Introduction

This chapter traces the history of education policy in the UK before briefly discussing the international context. It then looks at the impact of policy developments, positive and negative.

A short history of UK education policy

Origins

In the UK, schools developed over the course of the late 18th and 19th centuries as a means to provide a basic education for the emerging class of industrial workers and a more advanced education for owners, managers and professionals. Their function was as much about sorting as about educating, and there were huge inequities in provision and participation. It was not until after the Second World War that free primary and secondary education was provided for all. But there continued to be massive inequities in the length and quality of schooling. The postwar system of secondary education was officially ‘tripartite’, comprising: ‘grammar’ schools teaching academic subjects; ‘technical’ or ‘central’ schools teaching applied skills; and ‘secondary modern’ schools providing basic secondary education. The technical schools did not take off, leaving a system made up of grammar schools for those who passed the ‘11+ ‘ academic exam and secondary moderns for everyone else. Gradually, this system was eroded with the rise of ‘comprehensive’ secondary schools, which admitted students regardless of prior attainment. The push for comprehensive schools was driven both by the demands of organised labour for better education and by the demands of the middle classes, fearful that their own children might not get into grammar schools.

Introduction

The previous chapter described the three toxic mechanisms through which secondary schools might harm student health: educational disengagement; lack of school belonging; and fear and anxiety. The identification of these mechanisms was informed by qualitative research, some of it carried out by me and my colleagues in English secondary schools and some by other author researchers around the world. This qualitative research provides rich insights into the lives of young people and their teachers, how young people understand their place in schools and how this is implicated in some of their decisions, including their decisions to become involved in various risk behaviours. These compelling stories allowed us to develop a detailed understanding of the mechanisms by which schools might harm some students’ health. However, it would be hard to conclude from these stories alone that English secondary schools have measurable impacts on the health of their students, or whether such effects also occur in other countries. So in this chapter, I examine quantitative, statistical evidence from the UK and beyond to see whether this supports the existence of worrying trends in young people's health, the possibility of school effects on health and the presence of the three toxic mechanisms.

Young people's health and risk behaviours

The first set of quantitative evidence I briefly review is evidence about trends and patterns in young people's health and risk behaviours.

Introduction

In Chapters 6 and 7, we saw how interventions aiming to increase engagement, belonging, and safety and support in schools can benefit students across a range of health and educational outcomes. This chapter explores how school context, country context and the specific health outcomes being addressed affect what schools need to do.

School context

Different schools have different cultures, different capacities for action, different pressures and different priorities. So when embarking on change, they are likely to need to start from different places and do different things.

Factors affecting delivery

Schools will vary in how hard they find it to deliver health interventions. With Lauren Herlitz, Laurence Blanchard and other colleagues, I have undertaken a couple of systematic reviews looking at what factors affect this. We know from these that implementation is much easier if school staff have the confidence to feel that they are able to deliver the intervention and if they believe in its value. Implementation is also more likely when an intervention has the support of committed colleagues and senior leaders and when it aligns with national policy. Implementation is likely to be sustained if staff can see a rapid positive impact on students’ engagement and wellbeing. Sustained delivery is also more likely if interventions can be adapted to existing school systems and routines.

Implementation is harder when there is a norm within a school of prioritising educational outcomes over student health and wellbeing. It is also harder where there are time and resource constraints, a lack of staff training and a high staff turnover.

Introduction

This chapter describes the toxic mechanisms that occur in secondary schools which can harm young people's health. The chapter draws mainly on qualitative research to explore three toxic mechanisms as they are experienced by students. Some of this qualitative research has been done by me and my colleagues. Some of it has been done by other researchers. As explained at the start of this book, qualitative research draws on interviews, focus groups and observations to try to understand how people experience the world. Interviews and focus groups involve researchers asking open-ended questions and then listening to people's stories in their own words. Qualitative research explores people's accounts of their experiences and the meanings they give to these as well as how they act and interact with others. It can explore how people's actions can be enabled and constrained by the institutions within which they find themselves (such as schools). And it can explore the immediate consequences of their actions.

Qualitative research is strong on understanding the details of social processes and how these are experienced by people. It can help us develop theories about cause and effect in the lives of people and across society.6 Qualitative research is less strong on testing the wider applicability of these theories. It generally draws on small samples of participants and contexts. It doesn't collect exactly the same sorts of data from each participant.

Introduction

Schools are increasingly required to address student health and wellbeing. This development seems to be somewhat in contradiction to the picture presented in the previous chapter of schools having become overwhelmingly focused on maximising individual educational attainment. However, it makes more sense when viewed as the system adapting itself to try to compensate for some of its own adverse consequences.

Types of school health intervention

A variety of health and wellbeing interventions are now delivered in schools. Some of these are ‘universal’ interventions, aiming to promote the health and wellbeing of all students. These can include health education classes, providing, for example, sex or drugs education. They can include social and emotional education lessons focused on learning to manage ones emotions and relationships. And they can include classes and other activities focused on meditation and mindfulness, also to help manage one's emotions and relationships. Relationships, sex and health education is now a statutorily required subject in all English schools.

As well as interventions delivered to all students to promote health and wellbeing, other interventions target students engaged in certain risk behaviours or experiencing certain mental or physical health problems. These include cognitive behavioural therapy and counselling for students with anxiety or depression as well as group interventions for students experiencing problems with substance use. In 2017, the government initiated a new programme of mental health services in schools, with a focus on cognitive behaviour therapy to address mild to moderate anxiety and depression, and created school mental health support teams to deliver these.