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Sierra Leone: teenage girls are dying from unsafe abortions and risky pregnancies

I recently saw a girl in clinic with terrible complications following a caesarean section. The operation had been botched and she had an infection around her uterus. She was in terrible pain and critically unwell. This was in the children’s clinic; the girl was 14 years old.

This scenario is all too common. She is just one of the thousands of adolescent girls estimated to have become pregnant this year in Sierra Leone. In 2013 the country had the 7th highest teenage pregnancy rate in the world, 38% of women aged 20-24 had their first baby before the age of 18. Sierra Leone is by no means an exception. Worldwide teenage pregnancy is a huge issue, 11% of births globally are to women aged 15-19, with the majority of these taking place in low- and middle-income countries.

From a medical point of view, teenage pregnancy is terribly risky. Teenage mothers are estimated to be 40-60% more likely to die in childbirth. Their babies are 50% more likely to be stillborn or die shortly after birth than babies born to mothers in their 20s.

Terrifying medical complications aside, it can be devastating socially and economically for adolescent mums. In 2015, when schools in Sierra Leone reopened after the Ebola crisis, the minister for education banned visibly pregnant girls from school and sitting exams. This discriminatory ban persists and has been strongly condemned by, among others, Amnesty International.

A “bridging system” was started where girls can seek alternative education elsewhere, but the disruption remains huge. Often girls will be prevented from sitting exams and need to repeat a whole year of school, meaning many will not go back at all. This discriminates against the girls, but not the men who get them pregnant. After giving birth they face continued problems reintegrating into their schools of choice.

During the recent Ebola crisis teen pregnancy rates rose in Sierra Leone by an estimated 50%. This rise could give insights into why the country’s teen pregnancy rate is so high. A factor highlighted as being behind the spike in pregnancy during the Ebola outbreak was extreme poverty, with girls reportedly having sex in exchange for water, food or other forms of financial protection.

What can be done to help these girls? This problem is complex with many driving factors.

The UK is one of Europe’s great success stories with reducing its high teenage pregnancy rate. Improved sex education and access to contraception and changes in social norms are credited with this drop. Can any of the lessons learned be applied in this context?

Improving knowledge of and access to contraception is certainly important. Access to contraception in Sierra Leone is limited; an estimated 16% of women in Sierra Leone use contraception and this figure falls to 7.8% for teenagers. Safe access to abortion for girls who do not want to continue their pregnancy is essential. In Sierra Leone, the country with the world’s worst maternal mortality, abortion is illegal in nearly all circumstances and unsafe abortion is estimated to account for 10% of maternal deaths. This will only be compounded by Trump’s enactment of the “global gag rule” which has a disastrous effect on funding for organisations working for women’s reproductive rights.


The girls themselves will never be the key to reducing the teenage pregnancy rate. There has to be buy in from the men

However, assuming that knowledge about and access to contraception would end this problem is deeply misguided. It puts all of the onus on to the girls not to get pregnant, it assumes they have the option of making a choice. Even when contraception is available many of the girls are not empowered to insist on its use. This approach ignores the wider societal contexts that drive the high teenage pregnancy rate. A recent report by the Secure Livelihoods Research Consortium highlighted some of the inadequacies in current programming.

The girls themselves will never be the key to reducing the teenage pregnancy rate. There has to be buy-in from the men, and a change in attitudes that currently accept the concept of teenage pregnancy. Currently, a lot of work being done on this issue focuses only on the girls. Addressing the attitudes that perpetuate teenage pregnancy is difficult and there are few programmes that do this at the moment. It is easy to pick out and identify the teenage women, but harder to involve the men who could potentially impregnate them.

The high adolescent pregnancy rate, in Sierra Leone and around the world, jeopardises the achievement of the sustainable development goals (SDGs). The SDGs focus specifically on reducing maternal mortality, improving health for all ages and promoting women’s rights. Teenage pregnancy is a threat to the realisation of all those goals and so meaningful efforts to reduce the appalling rate are essential to making any progress.

In the hospital where I work, a teenage pregnancy support group is going on. Girls receive education sessions. Efforts are being made to find them jobs and reintegrate them into the school system. The excitement of the girls is palpable. Many of them have come from situations where they are not shown any respect, but now they are being empowered to take control of this important part of their lives.

This month the UK government hosted Family Planning Summit 2017 to recommit to this global issue, announcing that the UK would increase international development spending on family planning from £180m per year until 2020 to £225m per year until 2022. Governments from countries around the world came together to make commitments to improving women’s access to family planning. In the face of Trump’s regressive change to US policy, putting women’s reproductive rights at the centre of the international community’s agenda is of great importance.

Sierra Leone: teenage girls are dying from unsafe abortions and risky pregnancies

I recently saw a girl in clinic with terrible complications following a caesarean section. The operation had been botched and she had an infection around her uterus. She was in terrible pain and critically unwell. This was in the children’s clinic; the girl was 14 years old.

This scenario is all too common. She is just one of the thousands of adolescent girls estimated to have become pregnant this year in Sierra Leone. In 2013 the country had the 7th highest teenage pregnancy rate in the world, 38% of women aged 20-24 had their first baby before the age of 18. Sierra Leone is by no means an exception. Worldwide teenage pregnancy is a huge issue, 11% of births globally are to women aged 15-19, with the majority of these taking place in low- and middle-income countries.

From a medical point of view, teenage pregnancy is terribly risky. Teenage mothers are estimated to be 40-60% more likely to die in childbirth. Their babies are 50% more likely to be stillborn or die shortly after birth than babies born to mothers in their 20s.

Terrifying medical complications aside, it can be devastating socially and economically for adolescent mums. In 2015, when schools in Sierra Leone reopened after the Ebola crisis, the minister for education banned visibly pregnant girls from school and sitting exams. This discriminatory ban persists and has been strongly condemned by, among others, Amnesty International.

A “bridging system” was started where girls can seek alternative education elsewhere, but the disruption remains huge. Often girls will be prevented from sitting exams and need to repeat a whole year of school, meaning many will not go back at all. This discriminates against the girls, but not the men who get them pregnant. After giving birth they face continued problems reintegrating into their schools of choice.

During the recent Ebola crisis teen pregnancy rates rose in Sierra Leone by an estimated 50%. This rise could give insights into why the country’s teen pregnancy rate is so high. A factor highlighted as being behind the spike in pregnancy during the Ebola outbreak was extreme poverty, with girls reportedly having sex in exchange for water, food or other forms of financial protection.

What can be done to help these girls? This problem is complex with many driving factors.

The UK is one of Europe’s great success stories with reducing its high teenage pregnancy rate. Improved sex education and access to contraception and changes in social norms are credited with this drop. Can any of the lessons learned be applied in this context?

Improving knowledge of and access to contraception is certainly important. Access to contraception in Sierra Leone is limited; an estimated 16% of women in Sierra Leone use contraception and this figure falls to 7.8% for teenagers. Safe access to abortion for girls who do not want to continue their pregnancy is essential. In Sierra Leone, the country with the world’s worst maternal mortality, abortion is illegal in nearly all circumstances and unsafe abortion is estimated to account for 10% of maternal deaths. This will only be compounded by Trump’s enactment of the “global gag rule” which has a disastrous effect on funding for organisations working for women’s reproductive rights.


The girls themselves will never be the key to reducing the teenage pregnancy rate. There has to be buy in from the men

However, assuming that knowledge about and access to contraception would end this problem is deeply misguided. It puts all of the onus on to the girls not to get pregnant, it assumes they have the option of making a choice. Even when contraception is available many of the girls are not empowered to insist on its use. This approach ignores the wider societal contexts that drive the high teenage pregnancy rate. A recent report by the Secure Livelihoods Research Consortium highlighted some of the inadequacies in current programming.

The girls themselves will never be the key to reducing the teenage pregnancy rate. There has to be buy-in from the men, and a change in attitudes that currently accept the concept of teenage pregnancy. Currently, a lot of work being done on this issue focuses only on the girls. Addressing the attitudes that perpetuate teenage pregnancy is difficult and there are few programmes that do this at the moment. It is easy to pick out and identify the teenage women, but harder to involve the men who could potentially impregnate them.

The high adolescent pregnancy rate, in Sierra Leone and around the world, jeopardises the achievement of the sustainable development goals (SDGs). The SDGs focus specifically on reducing maternal mortality, improving health for all ages and promoting women’s rights. Teenage pregnancy is a threat to the realisation of all those goals and so meaningful efforts to reduce the appalling rate are essential to making any progress.

In the hospital where I work, a teenage pregnancy support group is going on. Girls receive education sessions. Efforts are being made to find them jobs and reintegrate them into the school system. The excitement of the girls is palpable. Many of them have come from situations where they are not shown any respect, but now they are being empowered to take control of this important part of their lives.

This month the UK government hosted Family Planning Summit 2017 to recommit to this global issue, announcing that the UK would increase international development spending on family planning from £180m per year until 2020 to £225m per year until 2022. Governments from countries around the world came together to make commitments to improving women’s access to family planning. In the face of Trump’s regressive change to US policy, putting women’s reproductive rights at the centre of the international community’s agenda is of great importance.

Sierra Leone: teenage girls are dying from unsafe abortions and risky pregnancies

I recently saw a girl in clinic with terrible complications following a caesarean section. The operation had been botched and she had an infection around her uterus. She was in terrible pain and critically unwell. This was in the children’s clinic; the girl was 14 years old.

This scenario is all too common. She is just one of the thousands of adolescent girls estimated to have become pregnant this year in Sierra Leone. In 2013 the country had the 7th highest teenage pregnancy rate in the world, 38% of women aged 20-24 had their first baby before the age of 18. Sierra Leone is by no means an exception. Worldwide teenage pregnancy is a huge issue, 11% of births globally are to women aged 15-19, with the majority of these taking place in low- and middle-income countries.

From a medical point of view, teenage pregnancy is terribly risky. Teenage mothers are estimated to be 40-60% more likely to die in childbirth. Their babies are 50% more likely to be stillborn or die shortly after birth than babies born to mothers in their 20s.

Terrifying medical complications aside, it can be devastating socially and economically for adolescent mums. In 2015, when schools in Sierra Leone reopened after the Ebola crisis, the minister for education banned visibly pregnant girls from school and sitting exams. This discriminatory ban persists and has been strongly condemned by, among others, Amnesty International.

A “bridging system” was started where girls can seek alternative education elsewhere, but the disruption remains huge. Often girls will be prevented from sitting exams and need to repeat a whole year of school, meaning many will not go back at all. This discriminates against the girls, but not the men who get them pregnant. After giving birth they face continued problems reintegrating into their schools of choice.

During the recent Ebola crisis teen pregnancy rates rose in Sierra Leone by an estimated 50%. This rise could give insights into why the country’s teen pregnancy rate is so high. A factor highlighted as being behind the spike in pregnancy during the Ebola outbreak was extreme poverty, with girls reportedly having sex in exchange for water, food or other forms of financial protection.

What can be done to help these girls? This problem is complex with many driving factors.

The UK is one of Europe’s great success stories with reducing its high teenage pregnancy rate. Improved sex education and access to contraception and changes in social norms are credited with this drop. Can any of the lessons learned be applied in this context?

Improving knowledge of and access to contraception is certainly important. Access to contraception in Sierra Leone is limited; an estimated 16% of women in Sierra Leone use contraception and this figure falls to 7.8% for teenagers. Safe access to abortion for girls who do not want to continue their pregnancy is essential. In Sierra Leone, the country with the world’s worst maternal mortality, abortion is illegal in nearly all circumstances and unsafe abortion is estimated to account for 10% of maternal deaths. This will only be compounded by Trump’s enactment of the “global gag rule” which has a disastrous effect on funding for organisations working for women’s reproductive rights.


The girls themselves will never be the key to reducing the teenage pregnancy rate. There has to be buy in from the men

However, assuming that knowledge about and access to contraception would end this problem is deeply misguided. It puts all of the onus on to the girls not to get pregnant, it assumes they have the option of making a choice. Even when contraception is available many of the girls are not empowered to insist on its use. This approach ignores the wider societal contexts that drive the high teenage pregnancy rate. A recent report by the Secure Livelihoods Research Consortium highlighted some of the inadequacies in current programming.

The girls themselves will never be the key to reducing the teenage pregnancy rate. There has to be buy-in from the men, and a change in attitudes that currently accept the concept of teenage pregnancy. Currently, a lot of work being done on this issue focuses only on the girls. Addressing the attitudes that perpetuate teenage pregnancy is difficult and there are few programmes that do this at the moment. It is easy to pick out and identify the teenage women, but harder to involve the men who could potentially impregnate them.

The high adolescent pregnancy rate, in Sierra Leone and around the world, jeopardises the achievement of the sustainable development goals (SDGs). The SDGs focus specifically on reducing maternal mortality, improving health for all ages and promoting women’s rights. Teenage pregnancy is a threat to the realisation of all those goals and so meaningful efforts to reduce the appalling rate are essential to making any progress.

In the hospital where I work, a teenage pregnancy support group is going on. Girls receive education sessions. Efforts are being made to find them jobs and reintegrate them into the school system. The excitement of the girls is palpable. Many of them have come from situations where they are not shown any respect, but now they are being empowered to take control of this important part of their lives.

This month the UK government hosted Family Planning Summit 2017 to recommit to this global issue, announcing that the UK would increase international development spending on family planning from £180m per year until 2020 to £225m per year until 2022. Governments from countries around the world came together to make commitments to improving women’s access to family planning. In the face of Trump’s regressive change to US policy, putting women’s reproductive rights at the centre of the international community’s agenda is of great importance.

Nursing shortages fuelling delayed discharge from hospital

There is no doubt that delays in arranging follow-on social care are causing more older people to be stranded in hospital. But a new analysis of the problem says shortage of district nurses is at least as big a factor.

The number of district nurses in the UK has plummeted by 44% since 2010 when counted as full-time jobs, according to the analysis of NHS data by consultancy Christie & Co (pdf).

The trend is described as a “key trigger” of hospital admissions of older people and of subsequent delayed discharge. District and other community nurses play a crucial role in treating people in their own homes or in care homes when they might otherwise be referred to hospital.

Since 2008, numbers of people aged 60 and over admitted to hospital have soared 65%, the analysis finds.

Michael Hodges, head of care consultancy at Christie & Co, says ministers are missing the bigger, more complex picture behind delayed discharge by focusing narrowly on blockages in the social care system.

“We need to take a much more rounded view of the whole health and social care system,” he says, “including workforce planning for essential roles like district and community nurses and a proper assessment of what more social care providers could offer to ease pressure on hospitals.”

According to a breakdown of delayed discharge figures by Christie & Co, some of the areas said by the NHS to have the worst problems have ample capacity in local care homes to accept older people from hospital for short-term “reablement”.

Homes in Birmingham, which is said to have the biggest delayed discharge challenge, are shown to be operating at only 77.5% capacity. Those in Hampshire, which is said to have the second most severe problem measured by number of days of discharge delays, are running at 84.2%.

“There are great opportunities – and not just for a quick fix,” says Hodges. “I really hope that somehow the politicians look at it properly and strategically for the long term.”

The analysis includes a survey of fees paid to care homes for state-funded residents by 123 English councils, four in five of the total, plus figures for fees charged by more than 200 care providers.

On average, “base” fees offered by councils are shown to have increased by 3%-4% this year. But providers have been able to negotiate better terms for care of older people, with an average uplift of 5.2%.

By contrast, fees for “specialist” care such as learning disability or low-secure accommodation have risen by only 1.9% on average – the second successive year to show such disparity.

Hodges says providers are starting to think twice about investment in specialist care and suggests policymakers need “urgently” to look at funding for this part of the social care sector.

The survey confirms a continuing trend of care home providers squeezing self-funding residents, with an average fee increase of 6.3% for private payers and as big a rise as 9.8% in one case.

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Half of pupils expelled from school have mental health issue, study finds

Half of all pupils expelled from school are suffering from a recognised mental health problem, according to a study.

Those who are permanently excluded find themselves at a significant disadvantage, with only one in a hundred going on to attain five good GCSEs, which are often used as a benchmark of academic success.

The majority will end up in prison, says the study by the Institute for Public Policy Research, which estimates that of the 86,000-strong prison population, more then 54,000 were excluded at school.

The IPPR says its research lays bare the “broken system” facing excluded pupils. It flags up high levels of mental health issues among permanently excluded students – at least one in two, compared with one in 50 pupils in the wider population.

The thinktank also highlights the disadvantages such children face, as those excluded are four times more likely to grow up in poverty and twice as likely to be living in care. They are also seven times more likely to have special educational needs than those who are not excluded, the report claims.

After exclusion, the study says there is a downward spiral of underachievement, with teachers in schools catering for excluded pupils twice as likely to have no educational qualifications.

Kiran Gill, an IPPR associate fellow and founder of The Difference, which works to improve mental health provision for excluded pupils, described the system as “burningly unjust”.

She said: “Theresa May says she is committed to improving the mental health of young people. Addressing the most vulnerable children being thrown out of England’s schools is a good place to start. Because unequal treatment of mental health may be an injustice, but the discrimination of school exclusions is a crime.

“If the government is serious about real action on mental health, there needs to be dedicated funding and thought through solutions rather than sticking plasters on the symptoms of the problem.”

The IPPR research was published before the government’s latest annual figures on permanent and fixed period exclusions from schools in England in 2015-16, which is scheduled to be released on Thursday.

Responding to the report, the Department for Education said any decision to exclude should be lawful, reasonable and fair, and should only be used as a last resort in response to serious breaches of a school’s behaviour policy.

“This government is committed to working with local authorities and schools to ensure children in alternative provision receive a high quality education,” a DfE spokesperson said.

“We are strengthening the links between schools and NHS mental health staff and have announced plans for every secondary school to be offered mental health first aid training. Later this year we will publish a green paper with proposals for further improving mental health services.”

  • In the UK, Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here

Half of pupils expelled from school have mental health issue, study finds

Half of all pupils expelled from school are suffering from a recognised mental health problem, according to a study.

Those who are permanently excluded find themselves at a significant disadvantage, with only one in a hundred going on to attain five good GCSEs, which are often used as a benchmark of academic success.

The majority will end up in prison, says the study by the Institute for Public Policy Research, which estimates that of the 86,000-strong prison population, more then 54,000 were excluded at school.

The IPPR says its research lays bare the “broken system” facing excluded pupils. It flags up high levels of mental health issues among permanently excluded students – at least one in two, compared with one in 50 pupils in the wider population.

The thinktank also highlights the disadvantages such children face, as those excluded are four times more likely to grow up in poverty and twice as likely to be living in care. They are also seven times more likely to have special educational needs than those who are not excluded, the report claims.

After exclusion, the study says there is a downward spiral of underachievement, with teachers in schools catering for excluded pupils twice as likely to have no educational qualifications.

Kiran Gill, an IPPR associate fellow and founder of The Difference, which works to improve mental health provision for excluded pupils, described the system as “burningly unjust”.

She said: “Theresa May says she is committed to improving the mental health of young people. Addressing the most vulnerable children being thrown out of England’s schools is a good place to start. Because unequal treatment of mental health may be an injustice, but the discrimination of school exclusions is a crime.

“If the government is serious about real action on mental health, there needs to be dedicated funding and thought through solutions rather than sticking plasters on the symptoms of the problem.”

The IPPR research was published before the government’s latest annual figures on permanent and fixed period exclusions from schools in England in 2015-16, which is scheduled to be released on Thursday.

Responding to the report, the Department for Education said any decision to exclude should be lawful, reasonable and fair, and should only be used as a last resort in response to serious breaches of a school’s behaviour policy.

“This government is committed to working with local authorities and schools to ensure children in alternative provision receive a high quality education,” a DfE spokesperson said.

“We are strengthening the links between schools and NHS mental health staff and have announced plans for every secondary school to be offered mental health first aid training. Later this year we will publish a green paper with proposals for further improving mental health services.”

  • In the UK, Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here

Half of pupils expelled from school have mental health issue, study finds

Half of all pupils expelled from school are suffering from a recognised mental health problem, according to a study.

Those who are permanently excluded find themselves at a significant disadvantage, with only one in a hundred going on to attain five good GCSEs, which are often used as a benchmark of academic success.

The majority will end up in prison, says the study by the Institute for Public Policy Research, which estimates that of the 86,000-strong prison population, more then 54,000 were excluded at school.

The IPPR says its research lays bare the “broken system” facing excluded pupils. It flags up high levels of mental health issues among permanently excluded students – at least one in two, compared with one in 50 pupils in the wider population.

The thinktank also highlights the disadvantages such children face, as those excluded are four times more likely to grow up in poverty and twice as likely to be living in care. They are also seven times more likely to have special educational needs than those who are not excluded, the report claims.

After exclusion, the study says there is a downward spiral of underachievement, with teachers in schools catering for excluded pupils twice as likely to have no educational qualifications.

Kiran Gill, an IPPR associate fellow and founder of The Difference, which works to improve mental health provision for excluded pupils, described the system as “burningly unjust”.

She said: “Theresa May says she is committed to improving the mental health of young people. Addressing the most vulnerable children being thrown out of England’s schools is a good place to start. Because unequal treatment of mental health may be an injustice, but the discrimination of school exclusions is a crime.

“If the government is serious about real action on mental health, there needs to be dedicated funding and thought through solutions rather than sticking plasters on the symptoms of the problem.”

The IPPR research was published before the government’s latest annual figures on permanent and fixed period exclusions from schools in England in 2015-16, which is scheduled to be released on Thursday.

Responding to the report, the Department for Education said any decision to exclude should be lawful, reasonable and fair, and should only be used as a last resort in response to serious breaches of a school’s behaviour policy.

“This government is committed to working with local authorities and schools to ensure children in alternative provision receive a high quality education,” a DfE spokesperson said.

“We are strengthening the links between schools and NHS mental health staff and have announced plans for every secondary school to be offered mental health first aid training. Later this year we will publish a green paper with proposals for further improving mental health services.”

  • In the UK, Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here

Half of pupils expelled from school have mental health issue, study finds

Half of all pupils expelled from school are suffering from a recognised mental health problem, according to a study.

Those who are permanently excluded find themselves at a significant disadvantage, with only one in a hundred going on to attain five good GCSEs, which are often used as a benchmark of academic success.

The majority will end up in prison, says the study by the Institute for Public Policy Research, which estimates that of the 86,000-strong prison population, more then 54,000 were excluded at school.

The IPPR says its research lays bare the “broken system” facing excluded pupils. It flags up high levels of mental health issues among permanently excluded students – at least one in two, compared with one in 50 pupils in the wider population.

The thinktank also highlights the disadvantages such children face, as those excluded are four times more likely to grow up in poverty and twice as likely to be living in care. They are also seven times more likely to have special educational needs than those who are not excluded, the report claims.

After exclusion, the study says there is a downward spiral of underachievement, with teachers in schools catering for excluded pupils twice as likely to have no educational qualifications.

Kiran Gill, an IPPR associate fellow and founder of The Difference, which works to improve mental health provision for excluded pupils, described the system as “burningly unjust”.

She said: “Theresa May says she is committed to improving the mental health of young people. Addressing the most vulnerable children being thrown out of England’s schools is a good place to start. Because unequal treatment of mental health may be an injustice, but the discrimination of school exclusions is a crime.

“If the government is serious about real action on mental health, there needs to be dedicated funding and thought through solutions rather than sticking plasters on the symptoms of the problem.”

The IPPR research was published before the government’s latest annual figures on permanent and fixed period exclusions from schools in England in 2015-16, which is scheduled to be released on Thursday.

Responding to the report, the Department for Education said any decision to exclude should be lawful, reasonable and fair, and should only be used as a last resort in response to serious breaches of a school’s behaviour policy.

“This government is committed to working with local authorities and schools to ensure children in alternative provision receive a high quality education,” a DfE spokesperson said.

“We are strengthening the links between schools and NHS mental health staff and have announced plans for every secondary school to be offered mental health first aid training. Later this year we will publish a green paper with proposals for further improving mental health services.”

  • In the UK, Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here

Half of pupils expelled from school have mental health issue, study finds

Half of all pupils expelled from school are suffering from a recognised mental health problem, according to a study.

Those who are permanently excluded find themselves at a significant disadvantage, with only one in a hundred going on to attain five good GCSEs, which are often used as a benchmark of academic success.

The majority will end up in prison, says the study by the Institute for Public Policy Research, which estimates that of the 86,000-strong prison population, more then 54,000 were excluded at school.

The IPPR says its research lays bare the “broken system” facing excluded pupils. It flags up high levels of mental health issues among permanently excluded students – at least one in two, compared with one in 50 pupils in the wider population.

The thinktank also highlights the disadvantages such children face, as those excluded are four times more likely to grow up in poverty and twice as likely to be living in care. They are also seven times more likely to have special educational needs than those who are not excluded, the report claims.

After exclusion, the study says there is a downward spiral of underachievement, with teachers in schools catering for excluded pupils twice as likely to have no educational qualifications.

Kiran Gill, an IPPR associate fellow and founder of The Difference, which works to improve mental health provision for excluded pupils, described the system as “burningly unjust”.

She said: “Theresa May says she is committed to improving the mental health of young people. Addressing the most vulnerable children being thrown out of England’s schools is a good place to start. Because unequal treatment of mental health may be an injustice, but the discrimination of school exclusions is a crime.

“If the government is serious about real action on mental health, there needs to be dedicated funding and thought through solutions rather than sticking plasters on the symptoms of the problem.”

The IPPR research was published before the government’s latest annual figures on permanent and fixed period exclusions from schools in England in 2015-16, which is scheduled to be released on Thursday.

Responding to the report, the Department for Education said any decision to exclude should be lawful, reasonable and fair, and should only be used as a last resort in response to serious breaches of a school’s behaviour policy.

“This government is committed to working with local authorities and schools to ensure children in alternative provision receive a high quality education,” a DfE spokesperson said.

“We are strengthening the links between schools and NHS mental health staff and have announced plans for every secondary school to be offered mental health first aid training. Later this year we will publish a green paper with proposals for further improving mental health services.”

  • In the UK, Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here

Half of pupils expelled from school have mental health issue, study finds

Half of all pupils expelled from school are suffering from a recognised mental health problem, according to a study.

Those who are permanently excluded find themselves at a significant disadvantage, with only one in a hundred going on to attain five good GCSEs, which are often used as a benchmark of academic success.

The majority will end up in prison, says the study by the Institute for Public Policy Research, which estimates that of the 86,000-strong prison population, more then 54,000 were excluded at school.

The IPPR says its research lays bare the “broken system” facing excluded pupils. It flags up high levels of mental health issues among permanently excluded students – at least one in two, compared with one in 50 pupils in the wider population.

The thinktank also highlights the disadvantages such children face, as those excluded are four times more likely to grow up in poverty and twice as likely to be living in care. They are also seven times more likely to have special educational needs than those who are not excluded, the report claims.

After exclusion, the study says there is a downward spiral of underachievement, with teachers in schools catering for excluded pupils twice as likely to have no educational qualifications.

Kiran Gill, an IPPR associate fellow and founder of The Difference, which works to improve mental health provision for excluded pupils, described the system as “burningly unjust”.

She said: “Theresa May says she is committed to improving the mental health of young people. Addressing the most vulnerable children being thrown out of England’s schools is a good place to start. Because unequal treatment of mental health may be an injustice, but the discrimination of school exclusions is a crime.

“If the government is serious about real action on mental health, there needs to be dedicated funding and thought through solutions rather than sticking plasters on the symptoms of the problem.”

The IPPR research was published before the government’s latest annual figures on permanent and fixed period exclusions from schools in England in 2015-16, which is scheduled to be released on Thursday.

Responding to the report, the Department for Education said any decision to exclude should be lawful, reasonable and fair, and should only be used as a last resort in response to serious breaches of a school’s behaviour policy.

“This government is committed to working with local authorities and schools to ensure children in alternative provision receive a high quality education,” a DfE spokesperson said.

“We are strengthening the links between schools and NHS mental health staff and have announced plans for every secondary school to be offered mental health first aid training. Later this year we will publish a green paper with proposals for further improving mental health services.”

  • In the UK, Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here