School nurses need more ‘clarity’ around their responsibilities in supporting young children’s mental health, a new study has found.
Research conducted by the University of Stirling suggested that the mental health work of school nurses was ‘often reactive’ and ‘lacks visibility’ in whole-school approaches to mental health.
The mixed-methods study, led by Dr Alison Hackett, an academic nurse with over 30 years of experience, examines how school nurses support primary school aged children’s mental health.
The university conducted a national survey of school nurses in Scotland alongside interviews with nurses, parents, teachers, and primary aged children to explore perceptions of school nurses’ mental health work.
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Results revealed that their impact is ‘limited’.
In interviews, school nurses described a ‘lack of clarity about their responsibilities’ in terms of mental health support for children, stating that their work was ‘often overshadowed by expectations related to safeguarding and child protection concerns’.
Instead of ‘proactively promoting mental wellbeing’, school nurses described their work as ‘reactive and expressed frustration and disillusionment at the constraints on their practice’ – notably workload capacity and lack of resources.
They also said there was a ‘lack of primary prevention and early-intervention programmes’.
Dr Hackett said: ‘Our findings show that school nurses’ mental health work is often reactive and lacks visibility in whole-school approaches to mental health.
‘This underlines the urgent need for a clearly articulated role within whole-school mental health frameworks that recognises their contribution to early identification, support, and coordination of care.’
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Alongside nurses, others interviewees such as educators and families also highlighted the potential benefit of better integrating school nursing into whole-school approaches to mental health, stating this could ‘enhance early detection and build the resilience of children, families and their communities’.
The researchers argued that rising mental health needs among school aged children call for investment, not only in staffing, but in ‘formalising’ the school nurses’ mental health role within education systems, training pathways, and policy guidelines.
Dr Hackett added: ‘It is hoped the results will inform education leaders, health policymakers, and commissioners of school nursing services about the potential that better supported and clearly defined school nurse roles have for improving children’s mental health outcomes and educational attainment, potentially contributing to safer and healthier schools.’
Professor Greg Mannion, co-author of the study, said: ‘This study shows that school nursing practice must evolve as children’s mental health continues to need support.
‘This study shows that school nurses’ work is supported and shaped by whole-school developments across curriculum, culture, and community.
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‘Evidence here shows that school nursing practice will become more relational and responsive to the distinctive setting in a given school.
‘Creating welcoming school environments both indoors and out and embedding school nurses within whole-school approaches are essential to enabling more preventative, visible, and effective mental health support.’