Social, emotional and mental health
Children and young people may experience a wide range of social, emotional, and mental health difficulties, which can present in many different ways. These may include:
- Becoming withdrawn or isolated
- Displaying challenging, disruptive, or concerning behaviour
- Experiencing underlying mental health difficulties, such as:
- Anxiety or depression
- Self-harm
- Substance misuse
- Eating disorders
- Medically unexplained physical symptoms
Some children and young people may also be neurodivergent, with experiences that include:
- Attention differences (e.g. ADHD)
- Differences in social communication and connection (e.g. autism)
- Attachment-related needs linked to early relational experiences
Persistent and Complex SEMH Needs
A small number of children and young people may face ongoing, complex challenges, even with sustained support. These may include:
- Difficulties with peer relationships and social interaction
- Disruptive or risk-related behaviours (e.g. oppositional behaviour, fire-setting)
- Attention and organisational challenges
- Low mood, withdrawal, or thoughts of self-harm
- Intense emotional responses, including phobias, anxiety, or depression
- Attachment-related needs
- Other significant mental health needs (e.g. PTSD, psychosis, compulsive behaviours)
What Schools Might Observe
What Schools Might Observe
- In educational settings, SEMH needs may be reflected in:
- Difficulties that go beyond typical classroom strategies
- Struggles with focus, affecting their own and others’ learning
- A gap between expected and actual attainment
- Limited progress, frustration, or reduced attendance
- Challenges in maintaining peer relationships
- Shifts in mood or behaviour, including withdrawal or conflict
- Severe or unpredictable behaviour across different contexts
Additional guidance can be found in “Mental Health and Behaviour in Schools” DfE November 2018: Mental health and behaviour in schools.
Key Principles for Support
- Provision should be tailored to the individual’s needs—not dependent on a formal diagnosis.
- Attendance should be considered in the context of mental health and wellbeing. Persistent or unexplained absence may indicate SEMH needs, including Emotionally Based School Avoidance (EBSA).
- Schools are encouraged to adopt a trauma-informed approach, focusing on understanding the root causes of behaviour and building trusting relationships with pupils and families.
Communication and Behaviour
Behaviour often communicates an unmet need. Research shows that over 90% of children and young people with SEMH needs also have unidentified language and communication differences.
To ensure a holistic and inclusive approach, schools should also refer to the Communication and Interaction section of this Toolkit when planning SEMH support.
For further insight into the connection between communication and behaviour, refer to the RCSLT Communication and Behaviour Factsheet.
Questions: What helps you learn best? What helps you feel better and more successful at school? What helps you?
Answers (Camden CYP, 2025):
A 'time out' card allowing me to have a movement break or time in a quiet space
When teachers follow-up with me if I've spoken to them about something
Having fidget or sensory toys to use
Smaller groups and quiet time
Felling welcomed in to the classroom
When teachers speak to me about my feelings
Have built relationships with teachers around me
General Approaches and Strategies
- Make curriculum adaptations, such as smaller PE groups or substituting Art for Music, to meet individual needs.
- Promote wellbeing and resilience through whole-setting initiatives, including anti-bullying efforts.
- Embed relational and restorative practices in daily routines and policies to support relationship-building and repair.
- Provide staff with supervision or debrief sessions to support their work with CYP with SEMH.
- Use monitoring tools like STAR and ABCC to identify behavioural triggers and inform support planning.
- Assign trusted adults for regular check-ins, helping CYP express emotions and build a support network.
- Use distraction techniques, assign responsibilities, and adapt timetables to maintain engagement and end the day positively.
- Apply trauma-informed approaches such as PACE, and support co-regulation by modelling de-escalation and self-regulation strategies.
- Refer to CAMHS for specialist support, including in-setting practitioners where available.
- Maintain open communication and review input from external professionals to inform practice.
- Ensure additional adult support is discreet and inclusive, allowing the teacher to engage directly with the student.
- Provide emotional regulation support through ELSA or emotion coaching.
- Review patterns of non-attendance, such as suspensions, and implement targeted interventions like social communication support or adapted timetables.
| Identified barriers and/or need: | Provision and/or strategies: approaches, adjustments and specific interventions expected to be made by settings according to the ages and stages of the CYPs. | How well implemented? | When and how? | ||
|---|---|---|---|---|---|
| Always | Sometimes | Not yet | |||
| Difficulties participating and presenting as withdrawn or isolated |
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| Behaviour that challenges expectations |
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| Attention difficulties, low level disruption |
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| Attachment difficulties |
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| Difficulties following and accepting adult direction |
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| Difficulty in making and maintaining healthy relationships |
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| Presenting as frequently unhappy or stressed |
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| Patterns of non-attendance |
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Difficulties participating and presenting as withdrawn or isolated
Provision and/or strategies:
- Analyse information observations; frequency observations and other observation sheets
- Teach behaviour expectations explicitly
- Identify areas of strength and build on the positive engagement to support generalisation to other areas
- Alternative methods to contribute in lessons
- Review CYP file and discuss developmental milestones with parents, refer to external agencies if appropriate
How well implemented?
When and how?
Behaviour that challenges expectations
Provision and/or strategies:
- Maintain a consistent message but flexible approach, e.g., "You need to be in your class learning." The strategies to support that may change e.g., use of an LSA/TLA, individual meeting with the teacher, build up time in class, 20 mins, 30 mins. Reward at the end of the day/week etc. (LSA/TLA= targeted/specialist)
- Teach behaviour expectations explicitly
- Offer choices to help the CYP to engage or leave the situation with dignity
- Carry out a risk assessment and implement a risk management plan with proactive strategies
- Implement a clear plan of action, agreed with parents/carers so a consistent message is delivered to CYP at school and home.
- Review CYP file and discuss developmental milestones with parents, refer to external agencies if appropriate
How well implemented?
When and how?
Attention difficulties, low level disruption
Provision and/or strategies:
- Use of prompting by teacher or additional adult
- Analyse data and staff feedback for trends that may inform where there are specific challenges
- Explicitly plan transitions between lessons and specifically after unstructured times
- Consider reasonable adjustments to behaviour policies to account for attention difficulties
How well implemented?
When and how?
Attachment difficulties
Provision and/or strategies:
- Be aware of CYP with attachment difficulties e.g., Looked After Children and young people, those who have experienced trauma and loss. Understand their profile and how they might respond in certain situations.
- Listen carefully to CYP voice and adapt support to incorporate their views
- Explicitly plan transitions with the CYP and their family. Think about introductions to new staff and contingency plans when there are last minute/unforeseen changes.
- Consider reasonable adjustments to behaviour policies to account for attachment difficulties.
- Analyse data for specific patterns that may exist e.g., particular times of year, particular lessons/activities, interactions with staff/other CYP
How well implemented?
When and how?
Difficulties following and accepting adult direction
Provision and/or strategies:
- Positive scripts to re-direct and reinforce expectations
- Provide limited choices to give the CYP a sense of control whilst following adult led activities
- Consider reasonable adjustments to behaviour policies
- Ensure the behaviour policy is explicitly explained to the CYP and applied consistently
- Analyse data for specific patterns that may exist e.g., particular lessons/activities, interactions with staff/other CYP
- Role play to model different responses to situations/interactions
How well implemented?
When and how?
Difficulty making and maintaining healthy relationships
Provision and/or strategies:
- Role play to model different responses to situations/interactions
- Restorative conversations as required
- Consider support/adjustment for unstructured times that promotes independence while enabling positive interactions with peers
How well implemented?
When and how?
Presenting as frequently unhappy or stressed
Provision and/or strategies:
- Review history and data to understand when this presentation started/occurs
- Establish a plan that the CYP can follow when they feel unhappy or stressed e.g., a quiet place to go to, to regulate, set times to check-in with a key adult/s
- Regular communication with home to share feedback between home and school to inform support
How well implemented?
When and how?
Patterns of non-attendance
Provision and/or strategies:
- Collaborate and plan with families to ensure consistency between home and school/setting
- Consider nurture/transition programmes and use of EBSA materials
How well implemented?
When and how?
Resources
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