Enhancing mental health support in schools: information

Through the EMHSS initiative, secondary students at Victorian government schools have easier access to counselling services offered by headspace.

Students can access EMHSS-supported counselling services via a referral made through a central contact person within and nominated by the school (e.g. a wellbeing coordinator or similar), or by being referred by themselves, a parent, or guardian.

To be eligible for this service, students must be:

• enrolled at a Victorian government secondary school at the time of referral; and
• experiencing mild to moderate mental health issues.

EMHSS services are available during school holidays. During these periods students can contact headspace directly to arrange an appointment.

For school-based referrals, the central school contact person must ensure:

• the student meets the criteria above; and
• the student is a mature minor and written consent has been received by the student; or
• written consent has been received from a parent/carer of a student for the referral and counselling service to take place, if the student is not deemed a mature minor.

In accordance with Department information and policy on decision making by mature minors, assessing whether a student is sufficiently mature to give their own consent to be referred to counselling services or receive counselling services is the responsibility of a principal or principal’s nominee. Nominees may include wellbeing staff or another nominated staff member, depending on the decision to be made.

Refer to Department information and policy on decision making by mature minors for more information.

To give informed consent, a student must have sufficient understanding and intelligence to enable them to fully understand what the referral and counselling service involves, what it is for, and why it is recommended to them as an individual. If the principal or nominated school support person decides the student is not a mature minor for the purpose of these decisions, their parents or carers will be informed and their consent will be sought prior to commencing any counselling.

The student or their parent/carer should be informed of the following before consent is sought:

• The appointment is an opportunity for the student to talk about their concerns with a clinician, in a safe and confidential setting.
• The appointment is provided by a clinician who will ask questions about the student’s presenting issues and provide appropriate support. This appointment will take approximately 45 minutes, with some time at the end to provide feedback to the referrer and book in further appointments as appropriate.

The first appointment will involve:

• the clinician ensuring that the student understands and consents to the referral to headspace and consents to receiving counselling services. The clinician will also ensure that the student understands the limitations to confidentiality and how information may be provided to others under specific circumstances;
• undertaking an assessment of need including a risk assessment;
• managing and responding to any issues of risk;
• making a clinical decision about the best way to support the young person (whether through this initiative or other avenues);
• booking the young person into another appointment dependent on need and availability
• offering feedback, strategies and tools to the student (and with the student’s permission, to the school and parents/carers to help support the student).

Further appointments will involve:

• identifying the issue/s of concern to be addressed;
• providing counselling and support to the student;
• offering feedback, strategies and tools to the student (and with the student’s permission to the school and parents to help support the student);
• making a clinical decision in collaboration with the student about further

Consent may be withdrawn at any time by the student or parent/carer. This may occur because the student no longer feels that they require counselling services or that they no longer wish to receive counselling support.

See the consent form for further details.

What happens where consent is not provided by a parent/carer?

Parents/carers should be informed about the counselling services on offer through school communications e.g. school newsletter. Information about the initiative should also be included on the school’s website where possible.

If a parent/carer informs the school that they do not want their child to access the counselling services, the school contact/principal should consider whether the student is a mature minor for the purposes of receiving counselling. They should also consider the reasons the parent/carer has given. The Legal Division should be contacted for further advice.

Confidentiality refers to the ability of students to ensure information discussed with headspace is not shared with others unless it is with the consent of the student or it is otherwise required or permitted by law.

It is important that confidentiality is discussed prior to referral and students understand that the sessions are confidential. This means that the clinician will only discuss what has been discussed in the counselling sessions with other people such as the school, family or other health professionals if given permission by the student.

In instances where this occurs, the clinician and student will agree together about what information (and how much detail) is provided to others.

The following exceptions to the duty of confidentiality will apply:

• The student or their parent/carer consents to the
• The disclosure is necessary to lessen or prevent a serious and imminent threat to any person’s life, health, safety or welfare.
• The disclosure is necessary to prevent a serious threat to public health, safety or welfare.
• There is another legal requirement for the disclosure, such as where production of documents is required by a subpoena.
• If the student is not a mature minor, information may be shared with a parent/carer.

Students and their parents/carers at participating schools will have access to detailed information sheets through their school contact and via headspace.

The school contact person should try to have the following basic information. For students who self-refer, the school contact will still be required to confirm all information requested below, with the exception of presenting issues/reason for referral, which the student is not required to share with their school contact:

1. Confirmation of consent form completion*
2. Student first name and surname
3. Student Date of Birth
4. Student personal telephone number and email address, home address or address where they will be located during counselling session and the contact details of a trusted adult (for voice or video conference appointments)
5. Suburb where the student resides
6. School name
7. Referrer first name and surname
8. Referrer role (can include self-referral)
9. Referrer contact details (email and phone numbers)
10. Brief description of presenting issues / reason for referral.**

*Please note that it will not be possible to proceed with a referral to this initiative unless either parent/carer consent or student consent for those deemed to be a mature minor has been obtained.

** Note that information regarding presenting issues may be limited for self-referrals and this will therefore be obtained from the student by the headspace clinician in the initial appointment.

Counselling via a participating headspace centre

The school contact person, student, or other person making the referral must call the number provided for their participating headspace centre during normal business hours. The headspace worker will then book the student in to the next available appointment for an intake session with a clinician.

For all referral methods, a school contact person is needed to ensure that the student can attend their appointment time and that they can support the student to access the appointment. This includes managing a student’s absence for the purpose of attending a counselling appointment or confirming that the student has access to a phone and a safe and confidential space for a remote appointment to take place.

As per the consent form, headspace will require the student’s personal phone number and email address, the address where the student will be located during the appointment and the contact details of a trusted adult, in the event that there are risk or safety concerns during the voice or video conference session and they require face to face support to ensure their safety.

To find your school's participating headspace centre visit headspace.org.au/headspace-centres.

Regional Telehealth Counselling Service

The school contact person, student, or other person making the referral must call the dedicated and direct phone line on 1800 959 050 between 9am and 4pm Monday to Friday during school term to book in an appointment.

If the session is taking place on school grounds it is important that the school provide a safe and confidential space and that school staff facilitate access to a phone. If the appointment is taking place in a remote learning environment, the school contact person should confirm that the student has access to a phone or computer, and provide advice on finding a safe and confidential space for the appointment to take place.

As per the consent form, headspace will require the student’s personal phone number and email address, the address where the student will be located during the appointment and the contact details of a trusted adult, in the event that there are risk or safety concerns during the phone session and they require face to face support to ensure their safety.

For appointments taking place at school, schools are encouraged to establish a counselling area within the school environment to allow safe access to the telephone counselling service. The counselling room is required to be a confidential, safe, quiet and comfortable environment. For further tips on creating this space, please refer to the Best Practice Guide – Establishing a counselling area in Victorian government schools to access the headspace Victorian Regional Telephone Service.

School absence for the purpose of attending counselling sessions

A fundamental element to the success of the EMHSS initiative is the ability for students to access confidential counselling services. This must be balanced with a schools’ duty of care obligations (see further information below), and the need to continue to monitor student absences, provide adequate supervision of students and maintain appropriate records.

When managing student absences from class for headspace appointments, schools must ensure the confidentiality of the student is prioritised - this is of particular importance in relation to parents or carers in the case of mature minors.

Schools are encouraged to establish protocols that suit the school’s unique context and existing systems, whilst maintaining the confidentiality of the student.

If documenting a student’s absence from class to attend a headspace appointment, the Department recommends the school notes only that the student is ‘Attending a Health and Wellbeing Appointment’ in student management software (if used) and that any specific reference to the details of their appointment, including that it is with a headspace clinician, is avoided.

Students should be able to discreetly attend headspace appointments without other staff members (other than those who need to know), students, or other members of the school community being informed or aware of their attendance at the appointment.

All staff (including casual relief teachers and specialist teachers) should be familiar with the school’s protocols to ensure students do not have to make a case for their absence each time they have an appointment.

Examples of effective systems may include:

• informing those teachers who need to know at the start of the school day, which students have been granted leave for a headspace appointment
• providing students with discreet real time appointment reminders
• updating appointment information throughout the day and communicating this information to teachers who need to know without delay.

At a student’s first appointment at headspace (either by phone or face-to-face), the clinician will seek consent for participation in the counselling session by asking the student how they feel about being in the session, and confirm that they are attending voluntarily.

The school contact person should assist the student to engage with the process of further EMHSS appointments and actions as required.

The school contact person should also be available for feedback at the completion of the appointment, or at another time, so that the headspace clinician can provide feedback about the appointment and further appointments if appropriate.

Will headspace share information with the school?

Conversations between headspace and the student will be confidential and not shared with others (including the wellbeing team at the school) unless:

• it is with the consent of the student (if they are a mature minor), or their parents/carers (if the young person is not a mature minor); or
• the disclosure is otherwise permitted or required by

The following are examples of when headspace may share information with the wellbeing team at the school:

• The student consents to the
• The disclosure is necessary to prevent a serious threat to public health, safety or welfare – for example, the student has an infectious disease and the disclosure is necessary to limit or prevent the impact that this may have on others in the school community.
• The disclosure is necessary to lessen or prevent a serious and imminent threat to any person’s health, safety or welfare, such as:
  • The student is at imminent risk of harming themselves; or
  • The student is at imminent risk of harming others.

Principals and teachers are held to a high standard of care in relation to students.

Whenever a teacher-student relationship exists, teachers have a special duty of care. Generally, teachers are expected to take such measures as are reasonable in the circumstances to protect a student under their charge from reasonably foreseeable risks of injury. The nature and extent of this duty will vary according to the particular circumstances.

A school’s duty of care is ongoing and schools should work closely with the student and parents/carers to ensure that even where a student has been referred to headspace, the school continues to monitor and provide ongoing support, consistent with these duty of care obligations.

For further information and Department policy relating to duty of care, please click here.

If schools require legal advice on any duty of care issues, please contact the Department’s Legal Division on 9637 3146 or at legal.services@education.vic.gov.au.

The Department of Education has a range of resources, guidance and programs available to promote and support mental health in schools. Visit the Mental Health Toolkit for more information.