Supporting mental health needs and behaviour

Published: Monday, 28 January 2019

Schools need to be aware of the range of mental health needs that pupils may have and have ways to identify pupils that may benefit from a referral for diagnosis. In this article, Suzanne O’Connell explains how schools can promote good practice in this area and how to work with others to identify a specific need.


  • Consistent disruptive or withdrawn behaviour may be an indication of an underlying mental health need.
  • Addressing the issue of mental health through the curriculum is important.
  • The Strengths and Difficulties Questionnaire can be used to assess whether a pupil may be suffering from a diagnosable mental health problem.

Behaviour such as being disruptive, withdrawn, anxious or depressed may be related to an unmet health need.

What are mental health problems?

Mental health problems might include:

  • Emotional disorders, e.g. phobias, anxiety states and depression
  • Conduct disorders, e.g. stealing, defiance, fire-setting, aggression and anti-social behaviour
  • Hyperkinetic disorders, e.g. disturbance of activity and attention 
  • Developmental disorders, e.g. delay in acquiring certain skills such as speech, social ability or bladder control, primarily affecting children with autism and those with pervasive developmental disorders
  • Attachment disorders, e.g. children who are markedly distressed or socially-impaired as a result of an extremely abnormal pattern of attachment to parents or major care givers
  • Other mental health problems including eating disorders, habit disorders, post-traumatic stress syndromes, somatic disorders, and psychotic disorders, e.g. schizophrenia and manic depressive disorder. 

What can schools do?

In order to help their pupils succeed, schools have a role to play in supporting them to be resilient and mentally healthy. Where severe problems occur, schools should expect the child to get support elsewhere as well and pupils and their families should participate as fully as possible in decisions.

Schools can use the Strengths and Difficulties Questionnaire (SDQ) to help them judge whether individual pupils might be suffering from a diagnosable mental health problem.

Addressing the issue of mental health through the curriculum is also an important way of helping students understand the problem and know what to do if they or someone they know experiences difficulties.

Good practice

There are a range of ways in which schools can promote pupils’ mental health. These include:

  • a committed senior management team
  • working with parents and carers as well as with the pupils themselves
  • continuous professional development for staff
  • clear systems and processes to help staff who identify children and young people with possible mental health problems
  • working with others to provide interventions for pupils with mental health problems that use a graduated approach to inform a clear cycle
  • a healthy school approach to promoting the health and well-being of all pupils in the school.


Consistent disruptive or withdrawn behaviours can be an indication of an underlying mental health problem. Only medical professionals should make a formal diagnosis of a mental health condition.

Schools can identify those who may be suffering from a mental health problem or be at risk of developing one through:

  • effective use of data
  • an effective pastoral system with at least one member of staff knowing every pupil well.

Schools should also:

  • listen to parents’ concerns
  • listen to pupils.

Evidence might be gathered through:

  • using the Strengths and Difficulties Questionnaire (SDQ)
  • assessing need using the Common Assessment Framework (CAF).

Pupils should be referred for a comprehensive assessment to CAMHS if, after using the SDQ, teachers suspect that there is a conduct disorder and if they are aware:

  • that they have another mental health problem such as depression
  • of a neurodevelopmental condition such as ADHD
  • of a learning difficulty or disability
  • of a substance misuse problem.


Strategies to promote positive mental health include PSHE education, positive classroom management, counselling, working with parents and peer mentoring.

For children with more complex problems, there should be additional support provided to the pupil’s teacher, additional educational one-to-one support for the pupil and/or therapy from a mental health specialist.


Where a case is referred to CAMHS, schools should:

  • use a clear process for identifying children who need further support, e.g. completing the SDQ
  • document evidence of the symptoms or behaviour
  • encourage the pupil and parents to speak to their GP
  • work with local specialist CAMHS to make the referral process as quick and efficient as possible and having the relevant forms, etc
  • understand the criteria that is used by specialist CAMHS
  • have a close working relationship with local specialist CAMHS
  • consult CAMHS about the most effective things the school can do to support children.

Information about services should be published in the local authority’s Local Offer.


Use the following items in the Toolkit to help you put the ideas in this article into practice:

About the author

Suzanne O’Connell is a freelance writer specialising in education. Prior to this she taught for 23 years and was a headteacher of a junior school in Nuneaton for 11 years.