Breathing exercises won’t fix a broken system
The uncomfortable truth about schools, mental health, and the illusion of wellbeing
This week Martin & I discuss whether schools can do anything to adress the mental health crisis being experienced by many young people.
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We - and by we I do not, of course, mean most of those actually working in schools - have somehow persuaded ourselves that schools can mend what society has broken. As rates of adolescent anxiety, depression and self-harm continue their grim ascent, we reach not for the roots of this misery, but for the nearest sticking plasters: mindfulness sessions, gratitude journals, breathing exercises and an ever-expanding carousel of ‘wellbeing’ initiatives.
It all sounds terribly humane. Who could object to teaching children to regulate their emotions? But beneath the soothing language, something rather troubling is happening. In our desperation to be seen to do something - anything - we have mistaken performance for provision. We have reimagined mental health as a competency to be taught, a skill to be mastered, as if anxiety were simply the result of faulty cognitive habits rather than a rational response to the world we have made and in which young people have to live.
The figures ought to make us pause. According to NHS Digital’s 2023 survey, 20% of 8 to 16 year olds and 23% of 17 to 19 year olds in England are now identified as having a probable mental disorder. Among older teenagers, over a third of young women meet the threshold. Mind notes that self-harm and eating disorders are rising fastest among girls, while Peter Fonagy, Senior National Clinical Adviser on Children and Young People's Mental Health for (the now defunct) NHS England points out that these trends reflect not just greater diagnosis but greater distress. Poverty, housing insecurity, family breakdown, and unrelenting academic pressure. These are the forces shaping young minds, not a lack of guided breathing practice. The House of Commons Library confirms what those in schools already know: support services are overwhelmed, thresholds for help are impossibly high, and too many young people are left stranded.
A headteacher at a school I work with recently told me about a Year 9 boy who had been referred for school-based wellbeing support after struggling with low mood. His ‘intervention’ consisted of attending a weekly mindfulness group in a room decorated with soft cushions, pastel posters, and laminated affirmations: You are enough. After six sessions of breathing exercises, his attendance had fallen further, his anxiety worsened, and he was refusing to enter lessons altogether. When staff discussed the case, the suggestion was that he might benefit from more mindfulness. No one mentioned the fact that he was living in temporary accommodation, caring for a younger sibling, and weeks behind in multiple subjects.
Mindfulness, in particular, has become the snake oil of modern schooling: endlessly promoted, poorly understood, and largely unexamined. Children sit in circles, eyes closed, learning to breathe through their distress while the conditions fuelling that distress remain entirely unaltered. In many cases, we are teaching children to adapt themselves to systems that are fundamentally indifferent to their wellbeing.1
Even worse, these interventions risk individualising failure. If you’re still anxious after six weeks of emotional regulation lessons, the implication is clear: you’re not trying hard enough; the fault is yours. Thus responsibility for suffering is subtly shifted from the structural to the personal. It is not poverty, insecurity, or family breakdown that leaves you anxious, but your own inability to ‘self-care’ effectively.
These therapeutic approaches are often curiously post-hoc. First, we tell young people that they are fragile, vulnerable, and at risk. Then, when they struggle, we interpret their struggle as confirmation of precisely that narrative. In attempting to explain why they feel sad or broken, we may end up supplying them with the very scripts that sustain distress. The story becomes the evidence; the diagnosis becomes the identity.
And yet, for all the political capital invested, the research tells a stubbornly consistent story. Large-scale studies, including the Department for Education’s own Education for Wellbeing trial, repeatedly find that these universal interventions produce little or no lasting improvement in anxiety, depression or wellbeing. If anything, those most at risk benefit least. Recent studies from Andrews et al. (2022) and Seely et al. (2023) suggest that outcomes often depend more on pre-existing peer networks than on the interventions themselves: for the isolated or socially anxious, these sessions may inadvertently deepen a sense of exclusion.
Systematic reviews from Miller & Thabrew (2024) and McKenzie & Williams (2018) have raised further concerns. Many trials rely on short-term self-reporting, where children, primed to scan for emotional difficulties, begin to interpret ordinary discomfort as pathological. What begins as prevention slides into low-grade medicalisation. The very attempt to manage risk often ends up amplifying it.
The uncomfortable truth is that schools are not mental health services, and cannot be made into them by bolting on a few PSHE sessions. What protects children is not positive affirmations but coherent curricula, expert teaching, strong relationships and a culture that values academic success without fetishising it. Security comes not from safe spaces but from schools that are safe.
Of course, none of this offers the easy optics that wellbeing workshops provide. It is far easier to train staff in mindfulness techniques than to redesign assessment systems, rethink league tables, or acknowledge the corrosive effects of chronic underinvestment.
And so, we tinker at the edges, prescribing breathing exercises to children who are drowning and, in the worst cases, unthinkingly pushing them under.
The best protection against mental health disorders that schools can offer (and the only ones teachers and other school staff are qualified to offer) is to be places of warmth and safety, where every child is known, where high expectations are matched with the support to meet them, and where success is made genuinely attainable for all. When children feel secure, valued, and able to achieve, the need for therapeutic sticking plasters might diminish of its own accord.
If you’ve found this post interesting, you might enjoy this week’s essay for paid subscribers on the Fundamental Attribution Error. I keep subscription as low as Substack will allow: £3.50 per month or £30 per year.
Multiple large-scale evaluations have found little or no lasting benefit from universal school-based mindfulness and wellbeing programmes, with particular concerns that such interventions fail to address underlying structural causes of distress and may risk individualising responsibility for mental health (Department for Education, 2022; Patalay & Fitzsimons, 2023 & Werner-Seidler et al., 2023).
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I strongly agree with a lot of points you made. In the end, both the education system and the wider political and economic context in which it operates give one – notably, a teenage one – many good reasons to feel anxious. Yes, breathing practice is not an answer to social disadvantage. Yes, the culture of self-care misteaches individuals to turn inwards in the face of systemic malfunctions. Yes, ‟children, primed to scan for emotional difficulties, begin to interpret ordinary discomfort as pathological”. And yes, neither schools are mental health facilities, nor teachers are qualified to provide mental health care.
Still, being somewhere in between a homeroom teacher and a school counselor, I believe that there is something schools could do about studentsʼ mental health, but it has less to do with safety (or ‟safetism”), and more to do with agency and attention. We can enforce smartphone bans and teach digital & sleep hygiene. We can bring shop class, or at least its elements, back to school. We can organize class trips in a way which would reconnect students to nature and make them wander together. We can moderate student self-governance in order to empower all kids, and not just those who already posses micropolitical skills. We can prioritise building a sense of community by means of collective actions and school traditions.
Arenʼt these ways too of creating spaces where ‟children feel secure, valued, and able to achieve”? Best wishes!
Interesting article. I'm an Education Mental Health Practitioner -- a newish children's mental health role where we're embedded in schools and tasked with a) providing targeted 1:1 CBT-informed work for anxiety and low mood b) doing whole-school awareness-raising and psychoeducation workshops. I love the first part of my role. Outcomes show that it really does work in most cases, although we have to be careful to make it age-appropriate (e.g. more behavioural tweaks than deep cognitive stuff) and kids and families value it.
I have lots of questions about the efficacy and potential iatrogenic harm of the second part. In particular, I don't want to be teaching primary-aged children about how to notice ordinary transient tricky feelings and label them as "anxiety" which, no matter how hard we try not to pathologise it, we have pathologised in the act of labelling. We are clinically trained NHS professionals, and more and more of us are being hired in rapidly expanding teams, so this isn't just a question of untrained school staff clumsily dealing with complex problems. It's about the overall idea that raising awareness and teaching kids to introspect more and harder will create good mental health outcomes when mounting evidence shows the opposite.