Mental health for CYP with SEND

Mental health is about how we think, feel and act. It affects how we cope with everyday life, build relationships, learn, make decisions and deal with challenges. Just as everyone has physical health, everyone has mental health too. Some days we may feel happy, confident and calm, while at other times we may feel worried, sad, frustrated or overwhelmed.

For children and young people with Special Educational Needs and Disabilities (SEND), mental health can be affected by many different experiences. For example changes in routine, difficulties with communication, feeling different from others, sensory sensitivities, friendships, school pressures, family circumstances or health needs. Good mental health helps us enjoy life, learn new skills, build relationships and cope with challenges.

Factors that can affect mental health

Mental health is influenced by a person's experiences, environment and circumstances. Some children and young people may face additional challenges that can increase the risk of poor mental health. These are sometimes called social and economic factors.

These may include:

• Living in a household experiencing financial pressures or poverty.
• Worrying about housing, food, clothing or other basic needs.
• Being a young carer for a family member.
• Experiencing bullying, discrimination or social exclusion.
• Feeling isolated or finding it difficult to make and maintain friendships.
• Living with family conflict, separation, bereavement or significant life changes.
• Having limited access to community activities, leisure opportunities or support services.
• Experiencing barriers to education, employment or training opportunities.
• Living with long-term physical health conditions or disabilities.
• Experiencing adverse childhood experiences (ACEs), such as neglect, abuse, domestic abuse or exposure to substance misuse. These experiences can have a lasting impact on emotional wellbeing and mental health.

For children and young people with SEND, some of these challenges may be experienced alongside additional pressures such as difficulties with communication, social interaction, sensory processing, accessing education, or feeling misunderstood by others. This does not mean that a child or young person will develop mental health difficulties, but it can increase the importance of having the right support, positive relationships and opportunities to feel included and heard.

Mental health difficulties are not caused by one single factor. They usually develop because of a combination of experiences, circumstances and individual needs. Protective factors such as supportive family relationships, trusted adults, inclusive schools, strong friendships, good physical health and access to early help can all support positive mental wellbeing.

Key message: Mental health is shaped by more than what happens inside a person. Family circumstances, community support, education, finances, relationships and life experiences can all affect how a child or young person feels and copes with everyday life. Understanding these factors helps us provide the right support at the right time.

How mental health difficulties might present

Mental health difficulties can look different for everyone. A child or young person may:

• Feel sad, worried, anxious or low for a long time.
• Become more irritable, angry or emotional than usual.
• Lose interest in activities they normally enjoy.
• Want to spend less time with friends or family.
• Have difficulty concentrating at school or college.
• Experience changes in eating or sleeping habits.
• Seem withdrawn, quiet or isolated.
• Have more frequent meltdowns, emotional outbursts or challenging behaviour.
• Complain of headaches, stomach aches or other physical symptoms with no obvious cause.
• Feel overwhelmed by situations they previously managed well.

For some children and young people with SEND, mental health difficulties may be shown through changes in behaviour, communication, sensory needs or emotional regulation rather than talking directly about their feelings.

Who you should talk to first

If you are worried about a child's mental health, it is important to tell a trusted adult. This could be:

• a parent, carer or family member.
• a teacher, teaching assistant or school support worker.
• a school nurse.
• a social worker or youth worker.
• a GP (family doctor).
• another adult you trust.

Talking to someone early is important because mental health difficulties are often easier to manage when support is accessed sooner. Sharing worries can help you understand what is happening, reduce feelings of isolation and enable professionals to provide the right support before difficulties become more serious. Early support can help prevent problems from reaching crisis point.

What to do if you think a child or young person is struggling with their mental health

The NHS advises parents, carers and trusted adults to:

• Listen and take concerns seriously

Create opportunities for the child or young person to talk about how they are feeling. Listen without judgement and reassure them that it is okay to ask for help.

• Notice changes

Pay attention to changes in mood, behaviour, eating, sleeping, communication or relationships that continue over time or affect everyday life.

• Stay involved and supportive

Show interest in the child's life, interests and achievements. Encourage activities they enjoy and help them maintain connections with family, friends and supportive adults.

• Maintain healthy routines

Support regular sleep, healthy eating, physical activity and predictable routines wherever possible. These can all have a positive impact on wellbeing.

Seek professional advice

If concerns continue or are affecting day-to-day life, contact a GP, school nurse, teacher or another professional involved with the child. They can discuss available support and, where appropriate, refer to local mental health services.

When to seek urgent help

If a child or young person has seriously harmed themselves, is at immediate risk of harming themselves or others, or is experiencing a mental health crisis, seek urgent help immediately by contacting NHS 111, attending Accident and Emergency, or calling 999 in an emergency.

Seeking help as an adult

If you have concerns about mental health as an adult, see our pages on Mental health and support