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Why we must do better for children in hospital schools

4 min read

When Faisal* walked through the doors of our school at the Maudsley and Bethlem Hospital, we only knew his name.
Like so many of our pupils, he had been admitted because of a mental health emergency and was too unwell to leave the ward. It took daily visits by our teachers to build trust and to work out what they could do to help.

They discovered that Faisal had been struggling to attend his own school for months, becoming a housebound recluse and living in self-imposed darkness, with the curtains drawn 24/7. Faisal had disengaged completely from learning and in many ways had disengaged from the world. 

Parents know all too well that young people like to complain about school. But even for pupils who would rather be anywhere else than learning about quadratic equations or Lord of the Flies on a Friday afternoon, the shared experiences, social contact and sense of a future they get from school are beacons in the dark. They’re things to guide the way. Things to warm your hands through a long night.  

Time and again we have seen even our success stories facing setbacks when they are forced to sit high-pressured formal examinations

So for Faisal, we did what we always do as teachers at a hospital school: we built an education around him without knowing when he might be discharged, or whether he’d be well enough to take his GCSEs. We shopped for textbooks on subjects we’d never taught before, from law to A Midsummer Night’s Dream. We studied them to ensure we could help Faisal as much as possible, getting our heads around the Latin root of Torts and trying out voices for Lysander and Puck. 

We showed that, when Faisal was ready, we’d be there for him – and so would a world of knowledge and wonder, just waiting to be explored.

But while he was well enough to come to the classroom, he was dreading the looming prospect of exams, which meant we were forced to make difficult choices. Instead of the 10 GCSEs he had studied for, he took exams in six, which was just enough for him to enrol at his college of choice. 

Faisal’s story is one of many in which a once-demoralised pupil was able to reintegrate into full-time learning due to a personalised and flexible approach. Over the last 12 years, less than half (44 per cent) of the young people admitted to the Maudsley and Bethlem Hospital School were in regular education.

By the time they were discharged, the percentage going back to school rose to 83 per cent. These are remarkable numbers, and we only hope to improve on them when we move into our new home at the Pears Maudsley Centre, a facility designed especially to give children and young people the specialised care they need, in 2024.   

But time and again we have seen even our success stories facing setbacks and reliving their worst experiences when they are forced to sit incredibly high-pressured formal examinations.

Of course it is important that we have consistent and fair methods of assessing students at key moments in their school life. But exams aren’t just tests of revision, knowledge and communication skills. They’re tests of stress management, and they are always going to risk penalising a student for a bad day – or worse, mental health issues that are beyond a child’s control.

Our experiences of working with children who face a range of mental health challenges have taught us that flexibility is the most powerful tool we have to support their recovery and route back into learning. As a country, we have shown that we can be flexible when students need it most, as we did during the pandemic, when lockdown prevented pupils from sitting in-person exams, and the government found a way to ensure they were awarded grades. Two years of algorithms and teacher assessment got them through, and allowed pupils to move forwards with their lives.

So why can’t we afford that flexibility to pupils who are in hospital at exam time? Young people managing complex mental and physical health needs simply may not be well enough. Awarding grades based on their academic “neighbours” back in their home school is an option that we know works.

We have come so far in our attitudes towards mental health, and we are better equipped to talk openly about how it affects us than ever before. As the latest NHS Digital figures show one in six children between the ages of seven and 16 has a probable mental health disorder, we have no choice but to be better. The Pears Maudsley Centre will be a symbol of that progress, and help a new generation of young people develop positive attitudes to mental health. 

But we must use these opportunities to learn some lessons of our own, and keep reforming practices that just don’t work for young people like Faisal. Allowing the most vulnerable children some latitude in school assessments could help so many of them find a way through the dark.

Maarten Crommelin is headteacher of the Maudsley and Bethlem Hospital School, part of which will have a new home in the Pears Maudsley Centre, due to open in 2024.

* Faisal's name has been changed

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