By Merry Wright, West London EMHP
I am a trainee Education Mental Health Practitioner (EMHP), one of the first EMHPs to be trained across the country, under a national programme to increase the workforce of child and young people early intervention mental health practitioners. My role as a trainee EMHP makes up the frontline of the Mental Health Support team initiative, providing the opportunity to deliver evidence-based early interventions for children and young people within the education setting.
My working week is split between training with University College of London (UCL) via the Anna Freud Centre and placement days with my Trailblazer site, Hammersmith and Fulham Mind (HF Mind). Combining training with placement provides an excellent context for learning; allowing me to develop skills and knowledge drawn from empirical evidence, whilst simultaneously integrating these with the practicalities of working with young people within the education system.
I have recently worked with an adolescent in a local college, providing an intervention for low mood. Alongside an understanding of the literature and methods of intervention developed through my training, I was required to draw on the expertise of my placement team to help me hold in mind factors including (but not limited to) the college’s priorities around poor attendence, the family context and views and most importantly, the young person as an individual, ensuring they feel heard and remain central to the process.
As well as using theory to support my practice, there have been many occasions where my practical experience has forced me to challenge the expectations and assumptions I have developed through my reading. So far, my direct interventions have been with adolescents, so in preparation I studied the intervention models, informed myself about the variety of presentations of distress and learnt about neural and behavioural changes in adolescence. What I quickly became aware of in practice, is the extent of the difference in levels of maturity, emotional literacy and ability to trust in the individuals with whom I was working. This meant I needed to adapt my communication style, work fluidly and be prepared to scrap my carefully planned schedule or change the direction of my intervention to promote client engagement. I have also realised how frequently anxiety and low mood co-exist in young people and have faced challenges in working with individuals to understand what drives their feelings and behaviours. This has highlighted to me the importance of working with them to prioritise their difficulties and plan the type of intervention that feels best for them.
Jordan Macedo, the Deputy Safeguarding Officer at St Charles Sixth Form College, where I am delivering one-to-one interventions with adolescents, has said that, “having the Trailblazer Team in college has already helped us tremendously, in reaching students who although reporting less severe problems/issues/difficulties, to ensure that these problems are dealt at source and stop them developing into harder, deeper concerns.”
Of course, during training, this flexibility is only possible when supported through frequent and high-quality supervision, which is provided formally through HF Mind every week. As students, we also benefit from a practice tutor group at university, a weekly highlight, where feedback and case discussion is encouraged to cultivate critical thinking and develop reflective practice. Through both UCL and HF Mind we can gain the perspective of various experienced clinicians with a variety of specialisms.
One of the first pieces of work I did with UCL was around understanding the wider context of the schools I would soon be working with, the socio-economic profile of the area, how the school serves the community in ways outside formal education and what other services and resources are available locally for families. It was only when I started working in school that I realised the importance of this knowledge, which has helped me develop a deeper understanding of the social context of the young people I meet and means I can build local community resources into my interventions and offer advice on available local services.
Something I particularly enjoy about my role is the variety, in line with the “whole school approach” ethos, known to be helpful when supporting emotional wellbeing and mental health. I am trained to support children and young people one-to-one with anxiety, low mood (in secondary) and behavioural problems (in primary), as well as providing universal and targeted group work for children and young people and psychoeducation workshops for students, parents and education staff. In the last few weeks of the summer term, I delivered an exam stress workshop to a group of year 11’s, a transitions workshop for two groups of year 6’s, provided two ongoing direct guided self-help interventions for low mood and met with a secondary school to begin planning for a targeted Interpersonal Therapy group for adolescents. I have learnt every education setting is different and approaching a new school/college with a range of available interventions provides the opportunity to collaborate with the school/college, students and families in a way that meets the needs of the whole community in a holistic way.
My training with UCL provides the grounding needed to give me structure and confidence in my work, whilst my placement provides the support to be flexible and creative in my approach, as well as the inspiration to continue my learning and development. The Trailblazer initiative is a pilot project and, whilst there have been challenges along the way, my colleagues and I have felt our feedback is not only taken on board, but actively used to shape and co-create the service as it develops. When I attended a recent feedback and planning meeting with the education settings we are currently working in, I was pleased to have this theme reflected by several of the schools/colleges in attendance.
Alongside many challenges, my limited time working clinically in this setting has offered pleasant surprises; I have been encouraged by openness around mental health issues, both amongst students and staff, which is far more advanced than when I was at school just over 10 years ago. I have also been inspired by individual accounts of their experiences of diversity and how they have coped with stigma and discrimination, it is this that will inspire me to stay curious and continue my learning beyond the scope of my current course.
There is doubtless a long way to go, but I hope the increased accessibility of youth mental health services which my role represents will serve to complement and enhance de-stigmatisation initiatives, encouraging people to seek support when they need it and promoting wellbeing and resilience within education settings and over time, within the wider community.