Supporters of the psychiatric diagnosis approach are quick to say, ‘But we don’t have any valid alternatives’. This is simply not true.

The alternative is to hear people’s stories.

Lucy Johnstone (2014) A Straight Talking Introduction to Psychiatric Diagnosis

Mental health crisis in schools: the need for a major re-think of our models

Dr Margot Sunderland (Director of Education and Training Centre for Child Mental Health and Co-Director Trauma Informed Schools UK) looks at the issues.


t the moment schools are doing their part in addressing the child mental

health crisis. But due to models of intervention that are not working, both staff and parents are often left feeling angry, frightened and hopelessness and many children and young people (CYP) are left in states of extreme distress. Some take their own lives whilst on a CAMHS waiting list. I would argue that schools need to re-think their fundamental underlying models for mental health and take on board the latest evidence-based research on how children heal from painful life experiences.

The Disorder Model of mental ill-health Mental Health Leads often attend courses which give a general message of “Spot the disorder, the symptoms and then refer on”. When referred on, many CYP then join the long CAMHS waiting list or never meet the threshold required in the first place. One 2021 research study1 asked children's services about their waiting times. Over one-third

of those who responded, reported children who had been waiting for more than a year for their first appointment. As one mother in the report said, “When it comes to children's mental health… It's just not there. There's no funding. There's no help." Her eleven-year daughter struggling with anxiety, obsessive-compulsive rituals and battling suicidal thoughts said, “I just need help. I can’t really wait any longer.” Another mother said “I have a nine-year-old curled up on his bed for hours. He’s anxious, depressed and often says he wants to die. He’s still on a CAMHS waiting list after over a year for a first appointment.” One of the major problems that children report to the Children’s Commissioner, is being ‘turned away’ from mental health services without getting treatment. 2

Challenging the word ‘disorder” as the pathologising of emotional distress At the moment, many schools are still using the word ‘disorder’, unaware of the big international challenge to the use of this term. ‘Disorder’ pathologises emotional distress. This leaves


distressed CYP feeling stigmatised and that they have something wrong with their brain. Faulty genes? Biochemical imbalance? There is no scientific evidence for these opinions, the latter a belief pushed by the drug companies. Even neurodiversity such as autism spectrum is down as a disorder in the ‘psychiatric bible’, Diagnostic and Statistical Manual of Mental Disorders (DSM-V). The clinical psychology section of the British

Psychological Society has moved away from the medical/disease model of human distress to a trauma-informed model. It’s called The Power Threat Meaning Framework (PTMF) 3. They have a very large following of psychiatrists as well as psychologists. They are campaigning for people to be given a choice, a disorder label if this is what the person/parent wants, or for someone to hear their child’s story in order to help them process traumatic events so these no longer haunt their lives. The model acknowledges the fact that, “Bad things happening, is usually sufficient explanation for mental health problems.” 4. As Dr Lucy Johnstone (key author of PTMF) says, “We talk of depressive disorder, bipolar disorder,

June 2021

credit: © Iagodina: Adobe stock

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