Author: Guardian Staff

Comments by the education secretary, Bridget Phillipson, about children’s “grit” are a distraction from the huge missed opportunity in the government’s expansion of access to mental health support teams in schools (‘Grit’ no substitute for better mental health funding for pupils in England, say experts, 16 May).Children are resilient – but they are living in an increasingly complicated world of challenges and conflict. They’re having to cope with the consequences of the Covid pandemic, the cost of living crisis, social media, and school, family and relationship pressures.We at the British Association for Counselling and Psychotherapy are pleased that the government recognises the importance of supporting children in all schools, but this announcement falls short of what’s needed. The plan will do little to meet the needs of children who need more than pastoral care and the low-level interventions provided through mental health support teams (MHSTs), but don’t require a referral to psychiatrists or child and adolescent mental health services.We estimate that about 730,000 children and young people each year will fall through the gaps in support available as part of this rollout. Instead, the government should have focused on an enhanced MHST+ model, which includes a clear referral pathway to funded counselling provision.It’s not just “grit” that will support children with their problems. It’s having access, when needed, to a trained professional counsellor. But that vital support is disappointingly missing from this plan.Martin BellHead of policy & public affairs, BACP I had high hopes that a Labour government might start to look seriously at how changes in education policy under Michael Gove might be impacting young people’s mental health and school attendance. Instead the focus is on fostering “grit”. My daughter is in the middle of GCSEs. The content for each subject is so great that when we put all the books, notes and revision aids into large carrier bags, there were 11 in total.Schools have had to cut music, breaktimes and art to ensure core subjects are covered. Some schools have gone doolally about punishing kids for minor misdemeanours, like forgetting a pen. Teachers are leaving the profession in droves. We keep trying to fix the kids, when we need to fix the problem. Maybe it’s the politicians that need to find the “grit” to focus on the causes, not the consequences.Caroline O’DwyerLondon A growing wealth of evidence shows that sustained access to nature and nature-based learning can improve health, wellbeing, development and resilience. Such approaches support children who struggle in traditional learning settings and stretch those who thrive in them.My organisation has seen this first-hand in our Stepping Stones to Nature programme. Embedding meaningful curriculum-linked nature activities into the school week, in some of England’s most deprived communities, has led to immediate improvements in wellbeing, confidence, communication and concentration.Nature should not be seen as an add-on. The government should explore how embedding it into classrooms, curriculums and school grounds – and making full use of the breadth of our green and blue spaces, from urban parks to protected landscapes – can improve outcomes in the short and long term.James MetcalfeDirector, North York Moors Trust

Thank you for Sheila Hale’s long read about her family experience of stroke (My husband and son suffered strokes, 30 years apart. Shockingly little had changed, 15 May). I remember reading her book as a junior doctor and despairing at the differences between the stroke and neurorehabilitation units that I worked on. This drove my career to stroke medicine, particularly rehabilitation.In 2021, without the technology to give thrombolysis beyond four and a half hours after a stroke, Sheila’s son was unfortunately one hour over time and the risks of severe brain bleeding outweighed the benefit. CT perfusion techniques mean that this time constraint is reducing, and mechanical thrombectomy is becoming more individually based and more available.Sheila is right to highlight that delivering the intensity of rehabilitation required in the NHS is a huge challenge – the inpatient and community teams I work with continually change what they do to use what resources they have, but we are constantly told there is no more money.The attitudes of doctors reflected in Sheila’s article sadden me, as prognostication in early stages is difficult and younger brains show greater capacity for recovery and adaptation. There is, however, that delicate balance of hope, uncertainty and reality. Perhaps this article will spark a campaign for post-discharge neurorehabilitation gyms in every locality. The evidence supports it. A stroke is often not the end, but it is a difficult journey to a new type of life.Dr Jessica BeavanConsultant stroke physician, Derby Sheila Hale highlights a tragic and unacceptable truth. For decades, rehabilitation has remained the poor cousin of surgery and medication in the NHS. Physiotherapy services are starved of the staff and equipment to deliver effective rehab. They are told to limit the number of times they can see a patient, and for how long. In effect, they are prevented from doing their jobs. The impact on patients is stark, as seen in this article. The impact is also harsh on physiotherapy staff themselves, who must explain this reality each day and go home every night feeling they have let their patients down.The NHS wouldn’t tell a surgeon to stop an operation halfway through. A pharmacist wouldn’t hand out 40% of a course of antibiotics. So why is it OK for patients to be denied a full course of rehabilitation?Sara HazzardAssistant director, the Chartered Society of Physiotherapy; co-chair, the Community Rehabilitation Alliance Sheila Hale mentions mechanical thrombectomy, a procedure to remove blood clots from the brain. This is available at 24 hospitals in the country, but can be done 24/7 at only six of them. So in York if you have a stroke that is suitable for this procedure, it is only available at the hospital in Hull Monday to Friday 8am to 4pm. I wrote to our local MP, Luke Charters, about this and he contacted the Department of Health, which said there were no plans to bring the service to the York and Scarborough Trust. Maybe when the NHS is sued for negligence in not providing this, things may change.Sally SimpsonYork It is true that many stroke patients feel abandoned by the NHS, as Sheila Hale states. But our work with patients at the Pulross Centre in Brixton, a rehabilitation unit that is part of St Thomas’ hospital in London, is reducing that. We deliver a weekly gardening session for patients, and when they are discharged, we gift them a plant to grow at home. If they don’t have a garden, we try to link them to a community garden or gardening group in a local healthcare setting.We introduced this during the pandemic when our gardens were closed and stroke patients were self-isolating; several felt alone and forgotten. We have used the gift of a plant or seeds as an expression of connectedness between all of us and to let our stroke patients know they are not abandoned by the NHS.Edward RosenLondon