Mental health, behaviour and attendance


One in ten children and young people aged between 5 and 16 have a clinically diagnosed mental health disorder. We look at new guidance intended to help support behaviour and attendance in affected young people.


  • Departmental advice on mental health offers clarification for schools on their responsibilities and duties.
  • Although national organisations can offer advice, schools should also investigate the resources that might be available locally.
  • Schools can use a ‘strengths and difficulties’ questionnaire to make initial assessments as to a child’s mental health.

There are a number of factors that put children at risk and many of these are cumulative. However, there are also a number of protective factors that can help build resilience. Loss or separation, life changes and traumatic events can be the catalyst that disrupts the balance between the risk and protective factors.

The document Mental health and behaviour in schools is non-statutory advice that clarifies the responsibilities of schools and how they can support behaviour that may be related to unmet educational or health needs. This document is available to download (

Key points

The key points in the document include the following:

  • In order to help 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.
  • Schools should ensure that pupils and their families participate as fully as possible in decisions.
  • Schools can use a strengths and difficulties questionnaire (SDQ) to help them judge whether individual pupils might be suffering from a diagnosable mental health problem.
  • There are resources available to help school staff support good mental health and emotional wellbeing.
  • Schools should consider if their pupils would benefit from the offer of school counselling services.
  • There are things that schools can do – including for their pupils, for those showing early signs of problems and for families exposed to several risk factors.
  • Schools can influence the health services that are commissioned locally through their local Health and Wellbeing Board.
  • There are national organisations offering materials, help and advice. Schools should look at what provision is available locally.

What schools can do

Key elements

The report notes that there are two key elements that enable schools to identify children at risk:

  1. The use of data to look at changes in patterns in attendance. Patterns should also be reviewed for changes to attainment and behaviour.
  2. Schools should have an effective pastoral system. At least one member of staff should know every pupil well and know what to do if they have concerns.

Strengths and difficulties questionnaire (SDQ)

Mental health and behaviour in schools recommends the use of an SDQ to assist in taking an overview and making a judgement about whether a pupil is likely to be suffering from a mental health problem.

The use of the questionnaire is intended to prevent delays in getting support in place where a pupil is suffering from mental health difficulties. Gathering evidence and working with partners can take time, and time is often critical for pupils in distress. The associated scoring sheets give overall scores considered normal, borderline and abnormal and, critically, the impact of those difficulties on relations and classroom learning.

The guidance notes that the SDQ may not be the right tool for all students and all situations, and some schools prefer to use the common assessment framework (CAF).


In some cases, pupils might need SEN provision due to their mental health problems. This might require additional support or the involvement of specialist staff or support services. In some cases, pastoral support will be needed and/or access to counselling services.

Promote positive mental health

Strategies to promote positive mental health include:

  • PSHE education – focusing on developing children’s resilience, confidence and ability to learn
  • positive classroom management and small group work
  • counselling
  • involvement of a child psychologist
  • developing social skills, perhaps through Social Skills Training (SST)
  • working with parents – helping better manage their behaviour at home alongside actions being taken in school
  • peer mentoring
  • positive classroom management and small group work can help pupils build coping strategies and improve both attendance and behaviour.

For children with more complex problems, in-school interventions might include:

  • support for the pupil’s teacher
  • additional educational one-to-one support for the pupil
  • one-to-one therapeutic work
  • medication
  • family support and/or therapy.

Serious cases should be referred to Child and Adolescent Mental Health Services (CAMHS). To help with this process, schools should:

  • use a clear process for identifying children in need of further support – e.g. SDQ
  • document evidence of the symptoms or behaviour
  • encourage the pupil and their parents to speak to their GP
  • work with local specialist CAMHS to make the referral process as quick and efficient as possible
  • understand the criteria that will be used by specialist CAMHS
  • consult CAMHS about the most effective things the school can do to support children.
  • Schools might also call on their local voluntary and community sector, or commission individual support directly.

Further information


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

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About Author

Dr. Suzanne O'Connell

Dr Suzanne O’Connell is a freelance writer specialising in education. She is also the Managing Editor of Attendance Matters Magazine. Prior to this she taught for 23 years and was a headteacher of a junior school in Nuneaton for 11 years.

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