of stress. They noted that many colleagues were feeling ill-equipped to deal with challenging behaviour in the classroom, and worried about the wellbeing of pupils whom they felt unable to help. Interestingly, therefore, any intervention that supported the wellbeing of pupils, also therefore had a knock-on effect on the wellbeing of teachers. Participants in the case studies frequently mentioned the positive effect of additional pupil support on themselves. For example, in a school which hosted The Place2Be service, a teacher spoke of a pupil who was having difficulties:
It's just reassuring to know that somebody else knows and you are not carrying the weight of it yourself.
Similarly in East Renfrewshire a teacher compared the situation in which she now worked, in a well established Integrated Community School to how she had felt in the past in a situation where the support for pupils was not so easily available:
Staff are much more aware of the fact that children have input from different agencies, whereas if you are not …..you assume nobody is bothering to deal with them and that affects morale. In a negative way, people feel they are bashing their heads against a brick wall.
The ASSIST scheme, in which teachers were supported by designated colleagues to develop solution-focussed, environmental responses to challenging behaviour was seen by some as primarily a mechanism for reducing the stress of teachers:
There will always be kids causing "dripping problems" and before ASSIST that was not being dealt with. That is where ASSIST is important because it [low level disruption] can be soul destroying for teachers. (Class teacher)
ASSIST is necessary for teachers' wellbeing. Obviously pupils' wellbeing is important, but to keep teachers in teaching is important. It is these things that wear people down. (Class teacher)
As part of a staged intervention approach the programme encourages teachers to think about low level disruptive behaviour in the context of the school environment and thereby implicitly addresses the link between behaviour and mental and emotional well being. The environmental approach has implications for whole school or whole class ethos, rather than being an individualised response to a naughty child. ASSIST offers teachers a confidential peer support service to develop a self-evaluative, solution-focussed route to managing difficult behaviour, without prejudice.
The strengths of ASSIST lie not only in its challenge to traditional individualised, punitive approaches to indiscipline. It is also designed to take into account the ways in which teachers develop their practice. Teachers develop their classroom practice partly through their own experience, and partly through discussions with other teachers (although some report difficulty in admitting to problems). Training approaches such as verbal presentations are often not very effective in altering practice, and the case studies have demonstrated the suspicion with which teachers can view advice from other professionals. The ASSIST scheme trains an unpromoted colleague to act as confidante and mentor, thereby giving credibility to the support offered (at least in the eyes of some teachers). It offers confidentiality, so will be acceptable to those teachers who do not feel confident to admit difficulties to other colleagues. And it takes a self-evaluative approach, so the teachers are able to build on their own experience. So whilst the delivery of ASSIST scheme is not without some challenges, it offers an interesting way forward in developing teachers' responses to challenging classroom behaviour, and in the wider issue of developing a school culture which values emotional well being.
Clearly, the links between pupil wellbeing, teacher wellbeing and school ethos are interrelated in a complex fashion. If teachers feel pupils are supported by specialists, this impacts on their own wellbeing which will in turn affect the ways in which they feel able to respond to pupils. And if teachers themselves are up-skilled to offer an environment which is more conducive to wellbeing and improved behaviour, this also reduces their stress levels and allows them to develop better relationships with pupils. There appears to be an upward spiral relationship, which can be accessed in various ways.
The focus on these new relationships in schools and the growth of support for pupils and their families to help them to deal with the difficulties that they faced was critical to many of the interventions which were subjects of this study. Was there any danger of troubled or troubling pupils being cast as passive subjects to whom help was administered - people who were 'done unto'? This issue had been addressed in some areas, to see how pupils and parents could be actively helped to develop their own coping strategies. However this was not a straightforward matter for schools, parents or young people.
One of the main issues for both pupil and parental involvement was the accessibility of the service. If schools acted as gatekeepers to the supporting agencies, then access to services was dependent on teachers' identification and interpretations of difficulties. And as already described, teachers can sometimes mis-identify issues, for example by focussing on disciplinary responses, or by failing to spot withdrawn pupils. If the school's systems are designed so that access to services is through senior management, then worried parents or pupils are required to present first to the school, which then determines the course of action. One parent in the interview sample had been denied access to services by a school for her daughter who subsequently ran away from home. This case demonstrates the need for multiple entry points to support services, allowing both parents and pupils to identify difficulties.
The Place2Be offered a support service which was highly accessible to children. By physically placing itself in a central position in the school, by maintaining a high profile, by operating a straightforward system of pupil self referral, and making itself universally available for any pupil wanting to talk, it provided a service with which children felt very comfortable. At The Place2Be there was no threshold below which issues were not accepted; the counselling service was open to any pupil who identified an issue which caused them concern. Consequently the pupils were confident that they would always be taken seriously and The Place2Be staff were in a position to identify those who required more intensive support.
Whilst The Place2Be offered the most accessible self referral service in the study, other services also offered pupils opportunities to self refer. School nurses, for example, operated drop-in clinics in some areas, and Newbattle High School operated the "Ozone" drop in at lunch times and youth counsellors also took a proportion of self referrals. Whilst it is vitally important that children and young people are given opportunities to present emotional difficulties, and this does increase the likelihood of identifying mental health difficulties, it does not result in all vulnerable pupils coming forward. It takes a certain level of confidence to approach a professional about personal difficulties, and those pupils who are very withdrawn are unlikely to take advantage of these service, as described by this youth counsellor:
Well the age group…for this age group self referral is not expected to be high. I think at the moment we are running with about 10%. And that actually is a pretty good figure for self referral for this age group so we can't expect that those young people who are pretty isolated … are going to refer anyway.
Consequently, to increase the accessibility of services to pupils there needs to be a range of different ways in which professionals interact with pupils, allowing other opportunities for young people to voice their concerns, and allowing the other professionals to observe behaviour of pupils and identify issues that might be overlooked in a busy classroom. An example of this approach could be seen in the services operated by the North Glasgow Youth Stress Centre where the delivery by Stress Centre workers of parts of the PSE curriculum to small groups of pupils allowed for these type of relationship to develop.
In the case studies, there were also some examples of interventions which gave pupils considerable control over their own support. For those pupils at Clydebank High School who had been identified as experiencing difficulties coping with being in class, there was an option to remove themselves to the designated supported environment of "room 43", at any time of their own choosing. This, it was felt was an inclusive strategy, as those pupils would possibly truant if they were not able to take refuge in this safe haven. And The Place2Be offered a child-centred therapeutic approach to a small number of pupils who were identified as experiencing significant mental health difficulties. Within the safe environment of The Place2Be room, they could choose any available activity (such as painting, playing in sand, puppetry), or no activity and it would be through this activity that the trained therapists would explore the issues which were troubling the children.
Summary
In this chapter we have looked at that aspect of the health promoting school which focuses on the effectiveness of the school's culture and environment in determining or transforming attitudes to emotional wellbeing and discipline. This has encompassed issues such as relations with the parent community, relations between teachers and pupils, and the tensions between delivering education in the mass and responding to the needs of individual children.
From the literature review we derive an analysis of how school environments might themselves create or exacerbate problems of wellbeing and indiscipline, together with a look at how we might theoretically engineer the school environment to produce better results. In part B the empirical evidence is used to explore how well Scottish schools appear to be responding to issues of ethos and environment, at least in the eyes of the stakeholders, teachers, parents and children who were interviewed.
In answer to the question, 'How might the environment of the school itself create problems of mental wellbeing and indiscipline?' the literature review reveals a number of important answers. Schools that are poorly embedded in their communities and in which individual teachers have little understanding of the sorts of daily problems being experienced by pupils and their families create a poor basis for establishing a health promoting school. Poor levels of understanding in turn affect the ability of the school to communicate with the parent group. Low levels of interaction between parents and school do not support rapid identification and remediation of problems.
The literature also informs us about how attempts have been made to engineer school ethos to produce better results in terms of wellbeing and discipline. These can range from overarching frameworks like the establishment of tiered response frameworks for classroom incidents of indiscipline, clear models of support for both teachers and pupils, and the importation of additional posts with different professional expertise, to more specific schemes hoping to promote peer mediation, pupil participation and so on.
Within the school, the nature of relations between teachers and pupils will become a critical factor in the way in which problems of wellbeing related to discipline are construed. Who is to blame when children misbehave? If the answer is always that the problem is conceptualised as one where the child has deliberately chosen to flout rules or be non-compliant, then discipline structures will be invoked. A recognition that external stressors or aspects of the school's operation itself may have contributed to or exacerbated an incident may be used to invoke a more supportive response. Where pastoral and discipline systems are not highly convergent this can lead to huge variability in the treatment of similar incidents, depending on factors like teacher knowledge of pupil and family circumstances, as well as the levels of pressure prevailing in the situation in which an incident occurs.
Schools must have a capacity to identify both general points of vulnerability for individuals or cohorts (like transition between primary and secondary), but also the specific vulnerabilities of groups like looked-after children. Any school in which bullying or racism is tolerated or even implicitly condoned cannot hope to avoid creating its own discipline problems.
The empirical evidence presented here supports the broader findings in the literature review. Knowledge of the catchment and the sorts of social problems that might be encompassed within it was seen as crucial, with commentators making a contrast between urban and rural areas, the latter benefiting from small school sizes and more stable community structures. Links were made from this directly to the ability of parents to be participative in aspects of education. Some commentators felt that the perceptions of schools (and authority structures generally) held by some of the most disadvantaged parents meant that some form of mediating service like link workers was very beneficial, giving parents less daunting routes through which to make contact with schools or address school issues in respect of their children's behaviour.
Within schools the same issues of teacher relations with pupils emerged as paramount, but respondents from all quarters acknowledged the very real tensions between delivering a mass education system to the many. With schools focusing strongly on attainment, the need to flex the system to make time and space for individual children who were troubled or troubling often proved difficult. Whilst acknowledging that it was not essentially incompatible for a school to aim for academic excellence whilst also operating a strong pastoral system, even critics acknowledged how little 'wriggle room' schools had in the way of teaching resources to take on both roles.
Buying in or attracting additional resource to access support from professionals specifically skilled up to deal with these sorts of issues provided one solution, but only worked at very simple levels if outside help was simply used to mop up problems schools felt too harassed or unskilled to deal with themselves. We return in chapter 4 to these issues of 'ownership' of the problem.
The ethos of the school was also critical in determining casual day-to-day relations between young people and adults. Informal rather than programmed interactions often gave young people an opportunity or window to raise issues which they would not have brought forward in more formal settings. In a reciprocal way, extra curricular clubs, school trips and outings often allowed teachers to see children in a different way and observe problems that they would not have noticed otherwise. In many instances non-professional support staff in schools can become the first port of call for distressed children, and schools need to be clear about both the value of approachable adults, but also the ways in which they need to be supported to seek out further help for children if necessary.
Finally, there are relatively few examples where young people (or their parents) have much autonomy in terms of seeking help or accessing service. Sometimes protocols of referral are daunting in themselves. Experimental schemes which allow pupils and their parents to self refer have, where managed properly, proved their worth.
In a variety of complex ways the school environments is thus a critical element in the development of a school and one which promotes mental wellbeing and helps deliver some solutions to discipline problems.
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