What is SEMH? How to Support Social, Emotional and Mental Health Needs in Children

SEMH, which stands for Social, Emotional, and Mental Health, describes children and young people who struggle to manage their:

• Emotions,
• Mental well-being, and,
• Social interactions.

SEMH needs are a type of Special Educational Need (SEN) primarily used in the education and health sectors in the UK. Understanding SEMH is crucial and empowering for educators, healthcare professionals, parents, and anyone interested in child development.

Children with SEMH needs often struggle with building and maintaining relationships both in school and in the wider community. They can feel anxious, scared, and misunderstood. This can lead to difficulties in engaging with education, putting them at a greater risk of becoming NEET (Not in Education, Employment or Training).

Social, Emotional, and Mental Health needs can be attributed to many causes, some less obvious than others. Life experiences, genetic factors, and environments all play a part and must be considered.

The most common causes of SEMH are believed to include the following:

Poor Attachment History

This could include a lack of:

• acceptance,
• needs being met,
• emotional warmth,
• positive feedback, and/or
• negative emotional responses by a caregiver.

Trauma History

This could include experiencing:

• Domestic violence,
• Abuse or Neglect,
• Bullying,
• Violent crime,
• Social exclusion
• Prejudice, and/or,
• Loss.

Current family dynamics and other social networks around the child (school, community, society, etc.) also impact children with SEMH and can be both positive and negative.

There are three critical aspects of SEMH, and these are:

SEMH: Social Needs

All humans are social creatures. However, many children struggle with building and maintaining social relationships, and sometimes, they can build primary superficial relationships that can exist within a specific context (such as within school) but break when extended beyond this.

Children may face additional barriers when building healthy relationships if there are additional communication, language or attachment concerns.

SEMH: Emotional Needs

Children with SEMH needs might display the following emotional signs/behaviours:

• Difficulty regulating their emotions, which can include breakdowns, emotional outbursts, mood swings or overreactions to situations,
• High levels of anxiety, worry or fear,
• Attachment issues or trouble with trusting others,
• Being in a constant state of alert,
• A need for safety, predictability or constant reassurance, and/or,
• Social isolation or withdrawal from their peer group.

SEMH: Mental Health Needs

Common mental health conditions that can be seen in children with SEMH needs include:

• Irrational fears,
• Obsessional pre-occupations,
• Intrusive thoughts,

A child who suffers from Anxiety might see threats in everyday situations which are based on their own lived experiences or understanding of the situation.

National data suggests that 99% of children with an SEMH diagnosis will not make the national average academic progress of their peers. By the age of 20, only 30% of adults who had a diagnosis of SEMH as children will have gained any qualification. These statistics should not just concern us but also motivate us to act.

These factors mean that children who leave school without any qualifications have a greater likelihood of becoming:

• NEET/Stuck in a cycle of unemployment,
• Addicted to drugs and alcohol,
• Involved in criminal behaviour, and
• Homeless.

To sum it up, children with an SEMH diagnosis are more likely to have much poorer life outcomes compared to their peers. They are much more susceptible to exploitation, grooming and becoming involved in criminal activities.

Supporting children with SEMH requires a combination of tailored strategies and interventions to enhance their social, emotional, and mental health.

By strengthening these areas, you can help children improve their mental well-being, academic engagement, and social relationships as they learn positive social behaviours.

Strategies that will support children who have SEMH needs include:

Developing Emotional Literacy

By teaching them emotional literacy, you can help children recognise, label, and express their emotions appropriately.

Tools like emotion charts and wheels can help children relate and identify emotions that they might not be able to verbalise, and social stories that model appropriate emotional responses to varied situations will help improve children's emotional literacy.

Books and games can be incorporated into your teaching or direct work as these can help to teach emotional regulation and empathy.

Positive Behaviour Support

Unlike many behaviour programmes in schools, communities and even the working world, children with SEMH need to thrive on positive behaviour. Delivering clear expectations using a positive tone will help create a positive behaviour environment. When expectations are met, these expectations can be reinforced by using rewards and praise.

One size never fits all, and each child you work with will have slightly different needs (encompassed as a SEMH need); therefore, each child will need their own behaviour support plan. This will help everyone working with that child to have the same clear expectations while providing a consistent response.

Building Strong Relationships

A key aspect of working with children is positive relationships with clear boundaries; this is no different for children with SEMH. By developing strong relationships with children, we help them to feel secure.

Each child should be assigned a key adult in each area of their life: mentors, pastoral leads, heads of year, etc. These adults can provide a consistent and joined-up approach to support the child's needs, ensuring they always have a reliable adult they can turn to for support.

Within school, peer mentoring and buddy systems can help foster social interaction and add a support system for the child.

Relaxation Techniques

Mindfulness, progressive muscle relaxation and deep breathing can all help children manage stress and anxiety. Incorporating these strategies into safe spaces and calm corners provide an area where the child can go to self-regulate when they are overstimulated.

Structured Routines

Clear structures, routines, expectations and boundaries will help children with SEMH needs feel more secure and less anxious. By providing consistency, you will help reduce the level of uncertainty that a child feels, which can help them better regulate their emotions.

Many children with SEMH needs can also benefit from having a visual timetable and the now and next board within the classroom. These can help the child to understand their day better and help them to feel more in control.

Social Skills

Social skills are likely immature for their age; the good news is that they can be taught through structured group activities that promote collaboration and positive social interaction. These help to develop essential communication and conflict-resolution skills.

Role-playing social situations that use scenarios such as appropriate responses to hypothetical situations can help build confidence in children when facing real-life interactions.

Cognitive Behavioural Strategies

Incorporating CBT can help you challenge negative thoughts that children with SEMH can display and teach them how to replace them with more positive or realistic ones. This approach can be particularly practical for children who struggle with anxiety or low self-esteem.

Multi-Agency Collaboration

Where it is in the child’s best interest, you should seek out support from and work alongside other agencies and services; this also includes working with parents, family members and anyone else the child identifies as important to them.

Typical multi-agency collaboration might include school counsellors, social workers, CAMHS (Child and Adolescent Mental Health Service), mentors, youth workers and family members.

Sensory Integration

Children with SEMH needs can become overstimulated, and this can lead to a lack of focus or negative behaviours. However, by offering movement breaks where you introduce a short time for physical activity, you can release pent-up energy, allowing children to re-focus on the task at hand. Movement breaks can also help to reduce anxiety and offer a distraction when anxious thoughts take over.

Sensory toys such as fidget toys, noise-cancelling headphones and weighted blankets can offer in-the-classroom support for overstimulated children to self-regulate their emotions positively.

Physical Activity

Structured play times offer another opportunity to allow pent-up energy to be let out and opportunities for supporting adults to role-model social skills.

Supporting a child that has SEN needs such as SEMH requires a comprehensive approach that combines emotional, behavioural and education interventions, all tailored to the child’s needs.

A better understanding of SEMH as a whole and the SEMH needs of the child you are working with will provide you with opportunities to empower the child to develop self-awareness, social skills, relationship skills and strategies they can use to self-regulate. These skills you can teach children will allow them to thrive academically and personally and help to develop the child as a whole.

What are examples of SEMH needs?

Examples include difficulty regulating emotions, anxiety, attachment issues, social isolation, and low self-esteem.

How can teachers support students with SEMH?

Teachers can provide emotional literacy activities, structured routines, clear expectations, relaxation techniques, and build strong, supportive relationships.

Is SEMH a special educational need?

Yes. In the UK, SEMH is classified as a type of Special Educational Need (SEN), and schools have a duty to identify and support pupils with SEMH needs.

What causes SEMH difficulties?

Causes can include trauma, poor attachment history, adverse life experiences, social exclusion, and family dynamics.

Can SEMH needs change over time?

Yes. With appropriate support and interventions, children can develop coping strategies and improve their social-emotional wellbeing over time.