A safe place for sad children

The Place to Be, a network of therapists based in London schools, offers a lifeline to pupils in distress. Barbara Lantin reports
When a child at school snatched Adam's toy the other day, the nine-year-old burst into tears. Instead of upbraiding him for immaturity, his psychotherapist gave him a hug. It was the first time Adam had cried since discovering his mother dead from a drugs overdose six months before.

Adam's trauma had come to nobody's attention until he began attempting to break into cars and set fire to buildings. When psychotherapist Camila Batmanghelidjh made a home visit, she found the child living with his alcoholic stepfather in complete squalor. "There was mould on the walls and a week's washing-up in the sink. It was horrendous."

Adam was taken into care and is now being looked after by a foster family. Equally important, he is seeing a therapist three times a week in school and is beginning to face up to his loss. He doesn't actually realise he is in therapy. As far as he is concerned, he is visiting his "Place to Be" friend.

The Place to Be is a network of therapists of different kinds working in primary schools with children who have difficulties ranging from divorcing parents and dyslexia to bereavement and bullying. However, the organisation defies simple explanation. At one north London school alone, 50 volunteers work with individuals and groups at different times. Each therapist is labelled with a bright yellow badge proclaiming them to be a P2B.

Camila Batmanghelidjh, the exuberant and dynamic linchpin of The Place to Be, started the project after seeing a suicidal seven-year-old girl. Laura had tried to kill herself both in school and out - by pulling a plastic reading folder over her head and wrapping a towel around her neck to exclude the air, by hanging from her bunk and by throwing herself in front of cars.

"Her mother could not keep appointments at the Child Guidance Clinic because of her other children, so I took a little suitcase full of toys to her school and started seeing her twice a week. She was a silent child who stared you out. It turned out she had been abused in the most appalling way over two years by the father of a friend. I asked the head if I could set up a room in the school for other children. He was very concerned and sympathetic. Laura is nine now and no longer wants to die."

Today, The Place to Be has more than 100 trained and training therapists working in seven London schools with several hundred children. At Carlton primary school in north London, evidence of the organisation is everywhere. The walls, once a drab, institutional cream, are splashed with brilliantly coloured murals depicting sea creatures, gardens and smiling faces. Therapy rooms with names like The Den and The Seaside (it's near the swimming pool) have appeared where there were store cupboards and boiler rooms. Once The Place to Be arrives on the scene, nothing is quite the same again.

Because of this high profile, there is no stigma attached to talking to a P2B. As a result, many children self-refer. "Most of our business happens in the school corridors," says Camila. "Children will look out for a particular volunteer and establish eye contact. The next week, they will wave at them. Then perhaps they will come up and do a joke. When they feel secure, they will ask if they can come and see them."

If this implies a casual approach, the reality is different. Each volunteer is interviewed in detail and carefully matched to the client. Each undertakes to see their child at a pre-arranged time every week for at least a year and will collect them from and return them to the classroom.

This commitment is vital for children who until now may only have experienced transitory relationships with adults. In return, the volunteer receives free twice-weekly supervision with a qualified psychotherapist.

The guarantee of confidentiality is also critical. Unless the child is at risk, nothing discussed in the therapy room is passed on. The existence of this "special friend" who will not snitch is hugely valued by pupils.

The range of problems - and solutions - is staggering. Laura was not the only attempted suicide. But the sad, detached children who attract no attention need help just as much. Sometimes, dealing with anxieties unblocks a learning difficulty. "Once the emotional baggage is removed, some children suddenly start to read," Camila reports. Much work is done with groups. "One of the most successful things we have run is the shy girls group. At the first session, there is complete silence - just lots of pairs of eyes. By the seventh session, they are standing on tables singing songs about themselves.

"I believe the mental health services, bogged down by lack of resources, have lost the capacity to be inventive and creative about the way they deliver. The most liberating thing you can say to some of these children is that there is no such thing as a bad child. Anything that comes across as negative is a way of defending themselves against painful feelings. Once they understand that - and realise you understand it - they begin to talk. Not long ago, a child asked for help because he wanted to stop bullying but did not know how."

Both teachers and pupils at Carlton speak enthusiastically about the difference The Place to Be has made to their school. Truancy, vandalism and bullying have decreased. Lorraine Sherr, consultant clinical psychologist at the Royal Free Hospital, who is conducting a long-term study of the project, says its presence has affected the whole institution, not merely individual children.

"Our early findings show The Place to Be makes the school a more caring environment," says Dr Sherr. "When one child is distressed, others come up with imaginative solutions instead of standing by and ignoring them or fetching a teacher. The project seems to teach them a way of coping emotionally which benefits the whole school. They are being given a new language of caring so they can recognise and articulate what they feel and think."

She also believes the project could provide a model for early intervention in behaviour problems. The Place to Be costs £15 per child per week compared with around £1,000 to keep a child in care and £492 in a young offenders institution. "Our research shows self-referral at this early age works. It is the most needy children who are being picked up. Normally, problems are only dealt with when they come to the attention of an adult. By making the help widely available, you are detecting hidden unhappiness before it bubbles up into something really big."

An estimated 2 million children suffer mental health problems in this country; the NHS has just 260 child psychotherapists. Expansion plans for The Place to Be are limited only by funding. A charity, it relies on voluntary donations and contributions from schools, but is awaiting the result of its application for a Department of Health grant. Permanent premises are being sought in south London to provide space for counselling parents and teachers, and an arts centre. It is hoped that Dr Sherr's work will produce a blueprint that could be adopted nationally.

"Every child could benefit from The Place to Be," believes Camila Batmanghelidjh. "Children who have been through the project are equipped to cope with life because we have given them a key to thinking about their difficulties in a way they can use in the future, no matter what those difficulties may turn out to be."