Empowering Young Minds

Empowering Young Minds

Transforming the School Nurse Role!

Training and transformational programme

Why is this programme important?

  • There are significant rates of mental health problems in children and young people, with 1 in 10 being affected
  • Only a quarter of those who need help are reached (Khan 2016)
  • 'Five Year Forward View for Mental Health' (2016) highlights the importance of early intervention and quick access to good quality care and that there should be investment in training to ensure all those working with children and young people (CYP) can identify mental health problems and know what to do
  • School nurses are in a unique position to offer early help

Aims of the programme:

  • To enable school nurses and nursery nurses to develop skills and confidence in promoting emotional wellbeing and good mental health in children and young people, integrating physical health and mental health in all that they do
  • To create sustainable change by attending to the system and setting in which staff work
  • Providing group supervision to give staff the opportunity to continue to learn as they try out their new skills, and be supported to manage any concerns/risk issues

Approach to the training programme:

  • Our model of training aimed to build on knowledge and develop communication skills but also addressed the emotional impact of the work and aimed to enhance reflective practice. Helping staff to feel contained and listened to themselves supports them in managing the inevitable anxiety of the work necessary to engage, contain and listen to CYP
  • Using a relational approach to communication skills helped staff understand the importance of active listening as a key tool to engaging CYP and their parents
  • We began by listening to their experience of being a school nurse, the pressures they were under and the difficulties they felt they faced (e.g. dealing with angry parents, worried they’d say the wrong thing)
  • Most school nurses had had very little training in mental health and felt ill equipped to open up a conversation about mental health

What did the training cover?

  • Development of good mental health and attachment
  • Specific mental health difficulties- identifying problems
  • Developing resilience in children
  • Communication skills development – particularly active listening and opening up a difficult conversation
  • Where and how to make effective referrals- enabling a child/family to take up help
  • Reflective practitioner model and use of self in the work
  • Understanding how wider systemic influences can impact inter-professional working

Key learning for staff:

  • Bringing together physical and emotional health – every contact with a CYP no matter how brief can be an opportunity to think about emotional wellbeing
  • The school nurse / nursery nurse can be a key attachment figure - this might be the first time anyone (you) has shown real interest in this young person
  • Shifting from a ‘diagnostic ’ model of understanding emotional health to a formulation model and drawing on individual, family cultural and social influences - 'It's not what's wrong with you, but what's happened to you'
  • Looking at things from other people’s point of view – ‘standing in the shoes’ of another (eg parent, teacher colleague, CYP) can enhance understanding and communication
  • Remember that others have a story that you can’t see: There is more going on than you realise
  • Better appreciation of why parents may be defensive and angry
  • Understanding that effective listening can be a powerful intervention (it’s not ‘doing nothing’) that helps to engage CYP and develop a containing relationship
  • The importance of reflective practice and the need for self- care, support and supervision

What difference has it made so far?

The programme has been at the heart of a transformational change process for the whole service, with a fundamental shift from what may have been seen as a ‘medical model’ of consultation.

Evaluation of the effectiveness of this programme is being done by City University and is not yet complete, however preliminary outcomes are showing:

  • Staff feel more confident to talk about mental health and they are finding this work satisfying
  • More time is spent discussing mental health with children and young people
  • More referrals are being made

We have recently presented the work at the International Conference for School Nursing in San Francisco and will be publishing a series of papers with City University.

We are very grateful to the Burdett Trust for Nursing and the Public Health Department of the London Borough of Tower Hamlets who funded this work.

Recent Tweets from Compass Wellbeing