Mayden hosted Dr. Amy Alexander, Dr. Alex Staines, and Dr. Mitchell Thompson for a webinar to discuss their evaluation project. They shared key findings from an evaluation of their Suffolk Mental Health Support Team (MHST). This services is part of Norfolk and Suffolk NHS Foundation Trust (NSFT). School mental health is a crucial topic at the moment, which highlights the importance of MHSTs.
The Suffolk MHST service evaluation was delivered as a 17 minute podcast. To hear the complete evaluation, access the full recording of the webinar here.
MHSTs represent a vital part of England’s early intervention services and are structured around three core functions:
- Direct intervention
- Whole school approach
- Giving guidance to schools and liaising with other services
The national MHST target is 100% coverage in schools and colleges in England by the end of 2029. Note: The NHS has defined the 100% target as children and young people (CYP) aged 5-18 in conventional education settings.
A foundation built on wellbeing and relationships
Suffolk was an early adopter of the MHST model. The are now currently reaching 50% of schools within their region’s remit. A standout element of their success has been their ‘MHST family approach’. Specifically, this prioritises the wellbeing and relationships within Suffolk’s own team. This supportive internal culture is key to fostering staff diversity and preventing burnout. Ultimately this ensures a more effective service for young people and their families.
Key data from their service evaluation (covering 2020-2023) highlights the following:
- Referral Trends: The majority of referrals were for female students, which aligns with Suffolk’s overall demographic. The highest reasons for referral were anxiety, low mood, and emotional dysregulation.
- Rapid Impact: The service impacted thousands of students, parents, and staff in just three months.
- The Consultation Model: MHSTs are reaching a large number of young people through their consultation model, although there are differences in how schools utilise these consultations.
- Programmes: Goal-based outcome measures show significant improvements for children in psychoeducation groups—such as the 8-week program ‘Brain Buddies’—in terms of understanding and regulating emotions. The teams offer around 15 types of whole school/college approach work.
Prioritising formulation-driven approaches for school mental health
A major theme emphasised by the Suffolk MHST was the importance of a formulation-driven approach. This involves looking at the broader context of a child’s life rather than treating symptoms in isolation. This allows for broader interventions that truly address underlying issues. Suffolk MHST has a multi-disciplinary team, with a diversity of staff – including psychologists, Educational Mental Health Practitioners (EMHPs) and Senior EMHPs, who have come from a range of backgrounds, including social work, nursing and teaching. This diversity allows them to draw upon a range of expertise to attend to the individual needs of the children/young people they support.
However, a tension exists between delivering these nuanced, formulation-driven approaches and the current system’s emphasis on short-term interventions. While a formulation-driven model is seen as the way forward, it requires more time and resources from already stretched clinicians, underscoring the need for more staff training to deliver these skills effectively. The re-referral rate is very low (at 8.5%) so it’s clearly working.
Suffolk MHST has a multi-disciplinary team, with a diversity of staff - including psychologists, Educational Mental Health Practitioners (EMHPs) and Senior EMHPs.
Practical examples
The MHST uses both individual and group therapy. They don’t just focus on the child’s symptoms – they try to understand that child’s unique situation, and see the whole picture before deciding on a course of action. Using goal based outcome measures (GBOs) ensures an outcome that matters most to the child and their family.
The Whole School/College Approach (WSCA) is at the heart of what the MHST does; it goes beyond clinical interventions and promotes a school/college environment that supports the child/young person. For example, they may suggest and help put in place assemblies on mental health topics, provide staff training, and initiate peer to peer support for LGBTQ+ students. The MHST also provides more guidance and liaison – acting as a bridge between the schools/colleges and other services (mental health and the voluntary sector as examples).
Teams have the ‘8-Key Approach’ as a structure – a framework for Mental Health Support Teams (MHSTs) to implement a whole-school strategy for mental health and wellbeing developed by the UK government’s Department for Education (DfE) and the Office for Health Improvement and Disparities.
The service gave examples of case studies where we can readily see the human impact of the MHST’s work. They illustrate the three core functions working together to create lasting change.
Case study one
A 17-year-old student with ASD and high anxiety initially received four individual sessions focused on developing coping strategies, resulting in improved anxiety scores. However, it became clear that family dynamics were hindering progress, leading to the offer of six family sessions. These included psychoeducation for all to better understand ASD. This systemic support led to the student reporting feeling more in control, culminating in her volunteering for the NSFT people participation team, illustrating how the right support can have an empowering ripple effect.
Case study two
The MHST partnered with primary schools to adopt a whole-school approach, aiming to help all students, not just those actively struggling. A core component of this partnership was the delivery of Brain Buddies, an 8-week programme for Year 5 and 6 students designed to support children with anxiety and emotional regulation. GBOs showed significant improvement.
Addressing systemic challenges and data gaps
While the positive impact it has is clear, the MHST faces significant challenges:
- Capacity vs. Demand: Demand for services currently exceeds capacity. This is where the third function—guidance and liaison—becomes crucial, helping schools with a whole-picture approach rather than treating children solely in isolation.
- Measuring Effectiveness: There is a major challenge in measuring the effectiveness of the ‘whole school/college approach’. The teams currently rely heavily on qualitative feedback, but struggle to collect the quantitative data needed to drive systemic change.
- Data Collection: A stronger push is needed for better data collection methods to monitor health inequalities and demographics, and to improve the routine collection of outcome measures data. Better dashboards are being developed to address this.
- Funding and Sustainability: Continued progress requires significant financial backing for the expansion of MHSTs and to ensure their long-term sustainability.
In conclusion, the Suffolk MHST service, built on relationships and clinical excellence, is focused on continually improving its evidence base to demonstrate its value and support the staff development needed to ensure all young people have access to the mental health support they need. The team concluded that whole school/college approaches are the foundation for systemic shifts, moving towards a preventative model rather than just reacting to crises.
Suffolk MHST uses Mayden’s iaptus software – we are continuing to support them to ensure that we provide the tools they need to deliver the best service possible. Learn more about iaptus.