1 Professionals involved in children’s mental health

There are many health and social care professionals who work to support, treat and ultimately to improve the mental health of children.

Here are examples of professionals who may work with children, and their roles and responsibilities.

Educational psychologists: have studied psychology and have taken additional training and study to specialise in working with children and families in education settings. Psychologists are not medical doctors (which include psychiatrists) and therefore do not prescribe medication. They can assess children and recommend interventions to support children experiencing social and emotional difficulties.

Activity 1 The role of an educational psychologist

Timing: Allow about 30 minutes

Watch the following interview with Liz talking about her work as an educational psychologist (about 5 minutes). Then reflect on each of the questions that follow and make a note of your responses. Watch the clip a few times if that helps you recall what was said.

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Transcript: Video 1

LIZ MIDDLETON

When I was a teacher, I was really lucky to be working with lots of other colleagues in London. And I became really interested in those children who had difficulties. They sort of drew me towards them, or they sort of caught on to me. So that I really felt that maybe I did have a way, or a rapport, or whatever of working with specific children.

And then when I explored it further, I was fortunate to be able to be supported. And then beginning to go on training, and then having the opportunity to actually then become an educational psychologist through funding. So that was what sparked it all off in the first place.

It's a big question, what an educational psychologist does. But it depends also on what expertise or interests you've got as an educational psychologist. In my case, for example, I was particularly interested in preschool. So I became the psychologist that went round lots of nurseries and preschool establishments and helped with teachers there and parents, working with various children to help with their practical skills, the things that they were finding difficult.

Some people might want to be involved more in behaviour management. So they might go into schools looking specifically at training staff to do with behaviour. Others might look much more at specific learning difficulties. I did that for a while myself. But specific learning difficulties, so the dyslexia or attention deficit. So they might have specific skills in that area.

There's the need to be very much someone who works within a team, ability to work within a team with other colleagues, but also the whole multidisciplinary approach. So you'll be going to meetings with psychotherapists, with health professionals. You'll be sometimes going to social services meetings. So a whole range of people that work in and around the child as well.

When you're assessing children, it's not just about what might be called individual formal assessment of the child, but you're actually doing a lot more to see what the child is doing within a particular context. So for example, some children may have problems at home where they don't have them at school, or have problems at school where they're not seen to have so many problems at home.

So you're looking to see where the problem is most apparent, but also seeing who it's the most problematic for. So you're looking in which context, how the child behaves with different people. So you're building up a whole larger framework and picture of the child, rather than just saying it's the individual child in isolation from everything else.

Thinking through all of the skills that psychologists would need, I think one of the most important is the ability to listen, listen really carefully to what people are saying, whether that be teachers, parents, the child in particular. But really not just listening, but actually looking attentive and being there, so that people can feel that you are genuinely interested in what they're saying. So that's a key skill.

And another one would be, you're not trying to solve problems as such, but more help people explore what the problem actually is. So really looking at it from all angles. So it's a bit like a detective in that sense. So you're finding out the different bits of evidence from everybody, and then seeing how it all pulls together to get a whole picture of what's happening with the child in that particular situation.

I think with working in many different professions, particularly when you're looking at sensitive issues to do with mental health, it's making sure that you look after your own mental health as well. Because it's so easy for people to then get into burnout situations where they're giving too much of themselves without actually looking at what they need to keep healthy, both physically, mentally, and also to keep the boundaries between yourself and also what you're working with. So I think that's crucial.

In a good day for me, as an educational psychologist, would be, for example, when a child has suddenly taken on, oh, so that's what the difficulty is, or, oh, so that's why I have the problems that I do have, or, it all makes sense now.

When I saw a child recently who had ADHD, oh, you understand what I'm talking about? So you're one of the few people that's understood when I say that my mind might be in a different space, what that actually means, because other people think I'm doing it deliberately, or that I might not actually be paying attention when I'm trying my hardest. But it's not easy for me to do that. So just getting that they actually feel themselves, that they can have an insight into their own difficulties is really pleasing.

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Health visitor: a registered general nurse who has done additional training to become a registered health visitor. Their role is primarily public health orientated and specifically focuses on working with children aged 0–5 years and their families.

Psychiatrists: medical doctors who have taken further training to study the speciality of psychiatry. Child and adolescent psychiatrists have specialised further and work with children with mental health conditions in both the community and inpatient mental health units. Psychiatrists can diagnose mental health conditions, prescribe medication, provide psychotherapy (i.e. talk-based therapies) and make recommendations for other interventions. They usually work in NHS-funded multidisciplinary teams with other professionals, including mental health nurses.

School nurse: a registered nurse who has done additional postgraduate training to become a specialist in children’s physical and mental health.

Figure 1 A school nurse

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This is a photograph of a child with a school nurse.

Figure 1 A school nurse

Social workers: support children and their families, helping to protect children’s rights and safeguarding children. They build relationships between agencies and help advocate for the child and ensure they receive the formal supports and resources that they are entitled to.

Special educational needs coordinators: often referred to as SENCOs. This role is statutory as part of the Special Education Needs and Disability (Department for Education and Department for Health and Social Care, 2014) legislation, which requires education settings to have a designated teacher who coordinates the special educational needs of children.

Teaching assistants: perform many important roles within schools, either working alongside the class teacher with targeted children who have special needs, or with small groups of children to help boost maths and literacy skills in particular. In more recent years their role has expanded, and some teaching assistants with higher-level formal qualifications have received further training to help them to nurture the wellbeing of children throughout the school.

Figure 2 A Teaching assistant supporting a child

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This is a photograph of a Teaching assistant working with a child.

Figure 2 A Teaching assistant supporting a child

Mental health nurses: Some mental health nurses have received further training and work in Child and Adolescent Mental Health Services (CAMHS) either in the community or in inpatient units, making them experts in supporting children with mental health conditions. Other health and social care professionals also specialise in child and adolescent health and work in CAMHS too, including social workers, practitioner psychologists (including clinical psychologists), child psychotherapists (specialists in talk-based therapies) and occupational therapists.

Therapist: A range of specialists who are skilled in a particular therapy or field, which can include the disciplines of speech and language therapy, psychotherapy, family therapy (where a therapist works together with the family unit in systemic therapy) and occupational therapists. All can make a valuable contribution to children and their mental health.