Article: Boys, PSHE and mental health

ConcernedPersonal, Social, Health and Economic education (PSHE) in academy schools is currently a patchwork of provision due to current legislation that commits new academies or schools converting to academy status to sign a funding contract stipulating the services it guarantees to provide – but gives discretion on the provision of other areas of school work.

This discretionary provision has an intention of giving schools freedom to innovate on the delivery of services, including delivery of a school’s curriculum. One outcome of this is that different schools provide different levels of PSHE, some providing comprehensive programmes whilst other schools devote less time and resources; there is no level playing field when it comes to PSHE. Yet this has been a failure of successive governments; there never has been a ‘Golden Age of PSHE’ – for example, calls for compulsory sex and relationships education to be a statutory part of the curriculum go back to the previous Labour administration and beyond so it is not only a failing of the current government.

Neil Carmichael, Conservative MP for Stroud and Chair of the cross-bench Education Select Committee, has recently called for PSHE to be made compulsory in all schools. In a letter to Education Secretary Nicky Morgan, the group of MPs supporting health education work with young people write that PSHE “can provide them with the knowledge and confidence to make decisions which will affect their health, wellbeing and relationships, now and in the future.” Sex and relationships education is one area of PSHE often portrayed as an example of how schools-based health education can impact on later life; whilst poor PSHE is not the only factor, teenage pregnancy, early parenthood and inhibited life opportunities, not to mention the burden on health services of Chlamydia infection, other STIs and HIV, these can all occur as a result of inadequate health education received in schools.

Boys mental health

Another area of PSHE that has potential to impact on health in later life has also come under scrutiny – mental health. The name of a current government strategy – No health without mental health (NHMH) succinctly sums up that if your mental health is poor then you are less likely to address other health concerns. Considering the mental health of boys and men – that a cohort of younger men have continuously presented as having the highest rates of suicide in the overall population – an unfortunate accolade now extended to an older cohort of men, then surely good mental health education that includes a gendered health perspective is a vital component of PSHE?

Whilst PSHE is not explicitly referred to in the NHMH strategy, the document acknowledges work in schools and that “there are many differences in the rates and presentation of mental health problems between men and women, and boys and girls. Improved awareness of these issues among staff is important.” The PSHE Association, providing guidance on PSHE for teachers acknowledges both the importance of linking PSHE with the Public Health Outcomes Framework and also offers guidance for teachers on the delivery of work at different school key stages on mental health and wellbeing. PSHE Association guidance and resources Preparing to teach about Mental health and Emotional wellbeing does touch lightly on gender differences in mental health, yet gendered provision of mental health education in schools is a Cinderella of a Cinderella subject; ie delivery of mental health education within PSHE is itself fragmented and patchwork due to different levels of provision by schools under the funding contract mentioned at the start of this article – provision of mental health education that explicitly targets an ‘at risk’ gender – males – is rare.

Government mental health champion Natasha Devon has sought to challenge this. In a recent TES article Natasha highlighted the issue of boys mental health and problems boys can experience if they want to express their emotional concerns, an anxiety being that they would be held up as subjects of ridicule by other young people if they exposed a concern. This will come as no surprise to people involved in practical and research-based male health education work. A pilot mental health session with Year 11 and sixth form boys is described that focuses on strengths-based work and defining what ‘strength’ actually means to young men; for example when challenging banter that crosses over into bullying, or being strong by seeking help for a mental health concern. The work that Natasha highlighted isn’t a new approach – men’s health literature provides examples of similar if uncommon schemes, but nevertheless it is welcome, particularly as it is being highlighted by a mental health champion.

Legislation, policy and guidance?

Mental health education in schools directly targeting boys is an uncommon occurrence. As schools are given carte blanche to arrange their own PSHE then it is unlikely that without expert direction and creating awareness of the issue of gendered mental health that schools will implement schemes such as Natasha’s on a national basis. What is needed is legislation, policy and guidance on practical work; legislation that Neil Carmichael and the Education Select Committee have called for – for PSHE to be made compulsory in all schools; a UK male health policy that acts as a driver of work with boys and men, that is integrated with other areas of policy such as education ensuring a cross-departmental commitment to realistically address very real male health concerns; and guidance – on ‘what works’, how to deliver the work, and the support out there for schools to ensure it’s delivered.

A conference on the mental health of men and boys at Leeds Beckett University in 2014 noted that “Personal, Social and Health Education should be gender informed/gender sensitive, with greater access to externally supported services; ‘Schools are the ultimate upstream setting which will pay off later downstream’”. There is plenty of research out there that can be used to inform practical solutions to male health concerns, including work with boys in schools. Isn’t it about time that the relevant government departments started to listen to people like Neil Carmichael and Natasha Devon about PSHE, consider the research and how gendered health work can address concerns, save cost-cutting departments money – and ensure that downstream problems and personal tragedies do not arise that come at a cost greater than a financial one to boys and men, to their families and relationships, and the wider community?