School seclusion, restraint and exclusion can increase trauma in children with mental health difficulties, says Centre for Mental Health

Restrictive interventions in schools can exacerbate behavioural difficulties among children who have had traumatic experiences, according to an evidence review published today by Centre for Mental Health.

Trauma, challenging behaviour and restrictive interventions in schools is a review of recent literature on the impact of seclusion, restraint and exclusion on children’s mental health. It finds evidence that the use of these restrictive interventions can make the problems they seek to resolve worse, creating a vicious circle of trauma, challenging behaviour, restriction and psychological harm. Yet every year thousands of children are subject to restrictive interventions in schools, putting their mental health at risk whether they have suffered traumas or not.

The review finds that one-third of children are exposed to traumatic events before the age of 18, and a quarter of them will later develop post-traumatic stress disorder (PTSD). Young people showing challenging behaviour in school are more likely to have experienced past traumas. If they are subjected to seclusion, restraint or exclusion, that experience can mirror the traumatic events that happened to them. This increases the likelihood of further challenging behaviour and an escalation of the cycle.

The review finds that alternative approaches are less likely to cause or exacerbate childhood trauma or distress. They include positive behavioural support, which can be helpful on an individual level, and creating trauma-informed schools, which have wider benefits to all children and staff. Being trauma-informed may help to prevent challenging behaviour by creating a safe environment where children are taught about their mental health and are helped to manage their emotions.

Centre for Mental Health chief executive Sarah Hughes said: “The Government’s election manifesto promised to take action to improve behaviour in schools, including greater use of exclusion. Our evidence review finds that we need a different approach to make schools safer and healthier places in which to learn and grow.

“Attempts to improve school discipline through restrictive interventions and exclusions will not work. For some of the most vulnerable and marginalised children they will entrench behavioural problems with lifelong consequences for them and their families. Helping schools to become trauma-informed is much more promising. As part of a ‘whole school approach’ to mental health it has the potential to benefit everyone, to make all children feel valued and understood and prevent exclusions and their devastating consequences.

“Our school years have profound and lasting effects on our mental health. The Government has recognised this by investing in new mental health teams to go into schools and putting the subject on the curriculum. It must now take the next step and help schools to boost children’s mental health in the ways they manage behaviour and create a safe and consistent learning environment for all.”