Developing outreach mental health provision across a cluster of schools Service development, multi-level consultation, and capacity building

Working as part of a London CAMHS team, KCGA's principal consultant developed and established an outreach mental health service across seven schools — five primary schools, a hospital school, and a secondary school — creating provision that had not previously existed in those settings. The work involved building a different kind of relationship between CAMHS and schools: not simply a referral pathway, but an embedded presence within each institution that allowed for consultation to teachers and senior staff, direct work with children and families, liaison with SEN leads and pastoral teams, and a more nuanced understanding of when and how specialist provision was needed. Each school was different — in its structure, its culture, and the particular pressures it was facing — and the work within each was shaped accordingly.

In one school, regular consultation with a young deputy headteacher — sometimes joined by the head — became the organising spine of the work. The leadership team was new and brought real energy and capacity to the role, with a genuine ambition to modernise and develop the school. But they were also finding themselves unexpectedly undermined. Pressure from the parent body — complaints, challenges at the school gates, a blurring of the boundary between appropriate responsiveness and an erosion of institutional authority — was landing on a leadership that had not yet fully consolidated its own sense of authority in role. The external challenge was meeting something internal: the ordinary uncertainty of leaders who are new, who are trying to bring about change, and who have not yet had time to develop the confidence that comes from sustained experience in role. The consultation worked at both levels — thinking about the dynamics playing out at the boundary with families, and supporting the leadership in taking up their authority more fully: recognising what they genuinely had to offer, managing the projections coming towards them, and holding their ground without either capitulating or becoming defensive. That combination — external pressure met by internal consolidation — is a recognisable pattern in leadership consultation.

Across the schools, a consistent developmental model emerged: an initial period in which the service was established, structured, and embedded within the school's own systems, followed by a transition to a more junior clinician who could sustain what had been built. That arc — building capacity and then transferring it — was an organisational intention, not simply a resource management decision. The aim was to leave each school with something that belonged to it, rather than a service dependent on any one practitioner's continued presence.

Service development — multi-level school consultation — leadership support — capacity building and transfer