Swedish Municipal Plans Overlook the Importance of Everyday School Life in Children's Mental Health

The researchers analysed municipal mental health action plans from 12 Swedish municipalities. Their findings show that schools' work on mental health is frequently separated from their core responsibilities of teaching and learning.

By contrast, teachers, educational support and the school's social environment receive limited attention in the policy documents.

The study found that schools are primarily described in four ways: as environments that influence pupils' wellbeing; as a place for delivering mental health promotion and prevention initiatives to all children and young people; as a place where mental health problems should be identified; and as partners to services such as social care and child and adolescent mental health services.

The analysis also revealed a pattern in which municipal approaches to mental health in schools are often individualised and shaped by a medical perspective. The emphasis is on identifying pupils experiencing mental health difficulties, providing health education and support programmes, and referring young people to healthcare services. School health services are highlighted as key actors in this work.

Teachers, teaching and educational support receive little attention

At the same time, many municipalities acknowledge the important role schools play in children's wellbeing. Succeeding at school and completing education are frequently described as important factors for good mental health later in life.

However, teachers, classroom teaching and educational support are rarely presented as tools for strengthening pupils' mental health. Nor do the action plans give much attention to the school's role as a social environment where relationships, security and a sense of belonging are developed.

This is despite previous research showing that school-related stress, high academic pressure and insufficient support in school are important contributors to mental ill-health among young people in Sweden.

"In this study, schools are primarily viewed as places for delivering targeted mental health interventions and for identifying and supporting children who are struggling. These are, of course, extremely important responsibilities. At the same time, it is problematic that the importance of everyday school life for children and young people's mental health is overlooked, because the real health-promoting potential lies in teaching and in the relationships formed at school," says Lisa Rydstad, PhD student at the Department of Public Health Sciences, Stockholm University.

Different approaches across municipalities

The study also found considerable variation in the types of initiatives prioritised by the 12 municipalities. Some focus on physical activity and improving the school environment, while others prioritise dedicated mental health programmes or parental support initiatives.

The researchers argue that greater attention should be paid to how schools' educational and social environments can contribute to better mental health among children and young people. They also call for more coherent national guidance to reduce differences between municipalities.

"Schools are recognised as important actors in promoting children's and young people's mental health in both Swedish and international policy. However, at the local level, the role of schools in mental health promotion and prevention appears to be interpreted in different ways," says Lisa Rydstad.

Håkan Soold