The role of education settings in promoting good wellbeing and mental health among children and young people has been increasingly formalised in national policy. But often the voices of the key stakeholders – children and young people – are not adequately sought, heard, or given due weight. In this article, Dr Ola Demkowicz, Dr Alexandra Hennessey and Dr Kirsty Pert reflect on insights from children and young people on what underpins and undermines education-based wellbeing provision.

• The World Health Organization recommends that education settings promote health, including wellbeing. The Department of Education currently offers training for school mental health leads.
• However, there are competing priorities and tensions for schools attempting to deliver both learning and wellbeing interventions.
• Our study gathered and analysed the views of children and young people on schools wellbeing provision and strategies.

Mental health provision in schools – aims and ambitions

 In England, the 2017 Green Paper set out plans to ‘transform’ mental health provision, placing strong emphasis on schools, and a current offer from the Department of Education aims to train school senior mental health leads. Guidance advises delivery of multiple approaches:

• Whole school approaches – which consist of a multilevel approach embedding and connecting varied provision across the culture and stakeholders.
• Universal provision – fostering skills such as emotion regulation and social skills among all, often through curriculum-based lessons.
• Targeted provision – offering support or skill-building for those at risk of poorer outcomes.

 Delivery challenges – stretched workforce, stretched resources

These approaches are delivered within the complex and dynamic context of each school – including its climate, teaching and learning practices, and leadership. Within local, regional, national, and international contexts they are delivered alongside growing demands on a stretched workforce and stretched resources. Teachers are faced with managing teaching and learning in addition to wellbeing provision.

University of Manchester research on school based wellbeing

Our team, led out of The University of Manchester were commissioned by the National Institute for Health and Care Excellence (NICE). Our project explored children and young people’s perspectives on school-based social, emotional, and mental wellbeing provision.

The aim of the work was to bring children and young people’s views into the design of national guidelines on school-based wellbeing (published in 2022). We met with 49 children and young people aged 6-17 spanning key educational stages, setting types, and demographic backgrounds, working to include those often not ‘heard’ or asked to share their views in research, such as those in alternative and special educational provision, from low-income families, and from UK ethnic minority backgrounds.

We talked with these children and young people in focus groups in 2021. We analysed these discussions then published a report focusing on specific practices and strategies to inform NICE guidelines; we then further analysed data to focus on the values, conditions, and foundations that children and young people considered to underpin effective wellbeing provision in schools, which we published separately.

Our findings – insights from children and young people

We found that children and young people held a vision of an integrated approach to wellbeing provision, embedded in a culture centred around community, connection, student voice, alongside a genuine prioritisation of wellbeing, with attention to individual needs and sensitivity.

These principles are intertwined – effectively building a social community where wellbeing is a central priority. This community should provide a culture that “everyone has to buy into”, in which children and young people are active partners in provision, have “a good relationship” with teachers and “can trust them”. In turn, staff can adapt to collective and individual needs and be discreet and sensitive.

Children and young people pointed to real world tensions that they see and experience. This included competing and contradicting wellbeing and learning agendas and impressions that teachers did not genuinely care about or understand wellbeing. We found that in exploring what underpins provision, we also learned about what can undermine it.

“You’re saying that that we should make lessons to address mental health but why is that? It’s because of school mostly, because at school you have exams and, I know that’s just how life is but you’re causing it and you’re just trying to fix it, isn’t it? […] Come on!”

This study offers important insights into how children and young people view wellbeing provision, as well as how a school’s culture provides a foundation for that provision.

Policy, practice and ambition

Our participants strongly endorsed an approach that positions wellbeing and connection as core to educational life. Current offers from the Department for Education to fund mental health lead training are welcome, but fall short of catering to children and young people across the country.

For instance, the Government’s goal to embed Mental Health Support Teams was focused on a target of only 36% of schools. Such efforts must be undertaken and coupled with ongoing – and more ambitious – investment, strategy, and support at national and local levels.

Meaningful engagement with the voice of young people

Our findings emphasise the importance of treating children and young people as active and valued partners. There is a growing focus on children and young people’s voice in system change, but this requires meaningful engagement beyond one-off meetings or tokenism. We commend NICE for working with our team to include the voices of children and young people in developing guidance, and encourage other organisations and policymakers to involve children and young people in national and local wellbeing and school policy decision-making processes. This should not be only an exercise in gathering youth voice for the sake of it but should include clear strategies for how such contributions will actually influence decision-making and change, which may require upskilling among policy teams and expert input.

We found that children and young people notice contradictions and tensions in narratives and practices. This is important, as it is, to our knowledge, the first study that explicitly outlines how tensions well known at policy levels affect how children and young people themselves view and engage with wellbeing provision.  We emphasise that these tensions are not the fault of individual teachers often working at (and beyond) capacity in difficult circumstances, but are reflective of wider challenges affecting settings, staff, and students.

We need to explore innovative ways to integrate the dual agendas of learning and wellbeing as complementary, not competing.

This integration requires critical system change, including a move away from traditional practices; such as reconsideration of high-pressure ‘single assessment’ high stakes exams, rolling back accountability pressures on teaching staff, effective resourcing, and evolving beyond traditional student-teacher power dynamics.

Such reforms would be complex and necessitate ambitious resourcing and strategy, but are crucial to achieve a wellbeing strategy as part of education that can work for children and young people. They should be prominently integrated into future policy goals by the Department for Education and other education policymakers.

Funding statement: The main project from which we draw our data was funded by the National Institute for Health and Care Excellence (NICE). The guideline referred to in this article was produced by the NICE. The views expressed in this article are those of the authors and not necessarily those of NICE. Full authorship team: Ola Demkowicz, Kirsty Pert, Alexandra Hennessey, Emma Ashworth, and Lucy Bray