Schools have taken on a substantial role in identifying and supporting children's mental health, largely because they are where children are.
Why schools
Universal reach, staff who see children daily and notice change, and no referral barrier.
Which makes them an efficient identification point.
It also places a demand on staff who are not clinicians and who have limited time.
The tiers
Whole-school approaches addressing culture, relationships and curriculum.
Targeted support for identified pupils.
And referral to specialist services for those who need clinical care.
Which mirrors the stepped structure used in health systems and has the same gap in the middle.
Mental health leads
Designated staff with responsibility for the school's approach, funded through training programmes in several countries.
Which is a coordination role rather than a clinical one.
Its effectiveness depends heavily on whether it comes with time to do it.
School-based teams
Support teams working across groups of schools providing lower-intensity interventions.
Which has been rolled out at scale in some systems and covers a fraction of schools in others.
Coverage is the main limitation rather than the model.
What the evidence says
Universal classroom programmes have produced mixed results, with some large trials finding no benefit.
Which was unexpected and has prompted reconsideration of universal delivery.
Targeted interventions for identified need have generally performed better than universal ones.
Attendance
Absence has risen substantially in several countries, with anxiety cited frequently.
Which sits at the intersection of mental health, education and family circumstance and is addressed poorly by any one of them.
Approaches that address the reason for absence outperform approaches that address attendance directly.
Special educational needs
Formal processes exist for assessing and providing for additional needs, with statutory plans in some systems.
Which parents frequently find adversarial and slow.
Independent advice services for navigating these processes exist and are worth using.
What parents can do
Raise concerns early with the class teacher or pastoral lead.
Ask specifically what support the school can provide and what the route to external help is.
And contact the child's doctor where difficulties are significant, since schools cannot provide clinical assessment.
Exclusions
Excluded pupils have substantially higher rates of identified mental health need.
Which raises the question of whether behaviour is being addressed as conduct when it reflects unmet need.
Alternative provision quality varies enormously and outcomes for excluded pupils are poor on most measures.
Transitions
Moving between schools, and particularly the move to secondary education, is a consistent point of difficulty.
Which is addressed through transition programmes of varying quality.
Additional support at these points has better evidence than year-round universal programmes.
Staff wellbeing
Teacher retention and workload are substantial problems in several systems.
Which affects pupils directly, since staff turnover disrupts the relationships that support is built on.
Programmes asking schools to support pupil mental health without addressing staff capacity have limited prospects.
What to ask a school
Who the pastoral lead is, what support is available, what the referral route to external services is, and how information will be shared.
Which establishes what is realistically available before a crisis.
Schools vary enormously in what they can offer, and asking early is better than assuming.
Online harms
Schools increasingly address online experience as part of wellbeing provision.
Which reflects that a substantial share of what affects pupils happens outside school hours and follows them in.
Confidentiality with young people
Schools and services balance a young person's confidentiality against safeguarding duties.
Which should be explained to the young person at the outset rather than discovered later.
Being clear about what will and will not be shared makes disclosure more likely rather than less.
Waiting for specialist services
Child and adolescent services have long waits and high referral rejection rates in several systems.
Which leaves schools supporting need beyond what they are equipped for.
Rejected referrals should come with advice about what else to do, and frequently do not.
Universal versus targeted
The evidence increasingly favours targeting resource at identified need over universal classroom delivery.
Which is politically harder, since universal programmes are visible and equitable in appearance.
Where budgets are fixed, the choice between them is real rather than theoretical.
Parents and carers
Parental mental health affects children substantially, and family-focused approaches address both.
Which is better supported by evidence than working with the child alone in many circumstances.
Family support services exist through local authorities and voluntary organisations and are underused.
Where to go first
The school for education-related support, the doctor for clinical concerns.
Which are complementary rather than alternatives.
Keeping records
Noting what was discussed and agreed with a school is useful if things need escalating.
Which is not adversarial and simply makes later conversations easier.
Following up a meeting with a short email summarising it serves the same purpose.
Raising something early, while it is still small, gets a better response than waiting until it is urgent.