A50Delivery risk: AmberGate: pending
Test mental-health support in schools
Existing action A50, assessed at the same scope.
Provisional single-reviewer assessment; not an approved business case.
- Who and where
- Children and young people in schools and colleges in England, especially those not yet covered and those whose needs are more than mild to moderate. (from the action record) Jurisdiction: England.
- Result so far
- Range if completed: 15.0–21.0 out of 30 (equal weights; not yet assessed: expected incremental benefit (Bn), incremental affordability (Co))
- Funded now (baseline)
- Teams covered 60% of pupils and learners in 2025–26, and the Spending Review 2025 commits to every school by 2029–30. The proposal is to make the remaining roll-out evaluable and to fill the needs gap, not to start a new service. (from the action record)
- The change assessed (marginal)
- A comparison-based evaluation and a route for greater needs. (from the superseded 4 October selection table)
- Domain home: Health
- In the national plan: Wellbeing list
What the evidence supports—and the next decision
More school mental-health coverage is not itself evidence of improved health or timely specialist care.
AI-assisted analytical follow-up · 8 October 2026. Proposed appraisal design; the attributed scores below are unchanged. No funding or delivery agreement is implied.
- Define the change
- Specify the practitioner offer, schools and referral gap beyond commissioned provision; establish an escalation agreement before expanding access.
- Test whether it works
- Validated symptom and functioning measures, waiting time, deterioration and referral completion against comparison schools or phased rollout.
- Establish the cost
- Practitioner time, clinical supervision, teacher time, referral capacity and follow-up. Cost displaced specialist activity.
- Protect against harm
- Safeguarding, consent and specialist escalation must remain available; screen for unequal access and unmet severe need.
Read with the outcome evidence and sources in the full assessment. Monitoring proposals are not existing baseline measurements. A numerical benefit or cost score needs evidence for the defined increment, not just the scale of the problem.
Full assessment of Test mental-health support in schools: ten criteria, scenarios, delivery, costs and monitoring
The ten criteria (0–3)
Each criterion is scored 0 to 3 by the reviewer. “Not yet assessed” means unknown: it is never counted as zero.
Scale and severity (Sc)2 of 3 — Serious harm to a defined group or widespread moderate harm
Reviewer’s reason: Provisional problem-importance judgement from linked site pages; not the scale of achievable benefit.
Increment beyond baseline (Ad)2 of 3 — Specific material change to existing delivery
Reviewer’s reason: Specify intervention and referral threshold; secure qualified staff and escalation to specialist care; evaluate outcomes. A missing rating requires a defined marginal change.
Confidence in the proposed action (Ev)1 of 3 — Indirect, mixed, modelled or weak causal support
Reviewer’s reason: Artifact describes early implementation evidence without a comparator; universal classroom programmes and targeted treatment differ.
Expected incremental benefit (Bn)Not yet assessed
Reviewer’s reason: Unknown unless a reasonably defined target-population benefit can be judged; no bonus merely for spanning domains.
Residual harms (Hm)2 of 3 — Manageable harm with specified safeguards
Reviewer’s reason: Over-referral, unmet specialist demand and inappropriate intervention.
Incremental affordability (Co)Not yet assessed
Reviewer’s reason: Practitioner time, supervision, specialist referrals, school time and follow-up.
Delivery capacity (Ca)1 of 3 — Binding scarce resource
Reviewer’s reason: Specify intervention and referral threshold; secure qualified staff and escalation to specialist care; evaluate outcomes.
Distribution (Fa)3 of 3 — Benefits concentrated on disadvantaged people with assessed burdens
Reviewer’s reason: Provisional distribution judgement for the stated target; verify who pays, who gains and excluded groups.
Meaningful first outcome (Ti)2 of 3 — More than one and up to three years
Reviewer’s reason: First meaningful outcome, not announcement: Symptoms, functioning, attendance and equitable access; unmet severe need.
Readiness (Rd)2 of 3 — Named commissioning/allocation/coordination step
Reviewer’s reason: Education and health commissioners, schools and providers; Evaluate defined care pathway
Four weightings
Normalised as 10 × weighted sum ÷ sum of weights, on a 0–30 scale. Where a criterion is not yet assessed, the range is the lowest and highest result if it were later scored 0 or 3 — not a score, a confidence interval or a rank.
- Equal weights: Range if completed: 15.0–21.0 out of 30. Not yet assessed: expected incremental benefit (Bn), incremental affordability (Co). Funding gate: not passed.
- Evidence doubled: Range if completed: 14.5–20.0 out of 30. Not yet assessed: expected incremental benefit (Bn), incremental affordability (Co). Funding gate: not passed.
- Scale doubled: Range if completed: 15.5–20.9 out of 30. Not yet assessed: expected incremental benefit (Bn), incremental affordability (Co). Funding gate: not passed.
- Cost ignored (the funding gate still applies): Range if completed: 16.7–20.0 out of 30. Not yet assessed: expected incremental benefit (Bn), incremental affordability (Co). Funding gate: not passed.
Funding gate: Not passed — the cost is not yet assessed or no allocation is committed for this scope. Ignoring cost in a weighting never removes the gate.
Delivery risk and gate
Delivery risk shown: AmberReview’s claim: Amber. Best the recorded evidence allows: Amber.
Review’s reason: Practitioner time, supervision, specialist referrals, school time and follow-up.
Why it is not Green yet
- Scope (population, place and increment) not verified against the delivery baseline.
- No verified owner with the powers in place.
- Delivery capacity not verified.
- Lifetime incremental costs not complete.
- No credible funding (a committed allocation for the scope).
- Safeguards not specified.
- Monitoring lacks a metric, a data source or a baseline.
Green needs verified scope, a verified owner with the powers, verified capacity, complete lifetime costs with credible funding, specified safeguards and monitoring with a metric, source and baseline. Amber means appraisal gaps remain; Red means a material delivery obstacle. Red does not mean unimportant.
Gate: Pending — appraisal incomplete (review label: “Pending: incomplete appraisal”).
Why: Scores incomplete; Funding gate not passed (cost unknown or no credible funding).
The gate is separate from national list membership: being listed does not make an option eligible, and an eligible option need not be listed.
Cost and funding
Lifetime costing: Not established. Review: “Full incremental costing not established in reviewed material”.
- Mental Health Support Teams: roll-out to every school and college in England by 2029–30 (not costed; C-MHST-ROLLOUT)
- Comparison-based outcome evaluation of the remaining roll-out, and specialist support for needs beyond “mild to moderate” (not costed; C-A50-EVAL)
Still to cost: Practitioner time, supervision, specialist referrals, school time and follow-up.
Funding status: programme route, not allocated.
Owner, powers and capacity
Proposed owner: Education and health commissioners, schools and providers (proposed, unverified).
Powers: needs a decision or allocation. Capacity: binding constraint.
Powers and capacity read from the review’s Rd and Ca anchors; no proposed owner has agreed to act (the review: “Proposed owners have not agreed to act”).
- England:
- NHS England and integrated care boards with DfE, schools and colleges (action record)
- Scotland:
- not assessed
- Wales:
- not assessed
- Northern Ireland:
- not assessed
Mental Health Support Teams are an England programme; Scotland, Wales and Northern Ireland run their own school counselling and wellbeing services, not assessed here.
Dependencies, safeguards and risks
Depends on: None recorded.
Safeguards
None specified yet.
Risks and residual harms: Over-referral, unmet specialist demand and inappropriate intervention.
Monitoring and measured results
Metric: Symptoms, functioning, attendance and equitable access; unmet severe need.
Data source: Not yet named. Baseline: Not yet established.
Measures already on the domain page
- 16–24-year-olds with a common mental health condition: latest 25.8% (2023/4); baseline 17.5% (2007) (England).
A page measure is not necessarily the review’s metric; linking the two is an editorial decision still to be made.
Evidence for the outcome
Outcome: Symptoms, functioning, attendance and equitable access; unmet severe need.
Artifact describes early implementation evidence without a comparator; universal classroom programmes and targeted treatment differ.
Effect records for this action
- Children’s mental health and timely access to support: size not established (plausible spillover, limited confidence; England)
SWOT points it addresses
- 25.8% of 16–24-year-olds had a common mental health condition in 2023/4, against 17.5% in 2007. (Health)
- School mental health teams are being rolled out to every school by 2029–30 without a published measure of what they change for children, so a national service could be complete before anyone knows whether it works. (Health)
Review record
Assessment status: Provisional single-reviewer assessment; not an approved business case.
Reviewer: Original assessment author (name not supplied). Reviewed: 6 October 2026.
Scored in the working review of 6 October 2026 on the shared ten-criterion scale (one reviewer); not independently calibrated.
First 90 days (review): Produce a signed scope and current-delivery baseline; Specify intervention and referral threshold; secure qualified staff and escalation to specialist care; evaluate outcomes. Obtain incremental costs and an accountable decision before expansion.
Decision route: Evaluate defined care pathway
An earlier assessment exists on the 4 October 2026 selection table (nine H/M/L bands; superseded 7 October 2026). Its bands are kept, not converted into these scores.
An editorial screening framework by one reviewer, not a formal appraisal or business case. Proposed owners have not agreed to act.