Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697751051704.pdf (Ireland)
The Mental Health Support Team Service Criteria The Mental Health Support Teams (MHSTs) are intended to provide early intervention for some mental health and emotional wellbeing issues, such as mild to moderate anxiety, as well as helping staff within a school or college setting to provide a ‘whole school approach’ to mental health and wellbeing.

The 2017 Green Paper Transforming Children’s and Young People’s Mental Health introduces the role of a Designated Senior Mental Health Lead within every school.
This person is expected to be responsible for developing the wellbeing approach within the school and to be the point of contact for identifying the right children and young people for the MHSTs to work with.

MHSTs will deliver three core functions: 1.

Evidence based interventions for mild to moderate emotional and mental health issues Individual/face to face ◦ ◦ Group work ◦ Group parenting classes 2.
Supporting the designated Mental Health Lead in each school/college to introduce or develop a whole school/college approach to emotional wellbeing.

1 3.

Giving timely advice to school and college staff, signposting and liaising with external specialist services to help CYP to get right help and support Each Team is made up of a Clinical Lead, Senior Team Lead, higher-level Supervising Therapist and Education Mental Health Practitioners (EMHPs) each working across 15-18 schools each.
Teams may also include Counsellors and Mental Health Support in Schools Practitioners who support the work of the service.

Who will MHSTs work with?

The table below sets out the range of presentations the service will be working with.

We will be asking school leads to help identify children and young people who fit with the following criteria.
Presenting issues we will work with What may be being impacted on or noticed Useful websites for self help Signs may include: • Recent onset of low mood • Impacting on falling out with friends, or socially withdrawing www.youngminds.org.uk www.camhsdorset.org www.minded.org.uk www.beatingtheblues.co.uk (possible charges apply) Low mood • Not doing well at school • Reduced concentration and attention • Reduced self-esteem and confidence • Poor sleep • Reduced appetite Has not been present for more than 3 months.
2 Stress Signs may include: • High level of stress around exams • School work • Relationships • Family break up • Loss (not bereavement) • Short outbursts or tearfulness www.youngminds.org.uk www.camhsdorset.org www.minded.org.uk www.anxietybc.com www.anxietyuk.org.uk Symptoms have been present less than 4 weeks Signs may include: • Worry around many things, not specifically in one Generalised anxiety/Worry area • Difficulties impacting on friendships • • Sleep problems Increased restlessness Symptoms have been present less than 6 months • Experience of a panic attack/fear of having a Panic disorder panic attack Symptoms have been present for less than 1 month Terror around a specific place, things, or actions – but not phobia or fear of blood, needle or vomit Phobias Symptoms may include: • Trembling hands • Feeling sick • Needing the toilet more frequently Duration of less than three months 3 www.youngminds.org.uk www.camhsdorset.org www.moodjuice.scot.nhs.uk/anxiety.asp www.minded.org.uk www.anxietybc.com www.anxietyuk.org.uk www.youngminds.org.uk www.minded.org.uk www.nopanic.org.uk https://www.nhs.uk/conditions/phobias/ www.youngminds.org.uk www.camhsdorset.org www.moodjuice.scot.nhs.uk/anxiety.asp Sleep problems Signs may include: • Difficulties getting to sleep • Waking during sleep • Recent change in the amount/quality of sleep • Feeling tired • Irritable • Unable to concentrate.
https://www.nhs.uk/live-well/sleep-and- tiredness/how-to-get-to-sleep/ https://www.sleepstation.org.uk https://www.mentalhealth.org.uk/publications/how- sleep-better https://youngminds.org.uk www.camhsdorset.org Behavioural Difficulties Mild Emotionally Based School Non Attendance (EBSNA) Duration of less than 3 months Signs may include: • Symptoms not associated with learning disabilities or neuro-developmental difficulties • A recent change in behaviour which is impacting on learning or social functioning https://www.nhs.uk/conditions/pregnancy-and- baby/dealing-with-difficult-behaviour/ www.familylives.org.uk www.parentlineplus.org.uk www.camhsdorset.org Symptoms of less than 1 months duration Signs may include: • Difficulties in attending school every day • School refusal no more than 2 days in a week • Worries about attending school • Not wishing to leave parent at gate • Difficulties in certain lessons Symptoms present no more than 1 month www.camhsdorset.org https://what0-18.nhs.uk www.Kooth.com https://www.youngminds.org.uk/parent/parents-a-z- mental-health-guide/school-anxiety-and-refusal/ 4 Presenting issues we may work with - Please discuss with us further first What may be being impacted on or noticed Useful websites for self help Anger difficulties Recent change in behaviour and presentation possibly linked to a specific event/incident Low self- esteem Recent change in behaviour and presentation possibly linked to a specific event/incident Mild social anxiety disorder Fear of social or performance situations, which impacts on ability to function effectively in daily life, causing distress or presentation of physical symptoms.
Compulsory behaviours New presentation of repetitive, rigid or ritualistic behaviours starting to impact on daily life possibly linked to a particular event/incident https://www.nhs.uk/conditions/stress-anxiety- depression/dealing-with-angry-child/ https://youngminds.org.uk www.camhsdorset.org https://www.moodjuice.scot.nhs.uk/Anger.asp www.familylives.org.uk https://www.camhsnorthderbyshire.nhs.uk/low-self- esteem www.youngminds.org.uk https://www.nhs.uk/conditions/social-anxiety/ https://www.anxietycanada.com/disorders/social- anxiety/ https://www.nhs.uk/conditions/anxiety-disorders-in- children/ www.camhsdorset.org www.ocduk.org www.youngminds.org.uk www.ocdaction.org.uk 5 New presentation of worry around becoming unwell or someone close becoming unwell (not in relation to already diagnosed conditions) which is impacting on function and/or wellbeing www.youngminds.org.uk www.camhsdorset.org www.moodjuice.scot.nhs.uk/anxiety.asp www.minded.org.uk www.anxietybc.com www.anxietyuk.org.uk New presentation resulting in impact on emotional welfare Mild health anxiety Friendship difficulties/bullying www.youngminds.org.uk www.camhsdorset.org www.bullying.co.uk https://www.supportline.org.uk/problems/bullying- at-school/ www.nationalbullyinghelpline.co.uk https://dorsetconnexus.org.uk/Page/5117 www.camhsdorset.org https://what0-18.nhs.uk www.Kooth.com https://www.youngminds.org.uk/paren t/parents-a-z-mental-health- guide/school-anxiety-and-refusal/ http://www.nshn.co.uk/downloads/Distractions.pdf www.papyrus-uk.org www.camhsdorset.org https://www.rcpsych.ac.uk/mental-health/problems- disorders/self-harm Moderate Emotionally Based School Non Attendance (EBSNA) • School refusal less than 4 days a week • Will attend for specific events/lessons • Reduced timetable • Early help intervention Symptoms present no more than 3 months Self-harm Self-harm is disclosed but is assessed as linked to low mood but not enduring and high risk in nature 6 We cannot work with the following but can help to signpost to other services if needed.
Conduct disorder Anger Management What may be being impacted on or noticed Useful websites for self help If there are concerns around conduct disorder please seek advice from GP, Paediatrics or the Core-CAMHS duty worker If anger issues are more longstanding and are seen in conjunction with a primary mental health need, refer to CAMHS.
If there are safeguarding concerns around family and safety, then school to follow their safeguarding procedures and consider discussion with CHAD/MASH www.actionforchildren.org.uk www.youngminds.org.uk/psaytoolkit www.familylives.org.uk www.parentlineplus.org.uk https://www.nhs.uk/conditions/stress-anxiety- depression/dealing-with-angry-child/ https://youngminds.org.uk www.camhsdorset.org https://www.moodjuice.scot.nhs.uk/Anger.asp Treatment of parental depression or anxiety Parents to be encouraged to seek support in their own right either through self-referral to Steps2Wellbeing or via their GP www.steps2wellbeing.co.uk www.mind.org.uk www.samaritans.org 7 Chronic depression If symptoms of low mood have been present for a long (1 year plus) time, and there are concerns around impact on function and wellbeing , please refer to CAMHS Gateway Social anxiety disorder If social anxiety is severe and longstanding, then please refer to CAMHS Gateway or seek advice from CAMHS Gateway duty worker.
www.youngminds.org.uk www.camhsdorset.org www.minded.org.uk www.beatingtheblues.co.uk (possible charges apply) www.moodjuice.scot.nhs.uk/depression/asp https://www.nhs.uk/conditions/social-anxiety/ https://www.anxietycanada.com/disorders/social- anxiety/ https://www.nhs.uk/conditions/anxiety-disorders-in- children/ Extensive phobias Blood, needle or vomit phobias should be referred to CAMHS Gateway.

Other phobias which are more established should also be referred to CAMHS Gateway in the first instance.
https://www.nhs.uk/conditions/phobias/ www.youngminds.org.uk www.camhsdorset.org www.moodjuice.scot.nhs.uk/anxiety.asp Severe, active and high risk self harm Refer to CAMHS Gateway for support around this level of self-harm.

Contact CAMHS Gateway duty worker for advice on standard working days.

If immediate danger call 999 or take to A&E.


www.papyrus-uk.org http://www.nshn.co.uk/downloads/Distractions.pdf www.camhsdorset.org https://www.rcpsych.ac.uk/mental-health/problems- disorders/self-harm Follow local safeguarding procedures if trauma is disclosed and ensure young person is safe.

Seek advice from CAMHS Gateway duty worker in first instance.
PTSD, trauma or nightmares www.youngminds.org.uk www.camhsdorset.org www.assisttraumacare.org.uk www.rcpsych.ac.uk/mentalhealthinfo/problems/ptsd/ posttraumaticstressdisorder.aspx www.rcpsych.ac.uk/mentalhealthinfo/problems/ptsd/ posttraumaticstressevent.aspx 8 Relationship problems OCD – moderate to severe Attachment – moderate to severe Assessment and diagnosis of neurodevelopmental disorders and LD Pain management Historic and current abuse/violence.
Severe Emotionally Based School Non Attendance (EBSNA) This may be better suited to support from school counsellor or pastoral worker/lead but seek advice from MHST if in doubt.

Refer to CAMHS Gateway or suggest discussion with GP www.relate.org.uk www.youngminds.org.uk www.ocduk.org www.youngminds.org.uk www.ocdaction.org.uk www.camhsdorset.org Discuss with early help teams/family partnership zones or with CAMHS Gateway duty worker in first instance.
Request family seek advice from GP/Paediatrics in first instance.

Request family seeks advice from GP/Paediatrics (via School) in first instance.

Suggest discussion with GP or Paediatrician Follow local safeguarding procedures and ensure that child is safe.
• School refusal • Complete non attendance at school • Refusal to attend school for any events/lessons • Not on school roll • Social care involvement Symptoms present for more than 3 months 9 https://healthyyoungmindspennine.nhs.uk/media/10 52/attachment-difficulties.pdf https://heeoe.hee.nhs.uk/sites/default/files/attachme nt_disorders.pdf www.autismwessex.org.uk www.fasdtrust.co.uk www.autism.org.uk www.tourettes-action.org.uk www.youngminds.org.uk https://www.nhs.uk/live-well/healthy-body/how-to- get-nhs-help-for-your-pain/ https://www.britishpainsociety.org/people-with-pain/ www.youngminds.org.uk www.nspcc.org.uk www.victimsupport.org.uk www.actionforchildren.org.uk www.the-shores.org.uk https://pdscp.co.uk/guidance-for-practitioners- working-with-cme-cmooe-ehe/ https://pandorsetscb.proceduresonline.com/p_ch_missi ng_educ.html What do the MHSTs offer?
The EMHPs will be able to deliver 6-8 sessions per child/parent from a menu of low intensity CBT interventions for children aged 5yrs -18yrs.

Alongside this, MHSTs will work with school staff to identify and offer a range of whole school activities such as assemblies, preparation for transition and managing exam stress etc.
The teams are also there to provide support to teachers and pastoral teams to help with their reflection and management of difficult or more complex cases and signposting to other services.

The team will also offer group work to children and parents on specific topics which have been identified as necessary.

How will the MHSTs work?


MHSTs will work with the designated senior MH lead within schools to set up a process to identify and approach children, young people and parents who meet the service criteria and who would benefit from a low intensity intervention.

During the COVID-19 period the MHSTs will work with schools to decide the best way to contact families.

Once families have agreed to become involved with the service we will find the most appropriate way to deliver the interventions.
This may be through a digital offer or when possible a safe distancing face to face intervention within the school environment.

Consent Any EMHPs currently in their training year will need consent from families for sessions to be recorded.

This is for the university’s purposes to assess the EMHPs skill and competency levels.

A consent statement is contained within the Request for Support Form, which needs to be signed before we can start work.
During the COVID-19 period it is most likely that all contact with children will be with the consent of a parent/carer.

However under normal operating circumstances the following will apply; 10 If working with children up to the age of 13 years, the team will contact their parents and/or carers and ask for agreement to start any support with their child.
If the young person is aged 13 years and over, the team may agree to see them on their own and contact them directly without first seeking parental agreement.

These decisions will be based on a case by case basis and agreed with the school.

Confidentiality and Safeguarding A confidentiality and information sharing statement will be agreed at the start of the any work with a child or young person, as part of the treatment contract.
Where concerns regarding the safety of a child are raised, this will be shared with the designated safeguarding lead within schools.

All members of the MHST will adhere to Dorset HealthCare University NHS Foundation Trust’s Safeguarding Policy and Pan Dorset Safeguarding Partnership Procedures and staff all hold a current clear DBS certificate.

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