Chapter 8 - Areas of Need: Social, Emotional and Mental Health (SEMH)

8.1 Definition

Children and young people may experience a wide range of social and emotional difficulties which manifest themselves in many ways. These may include becoming withdrawn or isolated, as well as displaying challenging, disruptive or distressing behaviour. These behaviours may reflect underlying mental health difficulties such as anxiety or depression, self-harming, substance misuse, eating disorders or physical symptoms that are medically unexplained. Other children and young people may have disorders such as attention deficit disorder, attention deficit hyperactive disorder or attachment disorder.

8.2 Indicators of difficulties

Children and young people with SEMH difficulties may display passive behaviours such as:

Anxiety
Low mood
Being withdrawn
Avoiding risks
Unable to make choices
Low self-worth
Isolated
Refusing to accept praise
Failure to engage
Poor personal presentation
Lethargy/apathy
Daydreaming
Unable to make and maintain friendships
Speech anxiety/ reluctance to speak
Task avoidance

Children and young people with SEMH difficulties may display active behaviours such as:

Challenging behaviours
Restlessness/over-activity
Non-compliance
Mood swings
Impulsivity
Physical aggression
Verbal aggression
Perceived injustices
Disproportionate reactions to situations
Difficulties with change/transitions
Absconding
Eating issues
Lack of empathy
Lack of personal boundaries
Poor awareness of personal space

8.3 A Graduated Approach

As described in Chapter 4 a graduated approach is applied to all types of need. The following pages contain three Social, Emotional and Mental Health checklists. They describe actions to be undertaken under each of these headings and follow the format of:

Assess
Plan
Do
Review

Checklist One describes actions to be undertaken for ALL children and young people. Much of this is based around Inclusive Quality First Teaching.

Checklist Two describes actions to be undertaken for SOME children and young people. This is based around Inclusive Quality First Teaching plus additional time-limited support programmes.

Checklist Three describes actions to be undertaken for a FEW children and young people. This includes Inclusive Quality First Teaching plus increasingly individualised intervention programmes to accelerate and maximise progress and close performance gaps.

The checklists are designed to assist schools in ensuring a rigorous, consistent approach to support for Social, Emotional and Mental Health.

Social, Emotional and Mental Health Checklist One - All Children and Young People

All teachers are teachers of learners with SEN.

All learners benefit from Inclusive Quality First Teaching.

There will be high expectations that good progress is made.

Checklist One - All children and young people
Assess	Is the learner underachieving or do they have any special educational needs? Are there any other factors such as EAL? Discuss any concerns with the learner, all teaching staff, and parents Establish the learner’s strengths and barriers to achievement Do observations in class and in less structured situations Review attainment and progress data Look at scores from standardised tests e.g. reading, spelling, maths and other diagnostic assessments Analyse the learner’s work and learning style – all areas Check attendance, health and safeguarding records Review school processes for ensuring Inclusive Quality First Teaching – ensure Social, Emotional, and Mental Health is supported through PSHE&C, the School Council, SEAL, Rtime, Circle Time, Lunchtime Behaviour Plans etc. Review school processes for creating an inclusive school culture supported by positive and consistent behaviour management Audit staff training needs.
Plan	Investigate local community assets to support child/family Involve the learner and their parent/s in the process Use a learning assessment to ensure appropriately differentiated work and ensure any gaps in learning are addressed Use the learner’s and teacher’s analysis of his/her learning style and needs to create an environment in which the learner can work; making use of flexible and multi-method learning approaches Ensure everyone manages behaviour processes consistently
Do	Revisit whole school Behaviour and Discipline Policy, Anti-Bullying Policy – Rules, Rewards and Sanction systems Use PSHE&C, Emotionally Friendly Schools, Social Emotion Aspects of Learning (SEAL), Rtime, Circle Time, Peer Massage where appropriate Promote a positive ethos and inclusive culture through assemblies, school council, and school newsletters Consider the DfE document - Mental Health and Behaviour in Schools. Departmental advice for school staff (DfE, November 2018) Be aware of the need to promote social, emotional and mental health during extra-curricular activities, school trips, lunchtime clubs
Review	Analyse to ensure teaching and learning has been effective. If it has, then continue to support the learner through the systems already in place. However, if the learner has not made the same progress as other learners with the same ability and needs then consider further support.

Social, Emotional and Mental Health Checklist Two - Some Children and Young People

Some children and young people will require time-limited intervention programmes in addition to Inclusive Quality First Teaching; in order to secure effective learning and increase their rate of progress.

Checklist Two - Some children and young people
Assess	Undertake classroom observations Discuss concerns with the learner, his/her parents/carers and all teaching staff Holistic view of the child/young person including other factors Pre and post assessment of interventions with clear success criteria Use assessment tools such as Executive Skills, Skills for Learning (formerly QCA EBD Scale available from TESS), the Boxall Profile, Goodman’s Strengths and Difficulties Questionnaire to base line and measure progress Risk Assessments Audit Staff Skills
Plan	Investigate local community assets to support child/family. Involve the learner and their parent/s in the process Involve Support Services at a consultation level Use assessment to plan appropriately differentiated work and ensure any gaps in learning are addressed Create an environment in which the learner can work; making use of flexible and multi-method learning approaches and consider alternative ways of recording to enable pupils to demonstrate their learning Consider deployment of support, ensuring everyone receives appropriate training and develops an understanding of the pupils needs Ensure everyone manages behaviour processes consistently Using appropriate paperwork, the teacher(s), in consultation with the SENCO, pupil, parent and others involved, are responsible for: Planning interventions Considering the time, support and resources required Setting appropriately challenging SMART targets based on age, prior attainment and SEN/SEMH needs, with clear expected outcomes Setting a review date
Do	Planned structured researched programmes of small group support delivered by trained teaching staff (Teachers and/or Teaching Assistants). It can be delivered within a whole class as part of guided work or in another part of school The class teacher should work closely with staff involved in delivering interventions to assess impact. The class teacher is responsible for ensuring and monitoring that learning progress occurs. Small group interventions with positive role models and differentiated learning to ensure success and increase self-esteem e.g. Nurturing Talk, Nurture Room Silver SEAL, Family SEAL Rtime, Circle Time Socially Speaking, social skills activities Understanding and controlling emotions activities Anti-bullying interventions Peer support systems Restorative Justice approaches Lego therapy Pyramid clubs
Review	Evaluate intervention to ensure teaching and learning has been effective. If it has, then continue to support the learner through the systems already in place. However, if the learner has not made the same progress as other pupils receiving similar support then consider asking for advice through a consultation with support services.

Social, Emotional and Mental Health Checklist Three - Few Children and Young People

A few children/young people will require increasingly individualised intervention programmes, in addition to Inclusive Quality First Teaching, to accelerate and maximise progress and close performance gaps.

Checklist Three - Few children and young people
Assess	Consider all previous assessments, progress over time and refer to appropriate support services. Support services may; Have discussions with the learner, parents/carers and teaching staff Make classroom observations, and use assessment tools Assess using diagnostic assessments Provide a report detailing recommendations.
Plan	Investigate local community assets to support child/family Involve the learner and their parents/carers in the process Use assessment of cognitive development to plan appropriate tasks and ensure any gaps in learning are addressed Make use of recommendations and strategies described in support services reports Consider deployment of support ensuring everyone receives appropriate training and develops an understanding of the pupil’s needs Ensure everyone manages behaviour processes consistently Using appropriate paperwork, the teacher(s), in consultation with the SENCO, pupil, parent and others involved, are responsible for: Planning interventions Considering the time, support and resources required Setting appropriately challenging SMART targets based on age, prior attainment and SEN/SEMH needs, with clear expected outcomes Setting a review date
Do	Planned structured researched programmes of small group support delivered by trained teaching staff (Teachers and/or Teaching Assistants). It can be delivered within a whole class as part of guided work or in another part of school The teacher in class should work closely with staff involved in delivering interventions to assess impact The teacher in class is responsible for ensuring and monitoring that learning progress occurs Small group interventions with positive role models and differentiated learning to ensure success and increase self-esteem, for example: Nurturing Talk, Nurture Room provision Silver SEAL, Family SEAL Rtime, Circle Time Socially Speaking, social skills activities Understanding and controlling emotions activities Anti-bullying interventions Peer support systems Restorative justice approaches Lego therapy Pyramid clubs
Review	Review outcomes at the time previously planned. Evidence of outcomes should include all data and feedback from all involved – the pupil, their parent, the teachers, teaching assistants and SENCO. This review may also involve support services. The review will consider the impact of the intervention on the pupil’s progress and evaluate the effectiveness of the support. Analysis should ensure teaching and learning has been effective. If this is the case, then continue to support the learner through the systems already in place. However, if the learner has not made the same progress as other pupils receiving similar support then referral for an Education Health and Care Plan may be appropriate.

Diagram showing the processes for addressing social, emotional and mental health difficulties in children and young people.

8.4 Processes for Addressing Social, Emotional and Mental Health Difficulties

This flowchart demonstrates the process to follow when addressing social, emotional and mental health difficulties.

8.5 Whole School Behaviour and Discipline

The Headteacher must publicise the school behaviour and discipline policy in writing, to staff, parents and pupils at least once a year. The school’s behaviour and discipline policy must be published on its website. Schools have found that good practice involves the whole community taking part in regular planned reviews of policy.

Settings should consider whether continuing disruptive behaviour might be the result of unmet educational or other needs. The SENCO and others within the setting’s pastoral team have a vital role to play in joined up working.

Schools and early years settings can visit the Targeted Education Support Services page for further information.

8.6 Mental Health and Behaviour

The culture and structures within a setting can promote their learners’ mental health. The SENCO will ensure colleagues understand how the setting identifies and meets learners’ needs, provides advice and support to colleagues as needed and liaises with professionals from support services as necessary.

The following document may be useful:

Mental health and behaviour in schools. Departmental advice for school staff (DfE, November 2018)

Schools have access to the Emotionally Friendly Schools resource via the Educational Psychology Service.

Schools will already have access to the Wigan Mental Health Toolkit. If you would like more information please contact the Targeted Education Support Service (TESS)

8.7 EHCP Referral

It is only those young people with long term significant problems that will require an EHC Assessment based on:

Persistence over time
Intensity/severity
Duration
Frequency
Perceptions of degree of inappropriateness.