Dr Sarah Bell is a qualified teacher and Senior Research Associate in young people’s public health at Bristol University Medical School. She is currently working on the WISE project. Here Sarah discusses the importance of mental health and wellbeing research in schools.

by Dr Sarah Bell
9th October 2019



The importance of mental health and wellbeing research in schools

The latest national survey of trends in young people’s mental health, released in November 2018, reported that 12.8% of 5 to 19-year-olds had at least one mental disorder. Rates of mental disorder were shown to increase with age and to also have increased over time.

Over the last decade, an abundance of policy documents and guidance has been produced about young people’s mental health and wellbeing. In schools, both education (Department for Education) and health (Department of Health and Social Care) have an influence, and complications have arisen with terminology. Terms such as psychological distress, mental health, disorder and mental illness are used in health; social and emotional learning and behavioural problems are mostly used in education.

Child and Adolescent Mental Health Services (CAMHS), the main referral point for young people that schools are concerned about, is in crisis, with access to services currently a postcode lottery and only for the most extreme cases. Cuts in school funding have led to schools losing resources such as learning mentors, school counsellors and other pastoral support, including external services.

Within this context, schools are being asked to take on increasing responsibility for young people’s mental health and wellbeing. From 2020, schools will need to provide relationships education at primary schools, and relationships and sex education (RSE) at secondary schools. Health education will also be compulsory at all state-funded schools. Schools are being encouraged to introduce the curriculums from 2019. Ofsted don’t currently assess against mental health and wellbeing indicators.

Schools have copious amounts of guidance from government and other organisations to keep up with as well as daily news to follow. As a result, it can be challenging for schools to assess the best resources and information to access.

Voluntary organisations, charities and commercial organisations continue to provide a wealth of resources.

Examples include:

  • schemes of work (e.g. the PSHE association lesson plans and the Samaritans DEAL scheme)
  • healthy schools objectives (e.g. in Bristol, schools can be awarded a badge in mental health and wellbeing)
  • programmes such as ELSA (Emotional Literacy Support Assistant training), Thrive (based on attachment theory) and SEAL (Social and Emotional Aspects of Learning, a government-led whole-school initiative)
  • nurture groups
  • mindfulness and resilience projects.

Although royal involvement from Prince William and Prince Harry has raised the profile of mental health and wellbeing, and the government are taking mental health issues seriously, the key will be in research. In January 2019, the Wellcome Trust announced they would be committing £200 million to support this research over the next five years.

Many high-quality research projects are now happening. All those involved in the care of young people’s mental health and wellbeing are beginning to come together to tackle this issue. A systems approach and rigorous evaluation of existing and promising interventions for schools is needed and is now thankfully underway.

If you would like to get involved in young people’s mental health and wellbeing research, please do get in touch: s.bell@bristol.ac.uk.

References

National Centre for Social Research, the Office for National Statistics and Youthmind (2018) ‘Mental Health of Children and Young People in England, 2017’. NHS Digital.

 

Useful resources

PSHE association The PSHE association offers a programme of work to help schools plan a PSHE curriculum. The association has guidance on preparing to teach mental health and wellbeing and accompanying lesson plans (key stages 1–4) (free).

The Samaritans DEAL (Developing Emotional Awareness and Listening) is a free teaching resource for students (14 years and older). It is a set of web-based teaching resources containing session plans, film and audio clips, teachers’ notes and staff training materials (free).

Bristol Healthy Schools The Bristol Healthy Schools team designed the Mental Health and Wellbeing Badge with objectives for schools to achieve, to help them adopt a whole-school approach to improving mental health and wellbeing (free).

ELSA stands for Emotional Literacy Support Assistant. ELSA provides a training course aimed at teaching assistants in schools. ELSA support is a website which supports the teaching of emotional literacy. It contains free and charged resources.

Thrive The Thrive approach draws on neuroscience, attachment theory and child development to work with children in a targeted way. Some children’s early experiences mean that they have not developed a robust stress-response system and therefore find it difficult to relate or learn. Thrive offers a structured way to provide the missing relational experiences in order to rewire children’s neural circuitry for more effective functioning. They offer training and web-based resources (charged).

SEAL SEAL (Social and Emotional Aspects of Learning) is a whole-school social and emotional wellbeing resource with lesson plans for primary and secondary ages (free).

Nurture groups This Department of Education (Northern Ireland) web page explains what nurture groups are and includes an evaluation report about them.

Mindfulness Many different mindfulness resources (audio recordings, videos, books, apps, etc.) and programmes/courses are available and being used in schools. Currently, a large randomised controlled trial (RCT) to evaluate mindfulness practice in schools is underway (University of Oxford).

Resilience Boingboing (University of Brighton) provides frameworks, resources and training about resilience (free) and has a schools-based research project underway. They offer a guide called ‘Resilience approaches to supporting young people’s mental health’ which outlines school-based resilience-building approaches and programmes.

Sources of support for schools

TED talks, University of Bristol These TED talks are video clips about happiness. They are perfect for watching during tutor time, assemblies, PSHE lessons or staff meetings (free). There are lots of different talks related to mental health and wellbeing.

Anna Freud National Centre for Children and Families This is a leading centre in research for young people’s mental health and wellbeing. Find out about research going on and projects to get involved in. The centre also provides useful guidance and other resources (free).

This toolkit created by the Anna Freud Centre provides guidance on measurement tools schools can use to measure mental health and wellbeing, and numerous case studies of schools doing work in this area. Great to get started evaluating practice in your school and to get ideas (free).

Schools in Mind is an online network to sign up to for free. It provides schools with resources, guidance and approaches to support the mental health and wellbeing of young people. It also provides training, networking opportunities with other schools, and opportunities to get involved in research. See schoolsinmind@annafreud.org

Education Support Partnership (formerly Teacher Support Network) offers free telephone support and advice. There is guidance on concerns such as behaviour management, managing workload, relationships, professional development, wellbeing and managing stress.

Reading Well provides books related to mental health and wellbeing to use in school libraries, and gives guidance on how to run the scheme in schools. Reading Well has been evaluated.

The Young Minds website provides mental health and wellbeing guidance for students, professionals and parents. Young Minds provides training (charged) and an online community ‘360 degrees’ with free tips, advice and resources sent to you by email.

MindEd is a free e-learning resource for adults (professionals and parents). Sign up online for a free account.

Kooth provides free, anonymous online counselling for young people and other guidance such as articles written by other young people.

NHS choices has a section called Moodzone. It provides tips and advice on how to improve mental health, and on self-help and treatments (audio guides, mindfulness talking therapies). It also includes stories from other people (free).

IAPT (Improving Access to Psychological Therapies) Services provide free evidence-based psychological therapies. They offer psycho-education courses and 1:1 interventions relating to stress, low mood and depression, worry and anxiety, and also specific topics such as long-term health conditions, bereavement, and separation and divorce. Services operate locally; this is the link for the Avon and Wiltshire Partnership.

Where to find good quality research

Programmes are not always evaluated well and sometimes not at all. There are recommended websites to find good quality research such as the Cochrane and Campbell libraries, which provide systematic reviews (summaries of studies).

An example of a review: Health promoting schools (review of a range of randomised controlled trials that intervene with the school curriculum, wider community, or ethos or environment of the school).

An example of a meta-analysis (a statistical method to bring findings from different studies together): Social and emotional learning school-based interventions.

Randomised control trials and their evaluations

Randomised controlled trials (RCTs) are the highest quality studies in the research design hierarchy. There are often large numbers of participants (statistically determined sample) with an intervention group (who receive the programme being tested) and a control group (who continue with usual practice) to determine if the programme is effective on a range of outcomes (such as mental health and wellbeing). A number of relevant RCTs and their evaluations that report on the effectiveness of the intervention are listed below.

SEAL programme in secondary schools: national evaluation

Findings from the National Evaluation of Targeted Mental  Health in Schools 2008–2011

Promoting Alternative Thinking Strategies (PATHS) Evaluation report and Executive summary

FRIENDS: a cluster randomised controlled trial to Prevent Anxiety in Children through Education in Schools (PACES)

The WISE (Wellbeing in Secondary Education) study

MYRIAD: Mindfulness and Resilience in Adolescence project

STARS: Incredible Years Teacher Classroom Management

Youth Aware of Mental Health and The Guide




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