Girl standing outside school

It's hard to talk: Expanding Mental Health Support Teams in education

Type Policy and research document

Published on
1 January 2023

A sixth of children and young people between the ages of 6-16 years old have a probable mental health condition, rising to a quarter of 17-19 year olds (NHS Digital, 2022). Specialist services are failing to keep up with demand and waiting lists are growing (Royal College of Psychiatrists, 2021). Children and young people have been affected by unprecedented interruption to education and their social lives as a result of the Covid-19 pandemic. This is now being followed by a rise in the cost of living that will impact thousands of families struggling to make ends meet.

Supporting children and young people’s mental health is vital to prevent long-term health, social and financial impacts into adulthood. Schools and colleges are increasingly playing a part in recognising children and young people in need and providing mental health services. Early identification and support is key to prevent children and young people reaching crisis point.

Barnardo’s delivers 12 Mental Health Support Teams (MHSTs) across England and have been involved in their delivery since the first wave of commissioning in 2018/19. Barnardo’s has conducted research with children, young people, service commissioners, teachers and frontline practitioners as well as drawing on our extensive experience as a mental health provider for our latest report into MHSTs in schools. Our evidence shows their presence improves children’s mental health and wellbeing and achieves savings for the state.

Download “It's hard to talk.” Expanding Mental Health Support Teams in education to learn more.

The difference in the children, and in their parents has been amazing. They work with the parents too, reduce the anxiety in the parents and it changes everything for the child.

Primary School Teacher

The research also reveals a missing middle in available support for children and young people with moderate or complex needs. Expanding the services provided by Mental Health Support Teams, for example by introducing access to a Counsellor, would help to fill the gap and provide more effective support. 

What are Mental Health Support Teams (MHSTs) and how do they work in education settings?

Education providers play a vital role in mental health literacy through the curriculum, through identification of at-risk children and young people, through early intervention and access to specialist support (Department for Education, 2021). Teachers are the most common first point of contact and source of support for children and young people experiencing mental health issues.

However effective, early intervention for children and young people experiencing mental health issues is patchy and provided by several services.

MHSTs work in schools and colleges to address this through

  • creating a positive culture, focused on wellbeing
  • offering interventions for children and young people with mild to moderate mental health issues
  • supporting education leaders, teachers, parents and carers to identify mental health issues early and ensure children and young people can access support.
I think they are a brilliant idea. Senior leadership and teachers need be involved and see the incentive.

Barnardo’s Service User

What does our latest evidence show?

Barnardo’s research gathered evidence from service commissioners, teachers, frontline practitioners, children and young people. It shows:

  • MHSTs are effective at supporting children and young people with mild to moderate mental health problems. They improve outcomes for those with access to them
  • MHSTs are cost effective, saving the government £1.90 for every £1 invested. The analysis also suggests that the cost to the state of failing to roll-out MHSTs to 6.5 million children and young people is an estimated £1.3 billion.
  • High demand and long waiting lists for Children and Adolescent Mental Health Services (CAMHS), as well as a lack of other support options, places pressure on MHSTs which are set up only for mild to moderate mental health issues
  • Three quarters of children and young people want more support in schools (76%) and 73% of parents would like to see more funding available for mental health in schools.

Read further details in “It's hard to talk.” Expanding Mental Health Support Teams in education.

For us and our teachers, MHSTs are accessible, and it feels as though there is no wait time compared to other services. We also hear back so we know when a child's had their assessment and what is happening next. We don’t always get that elsewhere.


What needs to happen?

You can read nine detailed recommendations for national government, local authorities, regional decision makers and leaders at schools and colleges in “It's hard to talk.” Expanding Mental Health Support Teams in education.

To summarise:

  • MHSTs should be rolled out in all schools and colleges in England, helping schools to focus on wellbeing as well as identifying and providing early support to children and young people through specially trained staff
  • The MHST model should be expanded to meet the needs of more children and young people, particularly those for whom current MHST interventions aren’t suitable. The MHST+ model should include qualified counsellors working within MHST teams or in partnership.
  • MHSTs need to have clear guidance on what referral and outcomes data to collect as well as the tools and infrastructure to do so. NHS England should commit to publishing this data regularly.
  • MHSTs and other services supporting children and young people’s mental health, should be supported to innovate to meet local need.
  • The MHST workforce must be supported to grow and offer career progression as part of NHS long term workforce plans.
  • Ask the government to provide mental health support in all schools

    Barnardo’s have launched a petition calling on the Government to implement MHSTs to cover every school and college throughout England.

  • Get support with your mental health

    If you are aged 11-25 years old and need support with your mental health we can help you.

  • Commission us

    Contact us if you would like to commission Barnardo’s to deliver mental health services, or support a bid for an MHST