Mental health teams face 'moral dilemma' as schools struggle with 'missing middle'

Mental health support teams are facing "moral dilemmas" over which children to help as demand outstrips capacity, leaving schools struggling to support pupils who fall into the "missing middle." The "missing middle" refers to children whose mental health needs exceed what schools can provide through universal support, yet who do not meet the increasingly high thresholds for specialist Child and Adolescent Mental Health Services (CAMHS). This creates an "insidious" position for schools, which must navigate the gap between what vulnerable pupils require and what statutory services can deliver. The situation highlights the urgent need for system-wide solutions and adequate resourcing to ensure children do not fall through the cracks between universal provision and specialist mental health services, protecting both pupils and the professionals supporting them.