The Future of Education in Severe Youth Mental Health

The Need for More Support Schools

If there were more Support Schools for young people with severe and complex mental health issues, the demand for places in the Extended Treatment Facility to be built in the grounds of Prince Charles Hospital at Chermside would be diminished. During its thirty years in operation, the Barrett Adolescent Centre’s (closed in January 2014) waiting list indicated the ongoing need for such an inpatient service and, sadly, levels of high or very high psychological distress among those aged 18-24 and suicide rates among those aged 15-25 continue to rise. There are only positive outcomes if every young person in Queensland at risk of deterioration to the point that extended inpatient care becomes the only way to halt their decline is able to access a school that supports their particular needs while they remain in their own community with continuity of clinical care:

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  • Young people and their families/carers benefit from effective education and health services which are more likely to lay the foundation for productive adult lives.
  • The expense to the taxpayer of lifelong intensive health and welfare support (for both patient and carer) and greater demand on comprehensive extended inpatient treatment is circumvented.
  •  Increasing services for sufferers of mental health issues promotes greater understanding across communities and helps to reduce the stigma that still adds such a significant burden.
  • And, because this issue is all about young people at the most vulnerable end of the mental health spectrum, lives are genuinely saved.

APPROACH TO EXPANSION OF THE SUPPORT SCHOOL MODEL

Ways to expand the Support School Service most effectively need to go beyond simply finding locations and allocating staff. There must be cohesion and interaction between campuses to enable the sharing of expertise and assignment of individual students to the best location/staff/student group to suit their unique needs. In addition, this service component must have the profile throughout the Queensland Education system that will ensure that referrals can be made as soon as they are required – not just every Guidance Officer but all educators must be aware that Support Schools are in operation and referral guidelines must be easily accessible. If a unique and vital resource has been, albeit inadvertently, developed, it cannot be allowed to remain ‘under the radar’. Now that the Education service providers are aware that the need exists, everything must be done to ensure that those with those needs have access to the service that will facilitate their educational re-engagement.

Possible Models for Expansion of the Support School Model
As it currently stands, the Barrett School at Tennyson is a ‘special school‘ though the majority of services under this banner in the state are “for children with intellectual disability that either on its own or in combination with other disabilities severely impacts their ability to access and participate in education“. Although there may be some in the cohort that needs a Support School like the Barrett School that have dual diagnosis (i.e. and intellectual disability as well as severe mental health issues), the commonality is that the severity of the mental health issues have rendered other education options ineffective. So to expand the service, it may be more appropriate that that happens in the same way that another Education Department model has been developed. The Queensland Pathways State College (QPSC) campuses have proven to be extremely successful and could be the template that would allow for the wider the provision of specialised education programs for young people with severe mental health issues. Young people at risk due to youth justice, poverty, alcohol/drug issues and other circumstances that have led to extended disengagement from mainstream schooling are now able to attend one of the 6 campuses of the QPSC to access senior school levels of education in an environment supportive to their needs. (Although the QPSC does enrol some students whose challenges include mental health problems, that does not include those experiencing illness of the severity and complexity of those whose only opportunity for educational and social re-engagement is at a Support School where the environment, surroundings, program, and procedural structure focus solely on those within this particular cohort. It should be noted that some students who have attended/are attending a Support School may develop the capacity to be able to benefit from attendance at one of the QPSC campuses after a period of stability and progress at the Support School but there are young people for whom that environment/program may not be appropriate at any stage.) So if multiple educational facilities for at-risk young people of 15 years and older have proven to be required and effective, then the Queensland Education Department clearly understands that gaps can exist between mainstream schools and special education programs in order to properly accommodate ‘students with disability to access, participate and achieve at school’. And they have an administrative model (QPSC) and an effective program (the Barrett Special School) ready to implement what’s needed in more locations.

AUGMENTING THE SUPPORT SCHOOL SERVICE

As the family/carers play such a key role in a young person’s education and are also significantly affected by the mental health issues the student suffers, having the capacity to offer the services of a trained therapist leading onsite parent and carer psycho-education and family therapy would not only aid the families and the student but facilitate the effective delivery of the programs planned by the school education team. Similarly speech pathology is another area where young people can benefit from specialist services having been isolated from education and development opportunities for an extended period. With the multidisciplinary team at the AETC being such an essential approach to support for young people with mental health issues and with school environments throughout the state often being utilised for activities and support that can foster greater family engagement, the accessibility of key services that augment effective education service provision would enable teachers to enact programs that achieve lasting progress as they positively affect the family system around the young person.

HUB of EXPERTISE

Whatever the label, the concept of a ‘Hub of Expertise’ i.e. an active and accessible group of professionals providing consultation and training for educators across Queensland needs to be created to support teachers who are – and will certainly continue to be – identifying students with mental health issues whose needs must be appropriately met. Combining the knowledge developed from the Jacaranda Place AETC education team and the faculty of the Barrett School in a resource that allows for sharing of professional skills more widely is simply a logical step. The impact of mental health issues on young people was significant before the global pandemic and so the need from now will surge even more severely. So since staff across the ‘Support School Network’ and within the AETC will continue to develop innovative methods in relation to students with mental health challenges, this knowledge base is a resource that must be available to other educators who will inevitably encounter young people who need a specialised approach education in order to continue to engage and learn. The Case Management role being undertaken currently at the Barrett School at Tennyson is an example. This is – and will continue to be – a developing area of Special Education. Liaison with other entities like a base school, other education access points that meet individual needs and the key supports (family, clinical etc.) for each student will be a skillset that will be more widely needed as we continue the valuable aim to support young people in their local community schools wherever possible. Facilitating a network of education services in a bespoke program to meet unique needs requires adept handling. And more teachers in mainstream classrooms will be required to manage or at least understand the integration of multi-service delivery in order to ensure effective education. And when those local schools don’t have suitable environments or the capacity for the level of specialisation or complex education management, then referral to a known Support School with an experienced team that is also part of the community must be an available option.

As mental health issues dominate the lives of more and more young people, we cannot ignore the need for increasing the kinds of services that will prevent vulnerable young people from being lost to education – and therefore to lives that have purpose and hope. For Queensland to take this opportunity to create not just more services but a mechanism that will proliferate the expertise that will continue to expand will inevitably mean that more young people are re-integrated into education and training and at earlier stages than those who currently have spent years in the wilderness.

Finally … and Importantly

Before COVID-19, mental health was the predominating issue for young people and yet it was significantly under-resourced. The serious implications on mental health of the global pandemic and the ensuing – and ongoing – required restrictions specifically in relation to those who are at a time of life when the challenges and losses can make a devastating impact only increases the urgency of comprehensive action in this area. Investment in education options for young people suffering severely with mental health issues has gone from long overdue to a genuine state of emergency. And clear and concrete plans to rectify the chasm that exists must be put in place immediately. Planning and implementation for this should be straightforward with effective models in practice already that only require expansion or replication to provide an initial foundation that can then evolve to be the needs of the local cohort. The Barrett School at Tennyson, the education staff of the school that operated within the Barrett Adolescent Centre at Wacol and the team implementing the education program at the Jacaranda Place AETC  have knowledge and experience that they are clearly willing to utilise in whatever way will improve the lives of young people they know can be helped. Queensland has invaluable resources in these educators and should be utilising these:

  • to provide expert guidance to service planners who must put mental health focussed services into place and
  • to ‘teach the teachers’ in mainstream and special schools throughout the state (and elsewhere) to ensure more timely and accurate identification and support of young people with mental health issues.

A specialised approach that focuses on those with severe and complex issues can illuminate aspects and help develop effective approaches that could be applied in less specialised environments as early intervention to prevent a wider need for things like inpatient extended treatment and education. And the knowledge developed must inform education for the wider public to foster greater understanding of mental health issues. The positive outcomes in specialised education for students with severe mental health issue that are currently Queensland’s best kept secret need to move to becoming one of the state’s proudest achievements.