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One of the key challenges almost all local education authorities (LEAs) face is the increase in the number of pupils with mental health difficulties who are unable to cope in secondary schools, says the schools inspection body Ofsted.

One in three LEAs do not have a satisfactory range of provision for education pupils with special medical needs, the majority of whom are suffering from anxiety, depression or phobias, says Ofsted.

In the best LEAs provision includes a home tuition service, hospital teaching, adolescent psychiatric units and smaller units within other schools where students with depression can study.

Ofsted found that the quality of teaching and learning for these pupils is generally good, and that almost all pupils are pleased with their education, but many of those with depression, anxiety and phobias, and their parents, were concerned about the time they spent at home before they received help.

Ofsted says all schools should appoint a named person responsible for children who cannot attend because of their medical needs.

In a third of LEAs there are not enough opportunities for these pupils to work in group settings, so they are isolated at home for too long. Because they seldom leave home the home tutor may be the only contact outside the family.

- See website www.ofsted.gov.uk/publications/index.cfm?fuseaction=pubs.summary&id=3373