Virtual support for students, families, school and MHST staff
In 2018, a survey showed that online counselling was available in 13 LA areas through commissioned voluntary sector providers. It also suggested that ensuring access to CYP not in school was difficult to achieve.
In response to Covid-19, all areas have risen to the challenge of providing services to children outside of school, moving to the delivery of sessions virtually. They have used differing degrees of online and telephone sessions with at least one (City & Hackney) using text.
Many areas reported that a blended approach was likely to continue in some form following the return to school, subject to schools’ preferences. Some meetings lend themselves more readily to remote working – e.g. Islington reported that some types of training and meetings with schools could easily and efficiently take place online. Bromley are looking at an increased virtual provision following the return to school. Hammersmith & Fulham have held discussions around virtual versus live delivery with all schools. Camden are using a hybrid model, seeing people in school where possible and retaining online work (zoom or phone) where appropriate or desired; for example, meetings with school staff or parents are remote and with young people face to face where possible.
To support virtual services, online resource handbooks for both primary and secondary schools were made available in Ealing. Resources were designed with CYPs, parents/carers, schools and a range of other services and key professionals.
The experience of London MHSTs in relation to virtual working reflects findings from elsewhere. For example, a survey and interviews by the University of Oxford reported that, for people providing mental health services in schools (not limited to but including MHSTs) there were both benefits and disadvantages to providing mental health support remotely. Most (82%) found working remotely to be a positive experience, with the majority suggesting that remote provision of services should be an option following the return to school. Remote working was also felt to have led to challenges in terms of building and/or maintaining therapeutic dialogue, especially with new clients, however.
Different areas described the establishment of a variety of specific online groups or resources to support children and young people:
- Year 6 transition group (Bromley, Camden, Hounslow)
- Many online workshops/webinars were described – for example on return to school in Hounslow, Hammersmith & Fulham and SWL
- Webinars were recorded for a dedicated YouTube channel (Islington)
- Pre-recorded workshops/assemblies for pupils and parents (Islington)
- An anxiety group has been set up in Camden
- Creation of mental health support videos for Twitter and Facebook (Haringey)
- Self-care booklet for young people (Haringey)
- Support for children, families and schools around self – harming (Haringey)
In some areas, the maintenance of face-to-face support was described, however. For example, drop-ins at a youth centre with youth workers in Haringey, and drop-in sessions at schools in Hammersmith and Fulham.
The 2018 mapping exercise found that staff training on mental health was offered in most areas but that the extent of the training was variable. That report also highlighted challenges relating to support for teaching and other school staff, with support for staff mentioned by only four boroughs.
The 2020 data suggests the development of many mental health resources for school staff, with particularly good use made of online resources, for example MHSTs have made online resources available to staff through access to online programmes e.g. Kooth (SWL) and my-mind.tv (West London, Hammersmith & Fulham). These applications are being used to support various aspects of staff wellbeing, such as sleep, routine, and preparing for return to work.
Other specific resources designed to support school staff include:
- Staff wellbeing workshops, webinars and training (Haringey, Lewisham, West London, Islington)
- Staff support groups (Haringey)
- Drop ins for staff to discuss concerns around their wellbeing or around students (Hammersmith & Fulham)
- Mental Health awareness training for all schools to support their staff understanding the role of the MHST and the EMHPs (Hammersmith & Fulham)
- Development of supportive toolkits and guidance by partners (eg. Anchor and the Educational Psychology Service, EPS) to support teachers and staff (Haringey)
- Shape Up with Spurs (Haringey)
- Staff training delivered by the speech and language therapist (Haringey)
Changes to how and where individuals work have affected practitioners and supervisors in the same way as many others working in health and education. MHSTs described several examples of how they have adapted to support MHST staff during the response to Covid-19.
Hounslow have developed a schedule of supervision sessions, hub and management meetings, a monthly wider service team meeting, and a range of informal opportunities for team members to touch base remotely. These supporting sessions were initiated by team members and were designed to allow the service to continue to work closely and minimise feelings of isolation whilst working remotely.
Bromley are providing more virtual supervision and informal support on line using a variety of meetings and 1:1s.
Haringey and its partners delivered webinars for emotional wellbeing leads in primary and secondary schools. Haringey also described the development of a youth worker led mentoring programme.
The Anna Freud centre has developed a peer support programme piloted in 89 schools, funded by the DfE which includes a programme about how to run your own peer support scheme.
Links to parenting programmes was highlighted as a difficulty in 2018, whereas many areas have demonstrated attempts to support and engage parents and carers with their children’s mental health by the MHSTs. Examples include:
- Regular virtual coffee mornings to engage with parents/carers (e.g. Camden, Hammersmith & Fulham, Lewisham, West London)
- Parenting groups established (Camden primary schools), e.g. covering psychoeducation (West London and Hammersmith & Fulham)
- Webinars and workshops for parents (Lewisham, Haringey, Bromley, West London, Ealing)
- EPS and CAMHS joint planning to deliver specialised parenting classes in Haringey
- Mental Health Support Line set up offering advice and support to schools and parents (Haringey)
- Info Line for schools and parents (Central London)
- Development of supportive toolkits and guidance by partners (eg. Anchor and EPS) to support parents and children (Haringey) and anxiety resource pack and monthly newsletter (Central London)
- Support for schools, families and children around self-harming (Haringey)
- ‘How to zoom’ Support for MHST staff
Case study – Universal workshops in West London MHST
The West London MHST has developed a universal workshop programme offering psychoeducational workshops to parent/carers and school staff across all West London MHST schools. Content has been developed by the team and sessions delivered by EMHPs/children’s wellbeing practitioners (CWPs) via Zoom. The aim of the workshops is to provide multiple opportunities for parents/carers and staff to access support throughout the academic year including during half term breaks. Parent workshop topics include:
- Managing challenging behaviour (primary only)
- Managing your child’s anxiety (primary only)
- Sleep hygiene, routines & self-care
- How to talk about mental health with your child
- Mental health awareness & five ways to wellbeing
- Supporting children with their transition from year 6 (primary only)
- Supporting your child with exam stress (secondary and colleges only)
- Supporting children with their transition from year 13 (secondary and colleges only)
While virtual solutions have in some ways increased the potential to receive services provided by MHSTs, a lack of devices or private space will impact upon the ability of some children and young people – and their parents and carers – to access these services. A number of issues have been reported by the MHSTs:
- Digital poverty was mentioned as a significant issue in Tower Hamlets. In response, the service adapted their 8-week interventions into a brief 3 telephone session intervention to increase accessibility of the service and available support. Tower Hamlets has undertaken a trial of self-referral in selected schools to address the issue of decreasing referrals. This includes setting up remote hubs in schools, using a computer in a quiet space within schools for pupils to access a remote intervention.
- Other challenges associated with access were reported by the specialist speech and language school in West London which involved adapting the EMHP manuals through the purchase of ‘Communication in Print’ to support the language and communication needs of CYP.
- Hounslow reported challenges with virtual sessions. For example, online interactions take longer, poor connections and other malfunctions can have a detrimental effect on engagement and rapport-building can be more challenging. Some schools have been hesitant to facilitate a remote offer while the young person is at school. This has been mitigated by offering a safe space, IT equipment and access to a link worker during virtual sessions. Hounslow has increased the level of planning and communicated expectations about what would happen if connections fail or there is poor call quality.
- An additional issue around remote access in Hounslow is client preference for video appointments outside school hours (compared with face to face in schools). Hounslow has adapted by flexible working to increase later appointments, to ensure this does not put pressure on practitioner diary slots and narrows accessibility. They have worked with schools and parents to remind them that appointments will often fall within school hours, as would have been the case pre-COVID.