The NHS recently released figures showing that almost a quarter of a million young people were referred to NHS Mental Health Services in the first three months of 2022, which is already half as many as the total referred in 2021.1 This data set, first published in 2016, showed that by the end of December 2016 there had been 142,651 referrals to children and young people’s mental health services.
In 2019 to 2020, there were 408,275.1 In the school where I serve as a school counsellor, as part of a multidisciplinary wellbeing team, there was a sudden increase in the number of students using our mental health and wellbeing services after the lockdowns. More than 40% of our student population have accessed our support, totalling 10,000 occasions of service. The numbers revealed by the NHS and my own school’s service delivery are indicative of the level of need that young people are presenting with today.
I have been working as a counsellor for 10 years. A little over three years ago, I was the Head of Mental Health and Wellbeing services for METRO Charity, an equality and diversity charity providing health, community and youth services in London. I had been in a senior management role for some time, away from the frontline of counselling, with a heavy management role and less time spent on client work. A few months after starting my current role as a school counsellor, the country was in the midst of a pandemic. All services faced new challenges, and schools faced an unprecedented test. I observed a response so smooth that it belied the diligence of those responsible for implementing it.
Lessons shifted online, tutors and teachers became Microsoft Teams wizards, those students not logging on to lessons received safeguarding calls home to ensure all was well. Tutors contacted every student each week to check in. Staff arranged to deliver free packaged school meals to multiple locations for parents to safely collect.
Later, a voucher scheme was created for families who would normally receive free school meals but could not, with the vouchers redeemable at supermarkets. Both the pre-packaged school meals and the vouchers were put in place quickly to ensure that young people did not go without food. Remote work was provided throughout each lockdown, and the school remained open for the most vulnerable students and those with key-worker parents. After lockdown ended, the school became a COVID-19 test centre and everyone working in it became testing professionals, completing government training on how to correctly complete a COVID-19 lateral flow test and then record the result. Staff became responsible for guiding worried and anxious students through the rigorous and repetitive COVID-19 testing process. The infrastructure of the school changed quickly to accommodate a safe learning environment, but even with all these efforts, young people faced further challenge and disruption. The need that arose during the pandemic and endures today is massive, and no matter what resources are in place, it was always going to be a challenge to meet that need.
Limits and achievements of schools
In schools, there is a limit to the resources and time available to us to spend with each student, which often feels like not enough. The return to a relatively typical school day post lockdowns has highlighted this more than ever, as I see more students presenting with reduced resilience and personal agency, having lost so many of the opportunities to develop these skills with the support of staff. The time a student might have had with a school counsellor, learning support assistant, wellbeing lead or tutor was all stripped away. I think it’s fair to say that schools have tried to rise to the challenge of meeting this new level of vulnerability, but it would be foolish not to acknowledge that the success of our interventions was restricted and would have limited success in mitigating the impact of the pandemic.
During the pandemic, my ability to provide counselling support was considerably tested and diminished. I was not able to provide the usual face-to-face sessions, which were replaced with online interventions via a webcam, telephone or email. Whether or not students had the necessary equipment to facilitate these options was another issue, something schools had to try to overcome. Some were able to issue students with home computers and even arrange for internet access for the most vulnerable, but organising this took time and was another barrier to providing genuinely effective, timely mental health and wellbeing interventions.
Some students receive nurture and kindness at school that they may not receive at home. There are multiple reasons for this, not all of them sinister. During the lockdowns, this was difficult to provide without in-person contact.
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Since the return to school, following the last of the lockdowns, there has been a steady reduction of health and safety measures that were put in place to keep us safe. Gone are the days of hunkering down at home and isolating from friends and family if we tested positive for COVID-19. No longer do we walk the corridors of the school and witness a sea of masks hiding everyone’s faces. I no longer wash my hands each time I go in or out of a room. As the markings on the corridors which reminded us to keep our distance begin to fade, the impact on young people manifests itself.
Many young people are fraught with heightened levels of anxiety, and some have experienced an almost total erosion of resilience or personal agency. The idea of just coming into school, for some, is unachievable. For them, a kinder, more nurturing approach is what is helping to build confidence, to overcome the feelings of fear and feel able to return to the school gates.
I work with young people in school counselling to develop their ability to express their wishes and thoughts. I use games, like Connect Four, and principles of play therapy to begin a dialogue. I encourage young people to talk with me about their interests, to help them feel comfortable and practise being social, something many have forgotten how to do. For some, the isolation developed into acute anxiety about the very things they wished they were able to do – socialise, have fun, be young. Many have lost the confidence and the skills to make and maintain relationships. This work, in collaboration with colleagues in the wider school context, is slowly leading to a development of greater personal agency, confidence and social skills among the children and young people we support.
Lives lived online
During the lockdowns, young people seemed increasingly to live their lives online and even nocturnally, further reducing their contact with the physical world and their caregivers. This isn’t new; the evolution of mobile phones and social media means that this transformation of young people’s socialisation has been ongoing, but the pandemic intensified it. Online was the only way we were allowed to socialise, and this way of interacting became the new normal; now, for many, it’s ingrained. The end of the school day can result in a return home and an-ever increasing virtual life lived through social media.
In addition, spending so much time online produces a relatively narrow digest of news and information, resulting in young people often having constant exposure to potentially harmful influences, without the reprieve of something lighter. Stories, feeds, snaps and messages about distressing subjects, such as self-harm, intrusive thought and suicidal ideation, are consistently suggested or fed to them – sometimes with devastating effects. I often try to explain that social media and online gaming can be extremely useful tools for being social or unwinding, but to overuse or rely too much on them can result in them becoming unhelpful or harmful.
This change in the way young people spend their time, communicate and receive news, has, in some cases, led to a crumbling of social and emotional skills and a deterioration of real-world (physical world) relationships, which are key to personal growth and development. The opportunity, will and skill to talk with parents (and vice versa) has been lost or forgotten; or, in cases of parents trying to reach their children, there are new barriers to impede it.
During the pandemic, young people (and all of us) felt a sense of being out of control. Our routines and lives changed overnight, and we were restricted, no longer able to make the decisions we normally could about where to go, or what to do and when. This loss of control for young people meant that they took control of things that were available to them. Some controlled their eating, others used self-harming behaviours. These went unseen or unsupported, resulting in young people arriving at services after the pandemic with harmful coping mechanisms. The control that young people found in these behaviours became a crucial but distorted sense of comfort and one that many are unable to let go of easily.
The stress of exams
I am particularly mindful of those students taking exams over the past year and the year to come. With the end of teacher-assessed grades
introduced during the pandemic, young people are now facing traditional exams without the typical experience of previous cohorts. In addition to this reduced experience of the exam process, they have further difficulties, discussed above – reduced agency, increased anxiety and lack of confidence. In some presentations, this results in an over-readiness to give up, or an apathy that sadly they can’t recover from in the time available. The stress of exams can be tremendous. Many students overcome it and excel, but those who don’t, those who might have struggled regardless, will undoubtedly struggle all the more because of the legacy of the pandemic.
Repeatedly, I hear comments from adults suggesting that young people just need to toughen up. I have argued against the claim that young people are not tough or have no mental strength. I retort that young people are having to recover from the pandemic, while dealing with the threat and fears of the new COVID variant, the impact of the cost-of- living crisis, the national and international impact of the war in Ukraine and the existential threat of global climate collapse.
In 1943, Maslow wrote about the Hierarchy of Needs, recognising that for people to develop self-esteem and reach their potential, they need to feel safe, secure,
loved, fed, homed and that they belong. For many young
people, it is very difficult to feel safe in the world today.
Certainly, the world of the past few years hasn’t felt
safe for many of us. Is it any wonder, therefore, that,
according to a recent report from UK charity The
Children’s Society, there is a ‘…harmful downward
trend in young people’s happiness’?2
The legacy of the pandemic is that it has created a generation of young people who have a greater unmet need than those who came before. Child and Adolescent Mental Health Services (CAMHS), charities and school counselling, which were already inundated pre pandemic, will continue to be so for some time to come. Some schools have built significant wellbeing resources, employed full-time counsellors and designated a staff member responsible for leading students’ wellbeing. The lucky ones even have a dedicated space for wellbeing. All schools need to take a similar approach in order to meet the needs of all students, and the campaign continues to secure a government-funded counsellor in every school across the UK. BACP continues to lobby for this provision in schools,3 which was first raised in parliament in 2019, but progress is slow. Wales and Northern Ireland have government-funded, school-based counselling services, and Scotland is following suit, but England is lagging behind the rest of the UK.
Working in a school for the past three years has been my very great privilege and pleasure. I have been overwhelmed by the willingness of colleagues to go above and beyond to reach a young person. I have tried to do the same. I am supported, formally, by my supervisor, without whom I could not do what I do. I am also informally supported by my wife. Despite not knowing the details of my work, because of confidentiality, she is a much-needed light in the sometimes disorientating darkness. I am continuing to be inspired and driven by the young people, who have experienced so many harrowing events, so much challenge and disruption, and yet carry on, still believing they can achieve, aspire, actualise and become the best they can be. All they need, like me and any of us, is a little help.
1 Mental health services monthly statistics; 2022. https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-services-monthly-statistics (accessed October 2022).
2 The Good Childhood Report; 2022. www.childrenssociety.org.uk/information/professionals/resources/good-childhood-report-2022 (accessed October 2022).
3 School counselling in England campaign; 2022. www.bacp.co.uk/news/campaigns/school-counselling/ (accessed October 2022).