“An extreme manifestation of the system“: the link between school exclusions and mental health

In 2019, the rate of pupils being permanently excluded from schools in England was the highest in a decade.

(Photo By Daniel Leal-Olivas/AFP/Getty Images)

Rachel’s son, Ben, had undiagnosed attention deficit hyperactivity disorder (ADHD) in primary school. It was well managed by the school, she felt, so Rachel did not think to get an official diagnosis. But when he got to secondary school, things started to go wrong.

Ben was categorised as one of the “naughty kids”, she told me. He spent time in isolation and was given several fixed-term exclusions. It was only after he was formally diagnosed by a psychiatrist that he sought help, his education getting back on track.

But then tragedy struck when Ben’s father died by suicide. Ben developed symptoms of anxiety and depression on top of his ADHD. He needed crisis support for suicidal thoughts.

The school “seemed unable to distinguish between symptoms of a mental health condition and symptoms of a condition like ADHD”, Rachel said. In one incident, her son was isolated in a corridor with the doors locked. The situation escalated when he was threatened with further disciplinary action and he punched a window.

The wound was bad, nearly cutting a tendon in his hand. “The first thing we heard from the school was a phone call to say he’d been suspended for three days for damage to school property,” she recalled.

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Rachel contested the suspension but found there was little awareness of the guidance issued by the Department for Education on mental health or training for staff. Ben is still in school, but only because she has been able to advocate for him. “There are any number of kids in the same position who’ve got similar issues who haven’t got a parent who can do that, and they’re just getting swept under the radar,” she said.

School exclusions have been rising for the past decade. In the 2018-19 academic year, 7,894 children were permanently excluded from school, compared with 4,949 in 2013-14. Some 438,265 “fixed-period” exclusions were issued in the same year (up from 410,000 the year before). The “rate” of exclusions, the number of exclusions divided by the number of enrolled students, is also rising.

School exclusions have been on the rise since 2014

Rate of student exclusions in England, year to March

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At the same time, the mental health and wellbeing of students has been a growing concern. NHS data published at the end of 2018 showed one in eight pupils had a mental health condition and that the proportion had grown in the previous two decades. Services are struggling to cope with demand.

Read more: Why mental health is a human right

Despite a government investment of £1.4bn from 2015 to 2021, a quarter of the 130,000 children and young people referred to Child and Adolescent Mental Health Services were turned away due to rising demand and a lack of capacity. In Scotland before the start of lockdown, a record 10,820 children were on the waiting list.

The percentage of children with diagnosed mental disorders has increased over the past 20 years

Percentage of 5 to 15 year olds in England with a “mental disorder”

Children who go to a school in a poor area, who are on free school meals, are from particular ethnic minorities and who have a special need or disability are all more likely to be excluded, according to data collected by the Department for Education and by the Timpson Review, a recommendation on changes to policy by Conservative MP Edward Timpson published at the end of 2019. They are also at greater risk of “off-rolling”, the practice of removing a child from the register of a school. According to research by the Education Policy Institute in 2017, just under one in four children with a social, emotional or mental health need had experienced some form of “unexplained exit” from school outside of an exclusion. This means the rate of exclusions may be higher than the official data.

The above exclusion figures may still be an underestimate. Schools can use off-rolling – often for legitimate reasons, such as moving to another part of the UK – to disguise an exclusion, according to Ofsted. Schools are judged on the number of exclusions by Ofsted and so have a vested interest in keeping numbers low. Ofsted looked at the 19,000 year-ten secondary-school children who left in 2016-17 and found half of them did not attend another state institution, although they may have been home-educated or gone to an independent school. Some 300 schools had “exceptional levels of pupil movements when compared with schools with pupils with similar characteristics”.

BAME children are more likely to be excluded than White British

Rate of student exclusions in England in the 2018/2019 academic year, by ethnic group

There is a significant racial disparity in the data, too. A report by the Institute for Race Relations published in September 2020 found that black working-class boys are being excluded and ultimately criminalised by the school system in England. In particular, it argues, there is a pupil referral unit (PRU)-to-prison “pipeline”, with young Caribbean boys overrepresented in the PRU system and four times more likely to be permanently excluded. Students can be sent to PRUs if they have been excluded from mainstream education. In theory, they are meant to receive a more personalised education in smaller classes there from teachers with expertise in supporting learners with complex needs.

“School exclusion is an extreme manifestation of what the system is meant to do,” said Zahra Bei from the campaign group No More Exclusions. The group is pressing to change the culture around exclusion in schools to make it “unpalatable”, give schools and teachers the tools to support children better and ultimately to end the practice of exclusion, because they believe it is wrong. Bei has worked as a teacher in schools and at a PRU.

“We thought we were doing good social justice work [at the PRU],” she explained. The outcomes for the children in alternative provisions, however, are generally much worse than in a mainstream school. Only 1.6 per cent of PRU students achieve a grade five or higher in GCSE maths and English.

Bei would come across students with serious mental health issues who were being managed as if they had behavioural problems, and being punished for them. She came to the conclusion that working one-on-one with students was futile when the system was “fundamentally unjust”.

In school, children can hastily be labelled for their behaviour, which then becomes the focus of response rather than educators’ looking at underlying causes. This can start the journey towards fixed-term exclusions and eventually permanent ones.

The experience of being excluded can also affect the mental health of children and families. Dr Dan O’Hare, an educational psychologist based in Gloucestershire, comes across this regularly. He has seen children as young as five permanently excluded. They will suddenly be removed from their peers without a chance to say goodbye and without an idea of what is next for them, he explained.

“That’s the antithesis of what we know supports children’s mental health and well-being,” O’Hare added. It is the sense of connection, belonging and at least one adult who strongly believes in the child and has aspirations for them, he says, that is the foundation for mental wellbeing.

Exclusion can lead to children believing that they are “naughty” and “unwanted” rather than understanding that the issue is their behaviour. It is an experience that can stay with them for years. O’Hare was dismissive of the idea that a new school can be a “fresh start” because the children involved rarely get a chance to repair the harm done or be involved in what happens next.

Leaving a school leads to a huge sense of “loss” for the child and potentially for their peers. “Children are really aware of some of the injustices they see,” he added. Seeing a peer excluded has an impact on them all.

Research by the University of Exeter found that children who were excluded were more likely to develop a mental health issue within the next three years. The children’s charity Coram published a report last year highlighting the support for kids who had been excluded. Three quarters of parents said there was poor support to prepare their children for returning to school. That figure rose to four in five for those who had been permanently excluded.

Bei has no doubt that the process of exclusion has a serious impact on the mental health of children and their families. It “fractures families”, she said. Being told your child does not fit or is causing trouble “changes how you see your child” and creates feelings of guilt and shame in the whole family, she added.

When she interviewed former students of hers at the PRU, she found that some of them would wear their old school uniforms when family came to visit them to hide the fact that they had been excluded.

What is behind the rise in exclusions? Spending per pupil has fallen by 8 per cent in real terms since 2010, according to research by the Institute of Fiscal Studies. This means larger class sizes and less money to spend on additional and specialist support for children with challenges.

The Timpson Review found that the focus on exam performance and “rigid rules” in secondary schools were important factors. In June, researchers at the University of Oxford warned that social distancing rules could lead to a rise in exclusions for children who struggle to follow instructions. Teachers have also reported being unprepared and lacking training in non-discriminatory practices and their duties under the Equality Act.

Another explanation is the rise of academy schools, which have higher numbers of exclusions, greater latitude to exclude, less opportunity to contest an exclusion and less accountability to local government. The final Timpson Review included 30 recommendations, such as a stronger role for councils, limiting the use of fixed-term exclusions and making schools accountable for the pupils they exclude (but without specifying how).

The North East has the highest rate of exclusions

Rate of student exclusions in England in the 2018/2019 academic year

There are examples of a different approach to exclusions. In Glasgow, for instance, fixed-term exclusions are down by 87 per cent since 2007. There was one permanent exclusion last year. Youth violence has halved, the number of children in secure units has dropped to very low numbers, and more children are staying in school for longer and having a positive educational experience, according to figures from Glasgow City Council.

Maureen McKenna, the director of children’s services at the council, said the progress it has made is not the result of a “magic silver bullet” but the product of a focus on nurture and the best interests of the child, school community and staff. “We always look at the child at the centre,” she explains.

Read more: The lost children of lockdown

Glasgow aspires to be a nurturing city, an approach adopted across its Children’s Services. Part of that is seeing and nurturing the assets and positives a child has. McKenna highlighted the work done by local secondary schools using restorative justice, engaging the community and the city’s well-regarded violence reduction unit.

“It’s about: How do we get our young people to be leaders in their local community, how do we get them to take responsibility and be proud of themselves and their actions?” she said.

McKenna believes there will always be a place for exclusions in extreme circumstances and that the focus on off-rolling is misguided, as there will always be ways to game the system if schools want to. The most important factor, however, is being “solution-focused” and looking at the long-term outcomes for children.

In one example, she said that a troubled boy had threatened a teacher and been excluded. He went to another school for ten weeks while they worked with him and his family, and was able to return to his previous school. Eighteen months on, he is still doing OK. “It’s about telling the story of the child,” McKenna said.

A Department for Education spokesperson said that “being excluded from school should not mean exclusion from good quality education – that’s why we are taking forward ambitious plans to improve the availability of good Alternative Provision and to make managing behaviour a core part of early teacher training”.

The spokesperson added that schools have remained open to the most vulnerable pupils throughout the pandemic. “We know that some young people will return to school in September having been exposed to adversity or trauma that may have affected their mental health,” the spokesperson said. Some pupils with special educational needs and disabilities (SEND) may have had to stay at home or had different provisions over the past months. “We expect schools to work with their pupils and local services to make sure the right support is in place for children as they return to the classroom,” they said.