When a pupil's behaviour is connected to their mental health, a decision to exclude becomes more complex. Headteachers must carefully consider their duties under the Equality Act 2010 and the safeguarding framework before deciding to suspend or exclude. 

These 10 top tips draw on DfE guidance to help school leaders navigate this area lawfully, proportionately and with the pupil’s welfare at the centre.

Top tip 1: Ask whether mental health is driving the behaviour before reaching for a sanction

Behaviour that appears disruptive, withdrawn or anxious may be linked to an underlying mental health problem. Pupils with depression, anxiety, ADHD and autism are typically most at risk, and withdrawn pupils' needs may go unrecognised. Before responding with suspension or exclusion, ask: could this be a sign of an unmet mental health need?

Don't delay putting support in place while gathering further evidence. The pupil's response to support may itself help identify their needs. It's not the school's role to diagnose, but it is the school's role to observe, identify concerns, put pastoral support in place promptly and refer to appropriately trained professionals such as school nursing, educational psychology, Mental Health Support Teams (MHSTs) or children's mental health services.

Top tip 2: A formal diagnosis is not required before your legal duties kick in

This is one of the most common misunderstandings. Where a pupil has a disability that adversely affects their behaviour, the school must consider reasonable adjustments to its policies (including behaviour and exclusions policies), physical environment, level of support and response to particular situations. The duty arises from the nature and effect of the condition, not from a formal diagnosis.

A mental health condition may amount to a disability under the Equality Act 2010 where it has a substantial and long-term adverse effect on the pupil's ability to carry out day-to-day activities. 

Don't wait for a CAMHS letter or GP referral before considering whether Equality Act duties are engaged, and don't require a clinical diagnosis before putting pastoral support in place. While schools should not routinely require medical evidence for a mental health-related absence, evidence may be appropriate for long-term or repeated absences where it will help assess support needs.

Top tip 3: Make reasonable adjustments and document them properly

Applying a behaviour policy identically to every pupil may be unlawful if a pupil's disability makes it harder for them to comply. Schools must consider whether the pupil's behaviour arises from, or is materially affected by, the disability before deciding what action to take and, if so, make reasonable adjustments to behavioural expectations and sanctions.

Reasonable adjustments are not a tick-box exercise. They must be assessed individually and could include providing a trusted adult or key worker, offering access to a quiet space, modifying transition arrangements, adjusting timetables, uniform or lunchtime expectations, a phased return following absence, or providing smaller examination settings or sensory aids. Every adjustment should be identified through individual assessment and agreed in writing with the pupil and their parents or carers, assigned to a named responsible member of staff, given a clear review date and updated as needs change.

Top tip 4: Involve parents and carers early and record their views

Subject to any safeguarding concerns, early and sensitive engagement with parents and the child in identifying barriers, agreeing support and reviewing arrangements is both good practice and a DfE expectation. 

Support isn't always accepted or engaged with, which can be frustrating for schools. Give parents and carers a clear explanation of the school's concerns and the proposed plan so they can help encourage the child’s engagement. If parents aren't engaging, tell them anyway so they can't later claim they didn't know what the school was doing to support their child.

Top tip 5: Consult your SENCO, DSL and, where relevant, the local authority before deciding

Exclusion decisions involving pupils with mental health difficulties or SEND should not be made in isolation. Changed behaviour, withdrawal, self-harm, anxiety and unexplained absence may indicate not only mental health need but also abuse, neglect, exploitation or other safeguarding concerns. 

Where behaviour involves a safeguarding concern or the child has SEND, review the pupil's safeguarding record and assess whether appropriate provision is in place. Consider a multi-agency assessment involving the SENCO, DSL, senior mental health lead and relevant external agencies.

For pupils with an EHC plan consider whether the plan adequately addresses the pupil's current needs, check whether all provision under the plan is being delivered and consider whether an annual review should be brought forward.

For looked-after and previously looked-after children, the designated teacher and, where appropriate, the Virtual School Head should be informed at the earliest opportunity. Their advice should be considered when developing strategies to reduce the risk of suspension or permanent exclusion. For children with a social worker, repeated or prolonged absence may be a warning sign of safeguarding concerns and must be addressed through the school's attendance and safeguarding procedures.

Top tip 6: Don't use a part-time timetable as an alternative to exclusion

A reduced timetable carries litigation risk and should only be used in very exceptional circumstances where a medical condition (including a mental health condition) prevents full-time attendance. It must be agreed in writing with parents, have a clear purpose, a time limit, regular reviews with the pupil and parents or carers, and a plan to return to full-time education. A part-time timetable must not be used to manage behaviour.

Top tip 7: If a pupil is likely to miss more than 15 school days, notify the local authority

Whether absence arises from illness or exclusion, schools have a specific notification duty where a pupil is likely to miss more than 15 days of school. Notifying the local authority may trigger the local authority’s responsibility to arrange alternative provision under section 19 of the Education Act 1996. The local authority must consider the individual circumstances and should not apply an inflexible requirement for medical evidence.

Top tip 8: If exclusion is unavoidable, follow the statutory procedure precisely

If, having exhausted all reasonable alternatives, exclusion is still considered necessary, the headteacher must comply fully with DfE’s statutory exclusions guidance. 

The decision must be lawful, reasonable and fair, supported by a clear written record explaining the relevant evidence, adjustments considered, safeguarding issues and reasons for the decision. Good contemporaneous records are essential for the pupil's benefit and the school's legal protection.

Disciplinary action and pastoral support are not mutually exclusive and may need to run alongside one another. Permanent exclusion should be a last resort, but the school must act where necessary to protect other pupils and staff and to maintain a safe educational environment.

Top tip 9: Watch your language

Language matters. Framing a pupil as 'refusing' to attend, 'choosing' to be anxious or 'playing the system' may reflect a misunderstanding of the pupil's condition, generate an inappropriate response and expose the school to discrimination claims. Parents are increasingly making subject access requests for information held by schools, which means staff emails expressing opinions could be disclosed.

DfE guidance consistently uses neutral, barrier-focused language: 'barriers to attendance', 'anxiety about attending', 'social, emotional and mental health needs'. Use this framework in communications with pupils, parents and carers, and in all written records.

Top tip 10: Don’t dampen expectations

High expectations for attendance and behaviour can and should be maintained. The DfE advises that prolonged absence can itself increase future anxiety, making it harder for the pupil to return. That's precisely why early intervention and maintained contact matter so much.

The right approach is always support first, with suspension or permanent exclusion considered only after the school has addressed relevant contributing factors. Ask: do the mental health issues provide mitigation for the behaviour, or have sufficient interventions been tried but to no avail?

Schools that approach this area carefully, lawfully and with the pupil's welfare genuinely at the centre will be best placed both to support their pupils and to defend their decisions if challenged.

External resources

• Promoting and supporting mental health and wellbeing in schools and colleges (GOV.UK)
• Summary of responsibilities where a mental health issue is affecting attendance (DfE)
• Keeping children safe in education (GOV.UK)
• School suspensions and permanent exclusions (GOV.UK)