A powerful exploration of what 26 years inside schools, CAMHS, public health and the NHS revealed about childhood trauma, class, burnout, emotional labour and the social conditions shaping modern mental health. Part of the Architecture series.

After I trained as a therapist, over twenty six years ago, I never imagined I would end up working inside schools, local authorities, CAMHS services, public health systems and NHS clinical networks.

In truth, much of my career unfolded the same way my life often has — through curiosity, instinct and saying yes before I fully knew where something would lead.

My first real experience inside schools came after spending time observing a teaching assistant running small emotional support groups with children. I remember sitting there watching her use puppets to help eight-year-olds talk openly about feelings, worries and friendship problems, and realising I had never seen anything quite like it before.

Not long after that I was asked whether I wanted to be involved in a small project supporting children at risk of exclusion from school.

I had no grand plan. I simply said yes.

At first, I thought I would mostly be working with children who were fighting at break times or struggling with behaviour. But very quickly I started noticing something else.

The quieter children. The shy ones. The children who lingered behind wanting to talk. The children holding far more emotionally than anybody realised.

I remember going back to my manager and saying: “These children need more than somebody dealing with incidents. They need space to talk.”

And from there the work slowly grew.

I ended up helping develop emotional wellbeing support across several schools and a feeder secondary school at a time when early intervention in children’s mental health was only just beginning to receive national attention.

I spent months researching:

• child development,
• behavioural difficulties,
• emotional regulation,
• family systems,
• anxiety,
• group work,
• and therapeutic approaches that might genuinely help children struggling emotionally.

Within a short space of time I witnessed a huge range of realities behind school gates.

Teachers who cared deeply. Teachers who were burnt out. Teachers who probably should never have been teachers. Children from loving stable homes. Children living with chaos, addiction, violence or neglect. Parents trying their best on low incomes. Parents completely overwhelmed. Parents emotionally absent.

And what became immediately obvious was that children do not arrive at school as blank slates.

Their nervous systems arrive too.

The child lashing out in the playground. The child dissociating quietly in the corner. The child unable to concentrate. The child constantly seeking approval. The child exploding with anger.

Very often there was something sitting underneath the behaviour.

At that point the language around trauma and adverse childhood experiences was only just beginning to emerge publicly, but many of us working directly with children could already see the patterns.

Children exposed to:

• domestic abuse,
• addiction,
• chronic stress,
• instability,
• emotional neglect,
• fear,
• and unpredictability

often struggled profoundly with emotional regulation, learning and relationships.

School for many children was not simply education. It was structure. Safety. Containment. Predictability. Sometimes the only stable environment they had.

I also became increasingly aware of how much teachers themselves were being asked to hold.

Especially in more deprived areas.

Schools had quietly become emotional frontline services.

And yet at the same time there were constant gaps:

• lack of funding,
• long waiting lists,
• insufficient specialist support,
• overstretched services,
• and systems trying to manage increasing complexity with limited resources.

We worked closely with social care, public health teams and even police data at times, trying to understand broader patterns.

I remember discussions exploring the correlation between domestic abuse callouts and the schools generating the highest levels of emotional wellbeing referrals. The overlap was impossible to ignore.

Children absorb emotional atmosphere. Even when adults believe they are protected from it.

And often what was hardest was not the dramatic cases. It was the ordinary chronic stress families were living under.

Financial pressure. Relationship breakdown. Housing insecurity. Emotional exhaustion. Isolation. Parents trying to survive while carrying their own unresolved trauma.

Over time I moved into a Tier 2 CAMHS service where we deliberately created a far more open access model.

We removed much of the gatekeeping. Parents could come through schools, GPs or direct referral routes.

And again, the same themes kept appearing.

Angry children with histories of domestic abuse. Teenagers struggling with anxiety and depression. Parents trapped in toxic relationships. Women unable to leave because of financial dependence. Families exhausted by years of conflict. Children carrying emotional burdens far beyond their developmental capacity.

What struck me repeatedly was how often children were discounted in these dynamics. Adults still frequently underestimated the impact of chaos, fear and violence on children.

But children always know. Even when they do not yet have language for what they are feeling.

I knew this not only professionally, but personally.

I only witnessed my own mother being physically assaulted once as a child, but that single image stayed in my nervous system for years.

Other children were living inside those environments daily.

At the same time, I also saw how systems themselves operated.

Some parts were innovative, compassionate and genuinely trying to help. Other parts were overwhelmed, bureaucratic or deeply fragmented.

There were passionate clinicians. Committed teachers. Creative practitioners. Managers trying to hold impossible demands.

But there was also:

• red tape,
• political pressure,
• endless restructuring,
• outcome targets,
• funding limitations,
• and hidden hierarchies inside professional systems.

As I moved further into NHS leadership and quality improvement work, I became increasingly aware of how class, confidence, language and institutional culture shaped whose voices carried authority.

I cannot prove classism in a measurable sense. But I know what certain rooms felt like.

I know what it felt like to move between working-class realities and highly professional systems. I know what it felt like to watch ordinary families struggle to navigate pathways professionals spoke about as though they were straightforward. I know what it felt like to sit in meetings discussing mental health transformation while services on the ground were already drowning in referrals.

And I also saw how difficult genuine long-term change becomes when systems are constantly operating in crisis management.

Projects started. Funding disappeared. Waiting lists grew. Youth services closed. Community spaces vanished. Thresholds for support increased. Meanwhile need continued rising.

What struck me most over time was this: mental health does not emerge separately from society.

Lives shape nervous systems. Systems shape lives.

People do not simply wake up anxious, burnt out, depressed or emotionally dysregulated without context.

Over the years I listened to thousands of people speak about:

• housing insecurity,
• debt,
• burnout,
• relationship stress,
• caregiving pressure,
• loneliness,
• poverty,
• impossible workloads,
• discrimination,
• grief,
• addiction,
• trauma,
• and the emotional exhaustion of trying to sustain modern life.

And while therapy absolutely helps many people, I often found myself asking:

How much distress are we individualising that is actually deeply connected to wider social conditions?

Because many people were not failing. They were exhausted.

Trying to sustain:

• rising costs,
• insecure housing,
• childcare pressures,
• overstimulation,
• emotional labour,
• low wages,
• unstable relationships,
• and systems demanding more than many nervous systems can realistically sustain long term.

Public health research repeatedly reflected these realities.

Where people live affects life expectancy. Childhood adversity affects long-term health. Poverty impacts nervous systems. Trauma affects development. Belonging affects wellbeing. Isolation affects mortality.

The body keeps score not only individually, but socially.

I also became increasingly aware of how paternalistic many systems could become.

The assumption that struggling communities simply needed educating or correcting while much larger structural realities remained largely untouched.

And yet many of the same communities now struggling economically were built through generations of labour. Mining towns. Factory communities. Industrial workers. Families who physically built societies while often remaining excluded from the wealth generated through their work.

At the same time, modern culture increasingly tells people:

• optimise yourself,
• improve your mindset,
• stay productive,
• heal yourself,
• consume more self-development.

But there are limits to what individual nervous systems can tolerate when societies themselves become increasingly dysregulated.

This is not about removing personal responsibility. Healing matters. Awareness matters. Agency matters.

But context matters too.

And perhaps one of the deepest questions we need to ask is: What kind of society are we creating if so many people feel emotionally exhausted long before the end of their working lives?

What would a psychologically healthier society actually look like?

One with:

• more community,
• more emotional literacy,
• more meaningful work,
• more flexibility,
• more dignity,
• more creativity,
• more rest,
• and systems designed around human wellbeing rather than endless extraction.

I think about my own mother often when I reflect on these questions.

She was abandoned while pregnant with three children and left trying to survive inside systems that offered little genuine support. For years we lived in cramped stressful conditions before finally being housed. She later struggled with depression and migraines, often shutting herself away simply trying to cope.

As children, we absorbed that stress too.

And I think, in many ways, that experience shaped the direction of my entire career.

I wanted to understand:

• why people suffer,
• what helps human beings heal,
• why some thrive while others struggle,
• and what kind of systems actually allow people to grow rather than simply survive.

I am not naïve. I know people still have choices. I know accountability matters. I know healing requires participation.

But I also know there are invisible ceilings many people do not even realise are shaping their lives.

And I know from decades of experience that when people are given:

• safety,
• support,
• opportunity,
• dignity,
• emotional containment,
• and the right environment,

Human beings can grow in extraordinary ways. And yes I have witnessed it, I saw kids who were on the edge of prison, make a turn and walk a new life, kids chase me in the underground telling me how much better life was and those how were able to take their words and share them to the public and carve a new path for themselves. I saw woman we worked with come into the wellbeing project tired and with low self esteem, rise, make friends, learn what they loved and get jobs ….I saw over and over what happens when we give and create opportunities without a paternalistic attitude about who is deserving and who isn’t. And yes after years of working in the system. I wanted to let go and allow my life to gently unfold again….