Written evidence submitted by Zoe Catterall & Kate Rufus (CYP0046)


Who we are – provision of mental health support in schools:

We are the two-person CAMHS West’s Self-injury Pathway Project, launched in March 2019. Originally called the Self-Harm Pathway Project and funded for a year, we achieved 100% uptake from Somerset’s 38 secondary and middle schools.  Feedback for our training sessions was phenomenal; our funding was extended for a second year.  News of our effectiveness spread and we were approached by wider agencies, asking for help. We trained PFSA’s, Phoenix Group & Barnados staff, School Nurses, Social and Youth Workers, and were asked to deliver training to Foundation Year Nursing students.  Sadly due to COVID-19, this has not yet happened. To date, we have trained 1039 adults who work with children and young people. We have created a comprehensive programme that could be rolled out across all counties; including training sessions, guides and resources.  We have forged national links with leaders and agencies that work tirelessly to support young people who turn to self-injury to cope. I was asked to speak at a national conference, and recently featured on Surviving Self-Harm; a File on 4 documentary Long-term close collaboration with our 3 Participation Groups and 2BU (Somerset’s fantastic LGBTQ+ group for young people) resulted in training and resources inspired by young people, and a ground-breaking film, Just Hear Me.

Our funding runs out on 31st March 2021, as the number of young people turning to self-injury skyrockets.  We have been told that all available funding must go to face-to-face interventions.  However, this approach means that a huge percentage of children will receive no support at all.  Enabling staff to understand self-injury, and offering them concrete methods of support means there is a safety net cast out across all schools.  Staff cannot be expected to be expert in a behaviour most people find incomprehensible.  I have spent years researching self-injury.  My colleague and I have worked in primary, secondary, Hospital and Forest Schools.  We both worked in Pupil Referral Units; we know how schools work and how to ensure what we produce is of genuine use. 

Get this right, and the mental well-being of Britain’s children would be revolutionised.  It is that simple.  We must address teaching emotional literacy from the earliest school age and consistently through primary school.  If we teach children to not only recognise their own emotions but those of others, we create a universal language of feelings that enables them to communicate when things aren’t right for them.  Instead of shame and embarrassment, we have children who can articulate their internal struggles and suffering, to adults equipped with the skills to respond appropriately. We have an idea for a national primary school programme that embeds emotional literacy through core curriculum subjects.  Adults are afraid to tarnish youthful innocence with the sad reality of mental illness. Not talking to them about it because they are too young doesn’t stop it happening.  Instead, children learn about behaviours like self-injury from social media, film and television, siblings and peers.  How is this right?


Educating the entire school population is critical, and it must start with primary schools.  Training that is clear, practical and applicable for adults, alongside assemblies, lessons, group and 1:1 activities that are age-appropriate and child-centric.  The answer is not to focus on cure – prevention must be the priority.  As Young Minds’ Coronavirus: Impact on Young People with Mental Health Needs (Summer 2020) states, we need, “A long-term cross government strategy on young people’s mental health that prioritises early intervention...”

The current CCG/CAMHS model of funding short-term projects to create long-term solutions is fundamentally flawed.  Projects are given a year or two to develop; to build knowledge and understanding, relationships and resources, only to be discarded.  The same work is then commissioned under a different name a few months or years later.  This is frustrating and demoralising; wasteful of time, money and hard won expertise. There is no long term strategy for real and lasting change in this model.  We are greatly valued by our schools.  The excellence of our project is acknowledged, yet we are no longer being funded to do the work we are uniquely qualified to do.  This is clear evidence of a broken system.  The most vital source of how to help children and young people is the relationships built with our young people; these relationships are not transferable commodities.

Samaritans excellent report, Pushed from pillar to post, provides irrefutable evidence of a system failing children who self-injure.  Large numbers of children, who don’t meet the astronomically high threshold for CAMHS intervention, are considered too high risk for MHST low-level CBT-style support.  Most of these children do not need psychiatric intervention.  They need secure adults, who are able to give them space and time to be heard.  Adults who know of alternative coping strategies to try, who understand that self-injury serves an important purpose for that young person, or they wouldn’t do it.

I have already sent evidence of our work and impact to your Chair, Jeremy Hunt MP.  I am more than happy to provide further evidence to this committee, should you require.  This email, received after delivery of our initial training session, is indicative of the huge response we have had.

“I so wish I could have come to your self-injury training - I have heard it was excellent - one person said it should be compulsory. Is there any chance of it being repeated and we could host for staff from other schools?  Do you have a line manager we could email to say how brill it was? Well done & thanks.”


Previously, I sent similar information to ESFRA.  I received a response telling us that as a CAMHS service, we were the responsibility of Health & Social Care.  We don’t care whose umbrella we sit under.  We simply ask that you help us to stem the catastrophic ever-younger tide of children thinking self-injury is their only answer.



March 2021