This chapter explores the specific mental health issues relating to refugee pupils. It explores the nature of effective provision for refugee pupils and all pupils with social, emotional and mental health needs. The chapter examines the teacher's role in supporting the mental health of pupils. The mental health of children and adolescents has become an increasing concern and this is reflected in media coverage and political soundbites. In 1989, Bronfenbrenner formalised an ecological framework for human development. There are various layers to the environments that influence a child's development: the microsystem, the mesosystem, the exosystem, the macrosystem and the chronosystem. Bronfenbrenner discusses the impact of the macrosystem on an individual's development and, in particular, considers the cultural impact. Trauma can affect individuals in different ways depending on cultural background and therefore it is not possible to draw universal conclusions based on previous experiences with different cultural groups.