Written evidence from the PSHE Association (CMH0138)

Background on the PSHE Association and PSHE education
 

1. The PSHE Association[1] is the leading national body for personal, social, health and economic (PSHE) education in England, providing advice and support to a network of over 16,000 teachers and other professionals working in schools nationwide.
2. PSHE education is a non-statutory curriculum subject which covers the knowledge, skills and attributes all pupils need to develop in order to keep themselves mentally and physically healthy and safe and to prepare them for life and work in modern Britain. Evidence shows that well-delivered PSHE programmes have an impact on both academic attainment and non-academic outcomes for pupils, particularly the most vulnerable and disadvantaged.

Executive summary

3. Supporting children and young people’s mental health requires a response that covers the spectrum of need from promotion, prevention and increasing disclosures and help-seeking, through to specialist mental health services. Within this, the school curriculum and PSHE education specifically, can play a vital role.
4. PSHE education is the school subject through which skills, attributes and knowledge relating to mental health and emotional wellbeing are best delivered and therefore is a vital supportive and preventative part of a whole-school approach.
5. In this submission, we outline PSHE education’s crucial role in promoting emotional wellbeing, building resilience, establishing and protecting good mental health, and in preventing the development of mental health problems in children and young people
6. Despite this potential, due to its precarious, non-statutory position on the curriculum, hundreds of thousands of pupils miss out on PSHE education that can support their mental and emotional wellbeing.
7. Consequently, there is strong and growing support for statutory PSHE education amongst leading experts including the Children and Young People’s Mental Health Coalition, the Royal College of Psychiatrists, Rethink Mental Illness, Mind, YoungMinds, Royal College of Paediatrics and Child Health, Centre for Mental Health, Royal College of General Practitioners, Faculty of Public Health, Royal College of Nursing, Association of Young People’s Health, Campaign Against Living Miserably (CALM), Men’s Health Forum, The Children’s Society.
8. We ask the committee to consider statutory status for PSHE education amongst its recommendations. We ask that this entitlement to PSHE education apply to all school pupils at key stages 1-4 in all state schools, whether they are academies or maintained schools.

Poor mental health as a risk for all children and young people

9. There is much concern about young people’s mental health, and the linked issues of self-esteem, body image, their safety and relationships – both online and offline – as well as their anxieties about the future.
10. Poor mental health is the key emerging risk for children and young people according to recent research (SHEU, 2015; Cabinet Office, 2015[2]) and a number of recent reports, including:
1. The ‘Mental health and behaviour in schools’[3] advice published by the Department for Education (DfE) in March 2016 highlights that one in ten children and young people have a clinically diagnosed mental health disorder and that around one in seven has less severe mental health problems.
2. A report by the Chief Medical Officer found that 50 per cent of adult mental health problems start before the age of 15 and 75 per cent before the age of 18,[4]
3. The Chief Medical Officer’s 2012 report[5] suggested long-term costs associated with childhood mental health problems are estimated to be £2.35 billion and the short-term costs £1.58 billion.
4. The Prince’s Trust Macquarie Youth Index for 2017 revealed that young people’s happiness and wellbeing is at its lowest level since the first edition of the index in 2009.[6]
5. PSHE practitioners surveyed annually by the PSHE Association have listed mental health as the area of PSHE they want most support with in 2014, 2015 and 2016 surveys.[7]
6. University of Glasgow research suggests that social media has a role to play: “the need to be constantly available and respond 24/7 on social media accounts can cause depression, anxiety and decrease sleep quality for teenagers”[8]

The potential of PSHE education to support young people’s mental health

11. PSHE education develops a range of skills, attributes and knowledge associated with promoting emotional wellbeing, building resilience, and establishing and protecting good mental health.
12. A well planned and delivered PSHE curriculum[9] develops pupils’ understanding of how to maintain and make informed choices about emotional health and wellbeing; how to assess and manage risks to their health; how to keep themselves and others safe, how to recognise the signs of mental health problems and how to identify and access help, advice and support, for themselves or others.

1. PSHE lessons provide a space on the curriculum to promote pupils’ wellbeing through the development of a range of healthy coping strategies and an understanding of pupils’ own emotions as well as those of other people. Increasingly strategies such as mindfulness and other stress-management techniques are taught as part of a comprehensive PSHE programme.
2. PSHE lessons can help pupils to recognise and understand mental health issues that commonly affect young people, including unhealthy coping strategies such as self-harm and eating disorders. This increases the chances of earlier help-seeking and intervention
3. PSHE lessons can be used to enable pupils of any age to develop the skills, knowledge, understanding, language and confidence to manage online influences critically and to seek help, as needed, for themselves or others.
4. Talking openly with children and young people about mental health issues during PSHE lessons is a simple and effective means of breaking down any possible associated stigma.
5. PSHE lessons in primary schools provide invaluable opportunities for pupils to develop underpinning skills, attributes and knowledge – such as identifying and discussing feelings; simple strategies for maintaining their own emotional wellbeing; resilience and strategies for asking for help – that lay foundations for the more specific learning about mental health issues in key stages 3 and 4.

13. This inquiry also focusses on social media and the internet. In this respect PSHE education has the potential to make a major contribution. Whilst the technical aspects of online safety are covered on the computing curriculum, the impact of technology on mental health and emotional wellbeing is not primarily about young people’s understanding of technology. Rather it is about young people’s ability to understand healthy, safe relationships (whether online or offline); to recognise and manage risk; to critically evaluate information and to develop resilience. In response to the recent Children’s Commissioner ‘Growing up Digital’ report, Russell Hobby, NAHT General Secretary said that "It is only by tackling these sometimes difficult subjects that we can imbue children with the resilience and understanding that will prepare them for life in a digital world. The government must back teachers by making PSHE a statutory part of the curriculum."

Evidence

14. There is significant evidence supporting the positive impact of PSHE education on children and young people’s mental health.
15. The 2015 DfE review of impact and effective practice in PSHE[10] concluded that “the evidence shows that PSHE education can improve the physical and psychosocial well-being of pupils. A virtuous cycle can be achieved, whereby pupils with better health and well-being achieve better academically”
16. A meta-analysis of 75 studies[11] on universal school-based social, emotional and/or behavioural programmes concluded that these lessons could benefit pupils in seven outcome measures including social skills, antisocial behaviour, positive self-image, mental health, and prosocial behaviour.
17. PSHE education also has the potential to address issues which contribute to mental health related problems. A recent Cochrane Review of Health-Promoting Schools (Langford et al 2014)[12] demonstrated that health education, as part of a whole-school approach, can have an impact on pupils’ health behaviours; it also showed promising results in relation to bullying and violence. There is clear evidence that PSHE lessons can help to break cycles of abuse[13], teenage pregnancy[14], alcohol, tobacco and drug misuse, unhealthy eating and lack of physical activity[15], removing barriers to learning and improving vulnerable children’s health and life chances. The subject can also improve pupils’ resilience in response to challenges they may face.
18. Evidence also shows pupils who are positive about the PSHE lessons they receive are more likely to have positive relationships as well as a strong feeling of belonging at school.[16]
19. Taken together, this evidence suggests that when taught in line with good practice principles and supported by a whole-school approach, classroom-based learning can have an impact on both pupil health and the development of social and emotional skills and attributes. Research suggests that vulnerable and disadvantaged pupils in particular benefit from the kind of learning covered in PSHE education.
20. We believe this also helps to explain the strong correlation between schools which achieved a high grade from Ofsted for PSHE education and schools which were awarded outstanding grades for overall effectiveness, as identified in the 2013 Ofsted PSHE report (Ofsted, 2013)[17].
21. There is also growing evidence of the links between social and emotional learning, non-cognitive skill development and academic success:

1. A DfE commissioned report[18] (Gutman and Vorhaus, 2012) found that children with higher levels of emotional wellbeing have higher levels of academic success in school.

2. The Education Endowment Foundation’s Teaching and Learning Toolkit[19], which provides up-to-date summaries of the impact of different educational interventions, states that Social and Emotional Learning programmes have a “significant impact on attitudes to learning… and attainment itself (on average three to four months additional progress)” (EEF, 2014).
3. A study by US economist James Heckman[20] looking at the impacts of life-long learning in a range of educational settings highlights the positive relationship between socio-emotional skills, physical development, mental health and scores achieved in Standardised Attainment Tests (Heckman, 2008)
4. A study of emotional resilience programmes in 22 UK schools[21] (Challen et al, 2011) found short-term improvement in pupil attendance and attainment rates, particularly amongst those eligible for free school meals and pupils who had been performing at below national average in maths and English.
5. An analysis of over 200 Social and Emotional Learning programmes[22] by Durlak et al (2011) demonstrated improved social and emotional skills, attitudes, behaviour and an 11% improvement in academic achievement.

The impact of PSHE education’s non-statutory status

22. While many schools deliver high quality PSHE education, without parity of status with other subjects it is effectively optional for schools and as a result squeezed from the curriculum or poorly taught in too many cases.
23. Research cited in the Future in Mind report suggests that 93 % of universal mental health programmes in secondary schools are delivered through PSHE education.[23] However, Ofsted’s 2013 report into PSHE education[24] found that provision needed improvement in at least 40% of schools, with lessons too often delivered by teachers with insufficient training and curriculum time.
24. According to the Ofsted report: ‘in the two fifths of schools where learning was weak, pupils had gaps in their knowledge and skills, most commonly in the serious safeguarding areas of personal safety in relation to sex and relationships, mental health, and alcohol misuse.’ On the other hand: ’Where learning was good or outstanding, pupils knew how to resist peer-pressure that risked their health and safety, and had a good understanding of mental health issues.’
25. The Commons Education Committee ‘Life Lessons’ report concluded that PSHE provision is ‘deteriorating’[25], an assessment backed by Department for Education data[26] which suggests that PSHE provision decreased by over 32% at key stages 3 and 4 between 2011 and 2015, demonstrating the urgent need to act as hundreds and thousands of young people are missing out on this vital education to keep them healthy, safe and prepared for the modern world.
26. While there is strong evidence of the potential positive impact of high-quality PSHE teaching on pupils’ mental health, there is also clear evidence of the dangers of poorly taught lessons on the subject. There are particular risks in relation to lessons on eating disorders and self-harm which, when taught by inexperienced or untrained teachers, could prove ‘instructive’ to vulnerable pupils (Knightsmith, 2015)[27].
27. Due to its non-statutory status, responsibility for teaching PSHE education is often given to untrained, unprepared and inexperienced teachers, potentially putting vulnerable pupils at risk. Statutory status would ensure high-quality training in the subject for teachers and increase the number of lessons taught by more experienced teachers, reducing the risks and increasing the potential for positive impacts on pupils’ emotional health.
28. In the absence of high quality lessons, or sometimes any lessons at all, young people are more likely to turn to less reputable and sometimes dangerous sources of information and support. For example, ‘pro-ana’ online communities which advocate anorexia as a lifestyle choice and provide advice and support to maintain this ‘lifestyle’ as opposed to promoting support to change these harmful behaviours.

Support for PSHE education amongst leading experts as a means to support children and young people’s mental health and emotional wellbeing

29. In its 2015 Inquiry into Parity of Esteem for Mental Health, the All Party Parliamentary Group on Mental Health recommended that ‘mental health education should form a core part of the PSHE curriculum, to promote wellbeing and resilience in children and young people and prevent mental health problems developing’.[28]
30. Statutory status for PSHE education is supported by a number of expert bodies supporting children and young people’s mental health including the Children and Young People’s Mental Health Coalition, the Royal College of Psychiatrists, Rethink Mental Illness, Mind, YoungMinds, Royal College of Paediatrics and Child Health, Centre for Mental Health, Royal College of General Practitioners, Faculty of Public Health, Royal College of Nursing, Association of Young People’s Health, Campaign Against Living Miserably (CALM), Men’s Health Forum, The Children’s Society.[29]
31. The Chief Medical Officer’s 2012 report stated that PSHE education “forms a bridge between health and education by building resilience and wellbeing”.[30]
32. Statutory PSHE education was recommended by the Education Select Committee in its ‘Life Lessons’ report[31] and by the chairs of five select committees (Health; Education; Women and Equalities; Home Affairs; Business, Energy and Industrial Strategy) in their letter to the Education Secretary on the matter.[32]

Conclusions and recommendations

33. There is a broad consensus that education should equip pupils with the skills they need for personal, professional and academic success. Government priorities also point to a more expansive role for education in helping to improve the life chances of the most disadvantaged and to keep pupils mentally and physically healthy and safe.
34. Statutory PSHE education, provided by qualified teachers, sits at the heart of such efforts. The subject can provide pupils with the knowledge, skills and attributes they can apply to a range of areas helping them to keep mentally and physically healthy and safe, to manage risk, and enabling them to develop media literacy and key employability skills.
35. The PSHE Association has a set of principles[33] to apply to statutory PSHE to ensure high standards of rigour, balance and parent and community involvement.
    In campaigning for statutory status for PSHE education, we and our partners are calling for:

• An entitlement which applies to all school pupils at key stages 1-4 in all state schools, whether they are academies or maintained schools
• A duty on all state schools which gives PSHE parity of status with existing statutory subjects and which applies to the whole of the subject, not any single component of it.

36. We therefore ask the committee to consider statutory status for PSHE education in line with these principles amongst its recommendations.