The 10 year health plan: Improving the mental health of school-aged children

School nursing is critical to improving the mental health and wellbeing of school-aged children, as discussed in the 10 year health plan, argues Sallyann Sutton of the School and Public Health Nurses Association (SAPHNA).

School nurses are well placed to deliver on the Government’s aspiration in the 10 year health plan to improve the mental health and wellbeing of children and young people. However, the Government first needs to prioritise school nursing in their workforce plan, rebuilding school nursing services.

The Government has set out an ambition to halve the gap in healthy life expectancy between the richest and the poorest regions, while increasing it for everyone, and raising the healthiest generation of children ever.

As part of the plan, the NHS has committed to find solutions to the mental health crisis engulfing our children and young people.

This includes working to better identify and meet the children’s mental health needs, to ensure that support for children and young people’s mental health is embedded in the new Young Futures Hubs and that Mental Health Support Teams are extended.

A mental health crisis among school-aged children

In recent decades, the mental health of children and adolescents has become a national priority.

According to NHS Digital, 1 in 5 children aged 8 to 25 years has a probable mental health problem, a marked increase from previous years. Factors such as social media, academic pressure, family breakdown and the impact of the Covid-19 pandemic have all contributed to rising levels of anxiety, depression, and behavioural disorders.

The burden of mental ill health

There is unambiguous evidence that mental ill health has a profound impact of on academic achievement, social development and quality of life which often extends into adulthood, with those from disadvantaged backgrounds and racialised communities being disproportionately represented, widening health inequalities.

A report in 2024, estimated the economic and social costs of mental ill health across the life span in England, in 2022 was £300 billion. Implementing whole system approaches, integrating services and sectors including health, education, social care, and community organisations, could save billions and improve societal wellbeing.

Finding solutions to the mental health crisis

In a recent report, the Centre for Mental Health described children and young people’s lives as complex and mental health problems as multifaceted, influenced by issues including psychological, environmental and biological factors, social influences, emotional experiences, trauma, racism and discrimination. It said that this requires a range of interventions, at different life stages and across different settings, to prevent mental ill health among children and young people including school and non-school settings.

School nursing, part of the solution

School nurses are highly trained public health professionals who have long been a cornerstone of public health. School nurses have a unique interface between school-aged children, young people and families, communities, schools, and the wider health system.

They lead delivery of the Healthy Child Programme 5-19, an evidenced based programme for health improvement and public health intervention to support children and young people to achieve optimum health and wellbeing.

They have the expertise to work with individuals, communities and at a population health level, in schools and beyond the school gates, meaning that they are well placed to promote mental wellbeing, prevent mental ill health, identify problems early and offer early support or onward referral.

School nurses are key to a system approach, including working with NHS children’s mental and education providers, using their public health knowledge to influence local transformation plans, contributing to the development and delivery of local multi-disciplinary and agency pathways, supporting whole school approaches, implementing the relationship, sex and health education guidance and training education staff.

Challenges faced by school nurses

Where school nurses are well-integrated and adequately resourced, they contribute to positive school climates, reduced absenteeism, and better engagement with families and communities.

However, school nurses face significant challenges, the number of school nurses has declined over the past decade, coinciding with reductions in the Public Health grant.

A SAPHNA survey found huge disparities in school nursing services across the UK and a postcode lottery of delivery of the Healthy Child Programme 5-19, resulting in missed opportunities to promote, prevent and identify problems and intervene early. This situation needs to change.

Sallyann Sutton RN, SCPHN, BSc, MSc is professional officer at the School and Public Health Nurses Association.