Mental health and school attendance difficulties

There is a school attendance crisis nationally. According to NHS Digital 2023 there is a link between the rise in school absence and the rise of mental health and wellbeing challenges. 

Louise Parker Engels is one of the lived experience partners in our Families Programme. She also runs Define Fine, offering parent peer support for school attendance difficulties. She gives her insights into this increasingly critical issue.

About Define Fine

Struggling to attend school is often linked to mental or physical health problems, or to issues relating to special educational needs and disabilities (SEND). Frequently, however, these children are initially described as being ‘fine in school’.

Are they really fine or are they masking? Or just about coping? Many parents and carers, and even professionals, are unsure what they can do to support a child or young person who is distressed and struggling to attend school. 

Define Fine is a member of the PLACE Network, supported by the Charlie Waller Trust. We focus on parent carer peer support for school attendance difficulties nationally and also work in collaboration with local support groups across the network.

PLACE brings together projects and groups across the UK offering peer support for parents and carers of children and young people with mental health issues.

We are a team of parents and professionals with lived experience of school attendance difficulties. In addition to our online group parent peer support, we offer direct one-to-one support and case management at no cost to parents. As far as we are aware, that means we are unique as an organisation focused on school attendance.

We are a not for profit and we work alongside charitable organisations across the fields of send and mental health who share our values and ethos. We also provide  continuing professional development (CPD) training to local authorities and to health and education professionals. Our training fees for this work fund our peer support, along with grants and donations.

New report: Not in School

The Children and Young People’s Mental Health Coalition and Centre for Mental Health recently published a report: ‘Not in school: the mental health barriers to school attendance’. We welcome its findings and recommendations; they validate much of our collective lived experience in relation to what drives school absence.

It is, of course, vital to understand the importance of mental health barriers. We feel it’s also important to locate these in a wider context: taking into account children’s environment within and outside school helps ensure they receive effective, timely support. It’s also important to recognise that many children and young people may want to attend but they just can’t manage full time, and some can’t attend at all. As the report explains:

It’s important to recognise that many children and young people may want to attend but they just can’t manage full time, and some can’t attend at all.

“The rising levels of persistent absenteeism suggest there is a crisis in school attendance, but the drivers of this are more complex than often perceived. Social determinants of poor mental health such as poverty, housing insecurity, racism, bullying, caring responsibilities, and unmet SEND needs, amongst others, contribute to poor attendance at school.”

It goes on:

“In addition to this, wider systemic challenges such as the inaccessibility of mental health support and SEN diagnoses, inappropriate use of fines, and sanction-based approaches also contribute to attendance issues. While some current government initiatives are beneficial and have the potential to bring about change, the work cannot stretch far enough with a single-lens focus.”

Supporting children who are struggling

So what can we do when children and young people are struggling to attend school? As the report emphasises, support and intervention need to be based on the interaction between these “drivers” of school attendance difficulties. 

They also need to take into account the long waiting times for mental health treatment or support, and high thresholds for referrals and a lack of suitable services, as sadly too many children are falling between the gaps in provision.

Define Fine supports parents and carers of children and young people with physical and mental health difficulties. We also support those whose children have special educational needs and disabilities, particularly neurodevelopmental disorders such as autism and Attention Deficit Hyperactivity Disorder (ADHD) – diagnosed or suspected. Our children and young people are impacted by delays in SEND and mental health assessments and by insufficient service provision.

Define Fine has published a resource to help parents and carers work with professionals in planning support for children and young people with attendance difficulties. It is based on government guidance and can be found here: 

Barriers to school attendance

Moving away from a punitive approach

It is distressing for parents and carers to experience a decline in the mental health of a child or young person in their care as they struggle to attend school, as well as the practical difficulties. Many also report experiencing blame and the risk of fines and prosecution. As the report says:

“Punitive approaches to address attendance, such as fines, can be harmful to the mental health of the young person and their family at an already challenging time.”

We echo the report’s recommendation that the focus must move from blaming and punishing to assessing, acknowledging, and working together.

Adequately acknowledging and supporting their mental health needs, SEND or caring responsibilities will go a long way to ensuring that school is an accessible place where children and young people want to be.

The case for parent carer peer support

The report highlights that mental health problems, special educational needs and disabilities, and wider factors may all contribute to a decline in wellbeing in children and young people which affects school attendance.

Parents and carers typically struggle to navigate the systems and waiting times for mental health and SEND assessments, in particular the neurodevelopmental pathway for the assessment of conditions including autism and ADHD. Many must then deal with potentially punitive approaches.

It also highlights the need for support from the wider community, not only for the child or young person, but for the family. The Charlie Waller Trust is working hard to provide training and increase the availability of evidence- based, quality assured peer support for parents and carers.

PLACE Network

PLACE is an established network of parent carer peer support organisations, most working with their local communities and some offering support nationally.

There are also members who specialise in specific areas of need, including school attendance difficulties, eating disorders, neurodivergence, autism, ADHD and  pathological demand avoidance (PDA). 

Between them, the groups have vast collective experience of parent and carer peer support for children with mental health difficulties. 

The report concludes: “.. increasing the availability of mental health provision and investing in the wider system will address many of the barriers to attendance by giving children and young people access to much-needed support. Through tackling the underlying causes and systematic challenges, the barriers which drive school absence can be managed. Without providing the necessary support, or tackling the social determinants and drivers of mental health problems in children and young people, the ‘attendance crisis’ cannot be tackled.

“A whole education approach to mental health and wellbeing further addresses attendance challenges by fostering a school environment in which children have their needs adequately met and, as a result, they are keen to attend.”

We feel it may be helpful to add that they are keen and able to attend: many of our children are keen to attend already, but they need an appropriate, supportive environment so that they can. If they can’t attend, they need alternatives to allow them to access a suitable education.

many of our children are keen to attend already, but they need an appropriate, supportive environment so that they can. If they can’t attend, they need alternatives to allow them to access a suitable education.

We must all work together to support families, and to ensure that school is a place of safety and security for all children and young people. This is vital, not only for their education but also to promote their success and happiness now and in the future.

Find out more about our PLACE Network:

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