The DfE’s latest ‘Mental health and behaviour in schools’ document offers advice for schools on supporting pupils whose mental health problems manifest themselves in behaviour.


Schools’ responsibilities


The updated guidance contains more information on schools’ responsibilities in relation to mental health. Under their statutory duty, schools are responsible for promoting the welfare of their pupils – this includes preventing the impairment of pupils’ health or development and acting to enable all pupils to have the best outcomes.

Early intervention to identify issues and provide effective support is crucial – schools have a key role to play in prevention, identification, providing access to early support and working effectively with external agencies. Though there is no requirement to have a standalone mental health policy, schools are required to produce a range of policies which promote and support mental health and wellbeing.


Mental health and SEND


Schools are expected to consider how best to use their SEND resources to support pupils with mental health difficulties that amount to SEND, and to put arrangements in place which reflect the importance of safeguarding and promoting the welfare of all pupils.

Early intervention to address underlying causes of disruptive behaviour should include an assessment to determine whether the appropriate provision is in place to support any SEND the pupil may have. Headteachers should also consider multi-agency assessments for pupils who demonstrate persistent disruptive behaviour.

The graduated response process outlined in the ‘SEND Code of Practice’ provides a framework for deciding what support to offer – this would be good practice regardless of whether a pupil has SEND.


Creating and embedding a whole-school culture


Emphasis has been placed on how a school’s culture, ethos and environment can have a profound influence on both pupil and staff mental wellbeing.

Clarification on the role of schools and their leaders in embedding the culture has been added on pages 9 and 10. Leaders are expected to communicate their vision clearly, determine the training needs of their staff, promote CPD and raise awareness of mental health problems, and ensure there are clear policies and processes in place to reduce stigma.

The previous sections covering interventions, including PSHE, positive classroom management, counselling, developing social skills and peer mentoring, have been removed from the guidance and referred to here, as examples of strategies that can be used to support pupils.

Schools should use these strategies to support pupils who experience high levels of psychological stress, or who are at risk of developing mental health problems, and to develop a whole-school Behavioural Policy. Provisions should also be made to support vulnerable pupils or groups, e.g. those who have experienced abuse, neglect, exploitation, or a range of adverse parental, familial and contextual circumstances. More information on these expectations can be found on pages 9 and 10 of the guidance.


Mental health problems in children


The DfE has removed Annex A and summarised the important information in Chapter 3 about the range of emotional and behavioural problems that may be defined as mental health problems or disorders – this includes new information on stress and worry. More emphasis has been placed on the prevalence of mental health problems in pupils with SEND, as there is an increased risk of them experiencing these conditions.

The risk and protective factors remain largely the same; however, ‘being female’ and ‘problem solving skills’ have now been removed from children’s protective factors. There have also been additional risk and protective factors added to the table in the ‘In the school’ and ‘In the community’ rows on pages 14 and 15.


Experiences that may impact pupils


An additional paragraph on ‘other traumatic incidents’ has been added to this section – examples include natural disasters or terrorist attacks. The guidance explains that, as an example, schools should be aware of armed forces families who may have parents deployed in areas of terrorist activity.

Regarding the support provided to pupils during adverse childhood experiences, the guidance refers to ‘Working Together to Safeguard Children’ and explains that early help is more effective in promoting the welfare of children than reacting later. This support may come from existing provision in a school or may require the involvement of specialist staff or support services, such as the school nursing service.


Identifying children with possible mental health problems


Schools should ensure that they promote CPD so that staff are aware of how to identify possible mental health problems and what they can do if they have. The possible indicators of an underlying problem have been clarified on page 16, with more detail of the signs to look out for.

Information surrounding the Strengths and Difficulties Questionnaire (SDQ) has been condensed and suggested to be used as part of a school’s graduated response process.




New information about exclusions explains that, when an exclusion is a possibility, schools should consider any contributing factors that are identified after an incident of poor behaviour has occurred, which could include where the pupil has mental health problems.

Schools should consider whether action can be taken to address underlying causes of disruptive behaviour – if a pupil has SEND and/or is a looked-after child, there are additional requirements and expectations, and a permanent exclusion needs to be the last resort. In all cases, schools must balance the interests of the pupil against the mental and physical health of the whole-school community.


Children in Need and LAC


Children in Need, LAC and previously-LAC are more likely to have SEND and to experience the challenge of social, emotional and mental health issues than their peers.

A new section on Children in Need, LAC and previously-LAC emphasises that school staff need to be aware of how these children’s experiences, and their high prevalence of SEND, can impact on their behaviour and education. Schools should reflect this design and application of behaviour policies, including through individualised graduated responses, balanced with the needs of the whole-school community.

Effective multi-agency working is highlighted as an effective way to help inform a school’s assessment of a child’s needs. If a child is being supported via children’s social care, their social worker can be a source of information about needs, child-protection concerns and contextual circumstances. A school’s designated teacher and LA virtual school heads (VSHs) can also provide sources of advice and expertise.


Working with other agencies


New information on working collaboratively with other agencies has been included – the guidance highlights the importance of children being provided with support as soon as a problem emerges. Schools should be aware of the role they play in influencing and participating in the new multi-agency safeguarding arrangements.

Previously referred to as CAMHS in the 2016 version, the guidance now explains how schools can work with the specialist children and young people’s mental health services (CYPMHS).

Until 2021, all LAs are required to publish a multi-agency Local Transformation Plan – a strategic document setting out how children’s mental health services are being improved.

Schools can feed into this what they know about the needs of their pupils, and share their perspective, experience and knowledge, helping to shape a system that is better able to support pupils. The mental health support teams introduced in the ‘Transforming children and young people’s mental health provision: a green paper’ will build on these arrangements.


Commissioning direct services


Clarification has been added on page 23 around the importance of schools ensuring the external providers they commission are appropriately qualified and experienced.

New information about the school nursing service has been added on the same page, detailing the support that can be commissioned and how schools can work with school nurses and their teams.


Working with other schools


This new section explains how schools, that are organised in clusters or run by MATs, should consider collectively commissioning specialist support – this support can take the form of mental health workers, social workers or educational psychologists (previously referred to as child psychologists in the 2016 guidance).


Working with parents


The guidance highlights that a large proportion of pupils and families are not aware of the mental health support available in their school, and that it is important for schools to ensure they raise awareness of their services.


Working with alternative provision (AP)


This new section explains LAs’ responsibilities for arranging AP for permanently excluded pupils and the different routes into AP that can be taken. Schools can support children in engaging in education and identify SEND at an early stage – they can work jointly with partner agencies to address these needs. For pupils at the end of Year 11, and still in AP, schools should work with the provider to ensure ongoing arrangements to support their mental wellbeing are in place when the pupil moves on.


Further information


Chapter 5 outlines the measures set out on the government’s green paper to provide further support to schools and improve collaboration with specialist services.

The sources of support and information, previously contained in Annex B, have now been put into a table on page 28 – additional links for schools to access support have been added throughout this table.


What’s next?


  • Read the updated ‘Mental health and behaviour in schools’ guidance here.
  • Our Pupil Mental Health Resource Pack contains resources to help schools build provisions for and promote positive mental health.
  • Our article summarises the government’s response to the green paper and looks at the next steps that will be taken.
  • You can also get up-to-speed with the role of the designated mental health lead, using this article.




DfE (2018) ‘Mental health and behaviour in schools’