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The role of the school nurse in supporting school-age children with mental health difficulties: an integrative review

02 June 2022
26 min read
Volume 3 · Issue 3


In the context of rising mental disorder prevalence among school-age children and increasing pressures on services to deliver effective and efficient interventions, school nurses have been identified as a key workforce to clinically support school-age children with emerging mental health difficulties and existing mental health diagnoses.


This review aims to identify and critically analyse existing academic literature, in order to ascertain the current role of the school nurse in supporting school-age children with emerging mental health difficulties and existing mental health disorders. In doing so, this integrative review makes recommendations for future research and discusses implications for nursing practice.


An integrative review methodology was used in order to conduct a systematic review of the literature, in conjunction with the PRISMA (2009) guidelines. CASP tools were used to critically appraise the selected papers, and the findings were tabulated in order to identify emerging themes.


289 papers were found through database searches, and six papers were identified as relevant to this literature review. Although these papers were preliminary in nature, clear themes were identified across the selected papers. School nurses were found to be uniquely placed to support school-age children with emerging mental health difficulties and existing mental health diagnoses. However, barriers to effective interventions included school nurses' lack of knowledge and lack of resources within school nurse teams.


The lack of training and knowledge for school nurses within this clinical subject area is an urgent cause for concern, and future research and practice development is strongly recommended.

Mental health disorder prevalence among children and young people has risen worldwide in the last decade, with evidence to suggest that 75% of mental health disorders have a paediatric aetiology (Department of Health, 2015; Office of National Statistics, 2018). This trend is likely to have been compounded by the SARS-CoV-2 pandemic and the resultant international response (Singh et al, 2020). The pandemic has increased children's risk of isolation, exposure to online bullying, domestic violence and abuse, while necessitating the removal of critical protective factors such as school attendance, social support, and access to therapeutic services (Mansfield et al, 2021; Singh et al, 2020). Therefore, it is likely, as many children internationally have returned to school, that the negative impact upon their mental health will require proactive identification and increased support.

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