It’s important that schools make best use of their mental health support services as part of their whole-school approach to wellbeing. School nurses are an integral part of the wider mental health system.  Sharon White OBE is a qualified nurse, midwife, and school nurse with over 40 years’ experience of working with children, young people, and families. Before she left the NHS, Sharon was designated nurse for safeguarding and looked after children across a large city. She is now CEO of SAPHNA, School and Public Health Nurses Association and a globally recognised expert in school nursing. We recently spoke with Sharon to find out her views on how schools can use their partnership with school nurses most effectively and have put together this Q&A to share her thoughts.

How do you think the mental health lead in a school can make best use of mental health support services?

They need to map what they already have and understand who does what, perhaps invite the school nurse into the conversation to help them understand how everything fits together, especially if they are new to the role. Schools need to build relationships with mental health support services and know how to escalate if they don’t agree with a decision. 

A great way of building relationships is to get everybody in the room together (virtually if not physically) so everyone can understand the role of others, the tools and resources they use, the part they have to part and how their roles interact. This should give a clear picture of what services are offered and any gaps can be addressed. 

Have you any tips on how a school can work with their school nurse effectively to maximise their partnership? 

Schools can run CPD sessions for staff with the school nurse – joint sessions to increase everyone’s understanding of the role of the school nurse and how they can help promote positive mental health.

It’s important that the school and the school nurse recognise and respect each other’s code of conduct or confidentiality and how this may affect the way they work and the different ways they may report cases, to prevent misunderstandings later down the line.

All nurses have supervision every 3 months, which are support sessions to debrief – school nurses could have joint supervision with mental health leads so school staff safeguarding young people are more supported in their role and are being safeguarded themselves. 

Has COVID had an impact on the role of school nurses?

I think we’re firefighting now more than ever. Since 2013 the public health grant has been slashed by 35% yet, in just the last year, we’ve seen a 38% increase in child exploitation and a 300% increase in online child sexual exploitation. 

The lack of funding means we’re sticking plasters over wounds that are already there – there is so much more prevention work that needs to be done to protect children and young people. One positive outcome of the pandemic has been that covid has afforded us to be more visible with online meetings so there is the opportunity to reach more young people. Texting services and digital services have seen an increase in use of services. Remote access is easier for some children/young people and their familes, and for others, it’s simply more comfortable, not being in the same room and knowing they can talk with the camera off. Early indications are that vulnerable families are interacting more with services now than they were before so that’s very much a positive.

How can school nurses help with screening processes/understanding the needs of children and young people more in need of targeted support? 

To be a qualified school nurse you not only have to have done your nurse training but also be post-graduate qualified, most at master’s level. School nurses are highly educated health professionals, highly skilled in utilising many different tools and resources. They have a deep understanding of risk and protective factors and will look at all these factors when considering the best interventions for an individual child or young person. A tool some school nurses use is the Strengths and Difficulties Questionnaire (SDQ ), a mental health screening tool which highlights strengths as well as difficulties which is really helpful when supporting the child, providing opportunity to acknowledge what they’re going through and also point out their strengths. We can use these to build upon when deciding which interventions would be the most likely to work best for that individual.

How can school nurses help support early intervention and prevention?

We always look at what the individual child or young person needs. There are certain points in a child’s life where a school nurse will do an assessment which covers their physical and their mental health. These are generally at reception age, year 6 and mid-teens and this gives the opportunity for intervention to be put in place at the earliest opportunity if issues are flagged by the assessment that may previously have been missed. 

How do you think a school can help school nurses become an integral part of the mental health support within a school? 

The first thing is something I’ve already mentioned and that is to get a good understanding of what the school nurse does. 

A school nurse can offer informal peer support for the mental health lead – they can bounce ideas off each other. It is best practice, before a child starts in reception, that their health visitor and EYS will have given the school a heads up and a baseline of where they are and what support they might need. Best practice also sees regular liaison between school nurses and staff to check up on children and families throughout their school life.

Have you any specific examples of good practice you’d like to share? 

There’s lots of good practice around but an exemplar is Walsall School Nursing Service. The service provides support to children up until the age of 19 years.  The school nurse is a core part of the offer – they provide advice and support, parenting courses, text support for young people and for parents and training and support to schools. Schools could look at Walsall’s offer to help them assess what they’ve got and what they haven’t so they can address these gaps. 

Anything more you’d like to add about how school nurses can support wellbeing and protect the mental health of pupils and students?

School nurses could, in conjunction with mental health leads, co-produce interventions with parents and children. Use student council, listen to student voice and parent and carer voice to find out what the best interventions they think would work best for them and work together to make it happen. Schools could use their voices combined with those of school public health nurses to effect wider change e.g., influence and drive policy.

Come along to our discovery workshop on 10th May to gain more insights from Sharon about how you can make best use of your partnership with your school nurse to promote positive mental health in your school or college. 

Supporting Mental Health Leads provide targeted prevention

In our Wellbeing Club for SMHLs we have regular guest expert workshops related to all aspects of school wellbeing. You can access these helpful workshops in the course library inside our private Wellbeing Club membership. To find out how you can access funding to join our Wellbeing Club programme access our FREE funding information session.

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