Posted 19th December 2019
Tackling child mental health in disadvantaged areas
It is now over ten years since we set up the Bridge in Schools programme. That decade has seen huge growth and change. Here we review the developments that have shaped the programme and look at some of the challenges ahead.
Back in the 1990s, Bridge therapists decided to tackle a growing problem: specialist clinical support was not always getting to vulnerable children, who were struggling with emotional and mental health difficulties. There were a large number of children from families that were not getting to CAMHS, or could not pay to come to The Bridge Foundation for support; many were living with a level of disruption that meant that the only place they could reliably be seen was school.
So began the Cabot Project in East Central Bristol: a free service for parents of children aged 5 – 11 that led to the formation of Bridge in Schools (BiS) a decade later. Our proposal for a school-based counselling service for children and families in a deprived community won an award from a local trust in 2008.
Now 11 years on, BiS is widely recognised to be an important and highly effective programme not only for vulnerable children and their families, but also for teachers and schools across Bristol. Today we have a network of 9 partner schools including two Special Needs schools and a large secondary school. Last year, our Brief Interventions reached children in another 15 local schools, alongside supervision and training to staff in wider community and Academy clusters. We delivered over 2000 individual sessions of specialist mental health support to vulnerable families.
Our programme’s scope has also expanded beyond individual counselling. We now work at three levels of school life:
· with staff to support whole school wellbeing and mental health practice;
· targeted group interventions with vulnerable children; and
· individual, specialist interventions with highly vulnerable families.
The move to the current model took place gradually and emerged out of the dialogue with key colleagues in our partner schools. Not all children could benefit from direct therapy, and all benefited more when therapeutic thinking was embedded in the child’s support network. We began to offer parent counselling, more staff consultation, training and reflective practice, as well as joining the school in assessing the needs of their more vulnerable children and planning strategies for them.
It became evident that we had an important role in bringing together thinking around children, bridging divides between school and parents, building a shared understanding of a troubled child, and helping staff make use of their (often overwhelming) emotional experience with children. At the same time working closely with school colleagues gave us a deep respect and appreciation for the role played by teachers and support staff. In many cases this was a route through distrust to a family accessing or using therapeutic help.
Not only that but the structure and daily support for children in school was a source of containment that could make therapy possible when the family situation was too fragile to do so. Our confidence grew that this partnership approach could be the key to a really significant model for addressing the mental health challenges faced by families in areas of high deprivation. On the one hand, it allowed for early intervention before problems became too entrenched, while on the other it was able to get work started with some very vulnerable and disturbed children who could not be safely or reliably seen in CAMHS because of their family situation.
The value of the work is evidenced by validated clinical outcomes, and by the efforts of our partner schools to ring-fence funds for the service in testing financial times. BiS costs are higher than independent counselling, play or art therapy, because of the level of staff expertise required, and our uncompromising commitment to high clinical standards through investment in staff supervision and professional development. Yet even with the pressures of austerity, the experience of working with BiS has convinced many schools of the value of joining specialist therapeutic input to educational expertise in more systematic ways. Over half of the funding for our Partnerships comes from schools themselves, and we fundraise vigorously for the remainder.