Starting as a Police Sergeant in 1998, Claire Dunn frequently dealt with individuals in mental health crises, particularly young men aged 20-50. These encounters were often heightened during the winter months. As a first responder, she had no continuity of care, which was challenging. One memorable incident involved a man on a high-rise car park ledge, counting down from 10. After two hours of conversation, finding common ground in music and clubs, he stepped back to safety. Six weeks later, Claire saw him again, and he was doing much better, thanks to medication.   

However, the lack of updates on individuals' progress was frustrating. Did they make a full recovery? What treatment did they receive? These questions lingered. After medically retiring due to PTSD from a traumatic incident, Claire decided to pursue her interest in psychology.    

While studying, Claire worked with young people in alternative education settings, dealing with learning difficulties, self-harm, and suicidal ideation. This experience solidified her desire to work with children and young people. Her first role as an NHS Assistant Psychologist involved working in schools delivering targeted group interventions, one-on-one sessions, and workshops.   

Data from Power BI shows there is a disparity between the number of school referrals made for male and female students for one-to-one and targeted groups interventions, within the South-East locality. In January 2024, only 39% of referrals in the South East locality were for boys, despite suicide being the leading cause of death for males under 50 in the UK . This led Claire to initiate a Quality Improvement (QI) Project aimed at engaging more boys in therapeutic interventions (TI).   

The QI project revealed several insights particular to where the project was delivered: 

• The single largest barrier to treatment for boys was a lack of awareness that  a  Mental Health Support Team (MHST) worked within their school, 65% across years 7-10
• Boys are more likely to exhibit mental health difficulties through challenging behaviour. School staff are effectively identifying girls who present with symptoms synonymous with anxiety and low mood, over and above boys who present with symptoms synonymous with challenging behaviour
• Boys and girls both cited a ‘difficulty to talk about their mental health’ as their greatest barrier to seeking out/accepting support from MHST. This figure is twice as high for girls compared with boys – highlighting that boys are more willing to engage in treatment if identified and referred into MHST

In contrast with research, practitioner gender was not a significant factor for boys in this QI project when considering mental health support, with 76% of boys reporting that they ‘did not mind’ the gender. To address these issues, several change ideas were tested:

• Conducting student questionnaires to understand boys' experiences and willingness to engage in TI
• Monthly participation groups for boys to provide feedback and co-produce solutions
• Staff training to recognise and address boys' mental health needs
• Assemblies and parent/carer forums to raise awareness
• Drop-in clinics at the end of the school day for boys to seek support discreetly

The outcomes of the QI Project led to a significant increase in referrals from 4% to 50%. The project highlighted the importance of early intervention and the need for collaborative efforts with schools and parents to break down stigmas and support boys' mental health.

A vision for the future

Claire's journey continues with a focus on further work and commitment to addressing mental health issues early in life. Her project shed light on how creating a safe and supportive environment for boys to seek help, she could try and make a significant impact on their mental health and well-being. She emphasises:

The findings from my project challenges much of the published research in this field, which suggests that boys and men are reluctant to accept therapeutic support. Once the barriers and problems were understood, I was able to measure and show that these boys were willing to accept and engage in TI once easily accessible. By creating a safe and supportive therapeutic environment for boys to seek help, I believe we can make a significant impact on the mental health and wellbeing of this group of young people. To truly break down the stigmas for men who are already in their 20s and 30s is difficult, however, if we approach the stigmas in childhood and adolescence, I predict that we might have more of chance to reduce male suicide for future generations. I would love to follow up these change ideas I have tested in this project, to see if this preventative and early intervention approach could prevent mental health difficulties in boys from evolving into what I dealt with in the police force. A QI approach grounded in co-production with the whole school community, including parents and carers, did enhance the understanding of the differing signs and symptoms of mental health difficulties in boys. This would lead to fewer boys ‘falling under the radar’ and increase the number of boys who access and engage in therapy. I will be monitoring this and would love to scale and spread this project, into other schools to test and adapt to ensure that greater number of boys, and in particular boys from deprived socioeconomic backgrounds, feel safe to access and engage in therapeutic support.

You can find out more about this project here: QI Project Storyboard.pdf