“We need you to notice us, we need you to not dismiss us, we need to feel heard”

: A Narrative Inquiry Into the Experiences of Young People with Mental Health Needs Who Are Receiving Outreach Hospital Education.

Abstract

A crisis in adolescent mental health has been widely declared and reportedly exacerbated by
the Covid-19 pandemic. Research evidence associates young people’s mental health
difficulties with destructive outcomes, including school non-attendance, educational
disruption and underachievement (BPS, 2017; McDonald et al., 2023). In England, when a
pupil’s mental health needs prevent them from attending school over time, their local
authority and school are obliged to refer them to Hospital Education services via a medical
practitioner (Education Act, 1996; DfE, 2013b, 2015b). Outreach Hospital Education (OHE) can
provide short-term provision for these vulnerable pupils, to mitigate negative consequences
of their educational exclusion and facilitate their recovery away from mainstream
environments. However, despite OHE being an established feature of education in England, it
is currently missing from national data and published literature. A dearth of research has
sought the perspectives of young people with mental health needs who experience OHE,
serving to exacerbate their purported invisibility as pupils within complex hospital education
services and local authority systems (Mintz et al., 2018).
This research aimed to contribute to the understanding of OHE for these pupils, through
placing their voices at the forefront of the conversation. It tells the stories of five secondaryaged informants receiving OHE in England due to medical mental health needs. Accounts of
their educational journeys were elicited through narrative interviews and analysed using a
voice-centred dialogical narrative analysis. Two typologies were created to capture the nature
and purpose of informants’ stories: chaos and moving through. By providing insight into their
narratives, considerations of informants’ experiences for professional educational practice
and further research were considered. Key discussion related to the importance of: relational
practice and whole-school approaches to mental health; promoting pupil decision making in
OHE referrals; school collaboration with OHE; and OHE services being better acknowledged
within national legislation, data, educational discourses and academic literature. Conclusions
suggest that pupils receiving OHE occupy multiple positions of struggle, strength and survival
which are each important, yet nuanced, aspects of their educational experiences to articulate.
Thus, professionals’ relational and voice-centred listening practices are necessitated to attend
to these intricacies and illuminate the often-marginalised experiences of young people with
mental health needs

Date of Award	5 Dec 2023
Original language	English
Awarding Institution	University of Bristol
Supervisor	Jon Symonds (Supervisor)