Social, Emotional & Mental Health

Overview

Social, Emotional and Mental Health (SEMH) is one of the four broad areas of special educational need. In England, over 350,000 children are identified with SEMH needs. These pupils may demonstrate a wide range of presentations, from withdrawn and isolated behaviour to disruptive hyperactivity.

The term SEMH replaced the earlier category of Behavioural, Emotional and Social Difficulties (BESD) in 2014. The word 'behaviour' was deliberately removed to encourage professionals to focus on the underlying emotional, social and mental health issues that drive what we observe.

A DfE rapid evidence review (2025) confirmed what educators and psychologists have long understood: behaviour should be regarded as communication and a clue that something is wrong. When a child struggles with social, emotional or mental health, their behaviour is their way of showing us they need help.

Contemporary understanding: SEMH needs are best understood and supported through a trauma-informed and relational approach. Many children with SEMH have experienced Adverse Childhood Experiences (ACEs) such as abuse, neglect, household dysfunction or bereavement. These experiences affect brain development, stress responses and the ability to regulate emotions and behaviour.

A relational approach prioritises safe, trusting relationships with consistent adults. It recognises that children co-regulate with the adults around them before they can self-regulate.

How Difficulties May Present

At a Personal Level

Low self-image, anxiety, depression, withdrawal, difficulty with emotional regulation, resentment or defiance.

At a Verbal Level

The child may be very quiet or, conversely, may use inappropriate language, threaten others, or struggle to express their feelings verbally.

At a Non-Verbal Level

Clinging, truancy, failure to observe social rules, disruptiveness, destructiveness, aggression or violence.

At a Work Level

An inability or unwillingness to work without direct supervision, to concentrate in order to complete tasks, or to follow instructions.

Internalising Presentations

These behaviours are often described as 'passive' but represent significant distress that may be less visible to adults.

Anxiety and worry
Low mood or depression
Withdrawal or isolation
Avoiding risks or challenges
Unable to make choices
Low self-worth or shame
Refusing to accept praise
Failure to engage with learning
Poor personal presentation
Lethargy or apathy
Daydreaming or dissociation
Difficulty making or maintaining friendships
Speech anxiety or reluctance to speak
Task avoidance
Physical symptoms (stomach aches, headaches)

Externalising Presentations

These behaviours are often more visible and may be labelled 'active' or 'challenging'. They communicate distress through outward expression.

Challenging behaviours
Restlessness or over-activity
Non-compliance
Mood swings
Impulsivity
Physical aggression
Verbal aggression or shouting
Hypersensitivity to perceived injustices
Disproportionate emotional reactions
Difficulties with change or transitions
Absconding or running away
Eating issues
Difficulty understanding others' perspectives
Lack of personal boundaries
Poor awareness of personal space

Trauma-Informed and Relational Strategies

Contemporary best practice emphasises understanding the root causes of behaviour and building relationships before focusing on behaviour management.

Relational Foundation

Build trusted relationships through consistent, warm interactions
Prioritise connection over correction
Use co-regulation: stay calm and regulated yourself so the child can borrow your calm
Notice and name feelings: 'I can see you're feeling frustrated'
Validate emotions before addressing behaviour: 'It's okay to feel angry, and I need you to keep your hands safe'

Predictability and Safety

Establish predictable routines and give advance warning of changes
Create safe spaces where pupils can go to calm down without shame
Use visual timetables and transition warnings
Reduce sensory overload where possible
Ensure the pupil knows which trusted adults they can go to for help

Positive Communication

Focus on the positive: notice and praise good behaviour and effort
Use positive directions: say what you want, not what you do not want
Give regular rule reminders and explain why rules keep everyone safe
Refocus with casual questions rather than drawing attention to misbehaviour
'When...then' language: establish a reward in exchange for task completion
Acknowledge and redirect: 'I understand you want to talk to your friends and I want you to finish this first'

Supporting Regulation

Teach and practise calming strategies when the child is calm
Offer choices to restore a sense of control: 'You can choose to work quietly or you can choose to work in the quiet area'
Use intentional ignoring for minor attention-seeking behaviours
Give time and space: walk away to allow the pupil time to choose and comply
Break tasks into small steps to reduce overwhelm
Allow movement breaks and sensory regulation tools

Consequences and Boundaries

Follow through with agreed consequences consistently and calmly
Keep consequences relational and restorative, not punitive
Stay focused on what you want and do not get drawn into side issues or power struggles
Repair relationships after incidents: 'We're okay. Let's try again.'

How Teaching Assistants Can Help

Build a warm, trusting relationship with identified pupils
Learn the pupil's triggers and early warning signs of dysregulation
Use proximity and calm presence to support regulation
Accompany pupils who need time to cool down to a calm, safe space
Use co-regulation: remain calm, lower your voice, slow your pace
Keep records of incidents and patterns to identify triggers and early warning signs
Monitor pupil progress towards their personal targets
Administer any agreed reward systems
Check in regularly to keep the pupil on task without being intrusive
Seek help from a colleague if a pupil is in crisis or refuses to leave the room
Support re-integration after an incident without shame or blame

Related Resources

Supporting Dysregulation

Understanding emotional dysregulation

Dysregulation & PACE

The PACE Approach

Playfulness, Acceptance, Curiosity, Empathy