Leader magazineASCL - Association of School and College Leaders

Growing apart


School is not the appropriate place for a year 10 student with a mental illness. But where else is there for him to go?

Tommy is mad. Not angry mad but crazy mad. He has just been diagnosed with 'emerging paranoid schizophrenia' and is 14 years old. His mental illness is emerging as he moves through puberty and will develop fully by the time he reaches the end of his teens - if he does.

I was surprised when Tommy's doctor at the Department of Child Adolescence and Psychiatry (DECAPS) explained that several mental illnesses can be triggered by the onset of puberty and develop in the early teenage years.

Apparently, in a large secondary school of 1,500 pupils, like ours, as many as three pupils could be suffering from a mental illness. Schizophrenia is the most common but other mental illnesses such as depression or being a sociopath develop even earlier.

One of Tommy's symptoms is that he sometimes stares off into space for quite some time - sometimes as long as five minutes. He glazes over and he seems to be watching something inside as it plays out across his subconscious.

The pupils delight in ratting him out in lessons. "Tommy's away with the fairies again, Miss," they shout.

He spends much of his time 'inside his head' and other pupils shun him. He is not easy to love and he seems incapable of caring about other people. It will not be long before he wanders restlessly about the school mumbling to himself.

Tommy hasn't always been like this. When he joined the school in year 7 he seemed perfectly normal. His mother noticed the changes first. Some of the symptoms of Tommy's mental illness are similar to the mood swings and changes that all teenagers go through and it was difficult to separate these out. However, there was something about Tommy that just wasn't quite 'right'.

He submitted a piece of English work that was particularly disturbing as it described how fire fell like rain from the sky and burned him all over his body.

He out-stared the pupil inclusion officer which 'freaked her out'. No mean feat. She is a formidable lady who rules with a rod of iron and not even the worst thug in the school dares confront her. But Tommy did. Despite a police officer standing between her and Tommy, he refused to back down. She felt frightened by the overwhelming sense that he meant to do her physical harm.

He has set several small fires in the toilets by lighting the cardboard inner tube of a roll of toilet paper. He likes to watch the flames but seems to do so in a controlled way. He always lights fires when he is alone and is content to watch them burn out - he doesn't feed them.

I suspect he gets the same kind of relief from watching the flames flare and die as a self-harmers do from watching themselves bleed. At the moment Tommy is mainly a danger to himself, not others.

I should have excluded Tommy several times over but I can't bring myself to because I know that he is ill, not naughty.

However, at the end of the day I have to consider the health and safety of everyone at the school and clearly Tommy cannot be allowed to continue to light fires.

It is inevitable that one day, one will get out of hand. His mother accepts this but knows that an exclusion will not stop him - it will just re-locate his behaviour to the home.

I am frustrated that there is little treatment available for Tommy. In the opinion of his doctor he is too young to be given the adult drugs to treat schizophrenia and his condition is not fully developed. Yet he desperately needs help.

School is not the right place for him. He is not happy here and is detached for most of the time. He has no friends and everyone is wary of him. He is unpredictable.

Occasionally, the old Tommy breaks through and you are filled with optimism. He will beam you a smile and wish you good morning but these are becoming increasingly rare occasions.

I suspect that there are many young people like Tommy in our schools. Why this should be I do not know. Perhaps we are just more aware of mental illness and, instead of describing kids as 'weird', we realise that they are ill. However, knowing this does not enable us to help them. We are educators, not psychiatrists.

What Tommy needs is a therapeutic environment and medication to give him back control of his mind and his emotions. He does not need geography at 11am on a Tuesday morning.

Jill Ireland is a headteacher in the east of England.

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