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Avery F, Kennedy N, James M, Jones H, Amos R, Bellis M, Hughes K, Brophy S. A systematic review of non-clinician trauma-based interventions for school-age youth. PLoS One 2024; 19:e0293248. [PMID: 39240823 PMCID: PMC11379276 DOI: 10.1371/journal.pone.0293248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 06/11/2024] [Indexed: 09/08/2024] Open
Abstract
Exposure to adverse childhood experiences (ACEs) is recognised globally as a risk factor for health problems in later life. Awareness of ACEs and associated trauma is increasing within schools and educational settings, as well as the demand for supportive services to address needs. However, there is a lack of clear evidence for effective interventions which can be delivered by non-clinicians (e.g., the school staff themselves). Thus, we undertook a systematic review to answer the question: What evidence exists for the efficacy of non-clinician delivered trauma-based interventions for improving mental health in school-age youth (4-18 years) who have experienced ACEs? The protocol for the review is registered in the PROSPERO International Prospective Register of Systematic Reviews (ID: CRD42023417286). We conducted a search across five electronic databases for studies published between January 2013 and April 2023 that reported on interventions suitable for non-clinician delivery, were published in English in the last 10 years, and involved participants aged 4-18 years (school-age) that had exposure to ACEs. Of the 4097 studies identified through the search, 326 were retrieved for full text screening, and 25 were included in the final review. Data were extracted from included articles for analysis and selected studies were quality assessed using validated assessment tools. Data were analysed through narrative synthesis. There was considerable heterogeneity in study design, outcome measures, and the interventions being studied. Interventions included CBT, mindfulness and art-based programs. A key finding was that there is a lack of high-quality research evidence to inform non-clinician delivered trauma-informed interventions. Many included studies were weak quality due to convenience sampling of participants and potential bias. Cognitive Behavioural Therapy (CBT)-based approaches are tentatively suggested as a suitable target for future rigorous evaluations of interventions addressing ACE-related trauma recovery and mental health improvement in school-age youth.
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Affiliation(s)
- Flo Avery
- National Centre for Population Health and Wellbeing, School of Medicine, Swansea University, Swansea, United Kingdom
| | - Natasha Kennedy
- National Centre for Population Health and Wellbeing, School of Medicine, Swansea University, Swansea, United Kingdom
| | - Michaela James
- National Centre for Population Health and Wellbeing, School of Medicine, Swansea University, Swansea, United Kingdom
| | - Hope Jones
- National Centre for Population Health and Wellbeing, School of Medicine, Swansea University, Swansea, United Kingdom
| | - Rebekah Amos
- School of Human Sciences, Bangor University, Wrexham, United Kingdom
| | - Mark Bellis
- Faculty of Health, Liverpool John Moores University, Liverpool, United Kingdom
| | - Karen Hughes
- School of Human Sciences, Bangor University, Wrexham, United Kingdom
- Policy and International Health Directorate, World Health Organization Collaborating Centre on Investment for Health and Well-Being, Public Health Wales, Wrexham, United Kingdom
| | - Sinead Brophy
- National Centre for Population Health and Wellbeing, School of Medicine, Swansea University, Swansea, United Kingdom
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Soneson E, Howarth E, Weir A, Jones PB, Fazel M. Empowering School Staff to Support Pupil Mental Health Through a Brief, Interactive Web-Based Training Program: Mixed Methods Study. J Med Internet Res 2024; 26:e46764. [PMID: 38652534 PMCID: PMC11077415 DOI: 10.2196/46764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 03/01/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Schools in the United Kingdom and elsewhere are expected to protect and promote pupil mental health. However, many school staff members do not feel confident in identifying and responding to pupil mental health difficulties and report wanting additional training in this area. OBJECTIVE We aimed to explore the feasibility of Kognito's At-Risk for Elementary School Educators, a brief, interactive web-based training program that uses a simulation-based approach to improve school staff's knowledge and skills in supporting pupil mental health. METHODS We conducted a mixed methods, nonrandomized feasibility study of At-Risk for Elementary School Educators in 6 UK primary schools. Our outcomes were (1) school staff's self-efficacy and preparedness to identify and respond to pupil mental health difficulties, (2) school staff's identification of mental health difficulties and increased risk of mental health difficulties, (3) mental health support for identified pupils (including conversations about concerns, documentation of concerns, in-class and in-school support, and referral and access to specialist mental health services), and (4) the acceptability and practicality of the training. We assessed these outcomes using a series of questionnaires completed at baseline (T1), 1 week after the training (T2), and 3 months after the training (T3), as well as semistructured qualitative interviews. Following guidance for feasibility studies, we assessed quantitative outcomes across time points by comparing medians and IQRs and analyzed qualitative data using reflexive thematic analysis. RESULTS A total of 108 teachers and teaching assistants (TAs) completed T1 questionnaires, 89 (82.4%) completed T2 questionnaires, and 70 (64.8%) completed T3 questionnaires; 54 (50%) completed all 3. Eight school staff members, including teachers, TAs, mental health leads, and senior leaders, participated in the interviews. School staff reported greater confidence and preparedness in identifying and responding to mental health difficulties after completing the training. The proportion of pupils whom they identified as having mental health difficulties or increased risk declined slightly over time (medianT1=10%; medianT2=10%; medianT3=7.4%), but findings suggested a slight increase in accuracy compared with a validated screening measure (the Strengths and Difficulties Questionnaire). In-school mental health support outcomes for identified pupils improved after the training, with increases in formal documentation and communication of concerns as well as provision of in-class and in-school support. Referrals and access to external mental health services remained constant. The qualitative findings indicated that school staff perceived the training as useful, practical, and acceptable. CONCLUSIONS The findings suggest that brief, interactive web-based training programs such as At-Risk for Elementary School Educators are a feasible means to improve the identification of and response to mental health difficulties in UK primary schools. Such training may help address the high prevalence of mental health difficulties in this age group by helping facilitate access to care and support.
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Affiliation(s)
- Emma Soneson
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Emma Howarth
- School of Psychology, University of East London, London, United Kingdom
| | - Alison Weir
- Faculty of Education, University of Cambridge, Cambridge, United Kingdom
- Howard Community Academy, Anglian Learning multi-academy trust, Bury St Edmunds, United Kingdom
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Mina Fazel
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
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Svensson Å, Warne M. Staff perspectives on poor mental health in secondary school students: an increasing problem handled with insufficient resources. Front Public Health 2024; 12:1292520. [PMID: 38496395 PMCID: PMC10940380 DOI: 10.3389/fpubh.2024.1292520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 02/05/2024] [Indexed: 03/19/2024] Open
Abstract
Introduction An increasing number of schools are recognizing the importance of addressing students' mental health based on the association with educational outcomes and long-term health. The school organization and the members of the school staff play important but, in several ways, challenging roles in this work. The purpose of this study was to explore views of staff from schools and school health services on mental ill health among students and their own role in detecting and managing it. Methods A qualitative study was conducted in a sparsely populated municipality in northern Sweden. In total, 40 participants from three secondary schools and the school health services participated either in focus groups or individual interviews. Participants were teachers, assistants, school nurses, school counselors and psychologists. Data were analyzed using thematic analysis. Results The analysis revealed the main theme Student mental ill health: an increasing problem handled with insufficient resources and two subthemes, i.e., Uncertainty in interpreting students' signs of mental ill health and the need to clarify roles and establish a supportive organization. Conclusions It was concluded that school staff were uncertain regarding how to interpret signs of mental ill health among students and required better knowledge and more resources to help students with mental ill health. A clearer organization and consensus regarding support for students with mental ill health were also necessary in light of the division of responsibilities between school staff and the school health services.
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Finning K, White J, Toth K, Golden S, Melendez-Torres GJ, Ford T. Longer-term effects of school-based counselling in UK primary schools. Eur Child Adolesc Psychiatry 2022; 31:1591-1599. [PMID: 33990854 PMCID: PMC8121011 DOI: 10.1007/s00787-021-01802-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 05/09/2021] [Indexed: 11/01/2022]
Abstract
Children's mental health is deteriorating while access to child and adolescent mental health services is decreasing. Recent UK policy has focused on schools as a setting for the provision of mental health services, and counselling is the most common type of school-based mental health provision. This study examined the longer-term effectiveness of one-to-one school-based counselling delivered to children in UK primary schools. Data were drawn from a sample of children who received school-based counselling in the UK in the 2015/16 academic year, delivered by a national charitable organisation. Mental health was assessed at baseline, immediately post-intervention, and approximately 1 year post-intervention, using the Strengths and Difficulties Questionnaire (SDQ) completed by teachers and parents. Paired t tests compared post-intervention and follow-up SDQ total difficulties scores with baseline values. Propensity score matching was then used to identify a comparator group of children from a national population survey, and linear mixed effects models compared trajectories of SDQ scores in the two groups. In the intervention group, teacher and parent SDQ total difficulties scores were lower at post-intervention and longer-term follow-up compared to baseline (teacher: baseline 14.42 (SD 7.18); post-intervention 11.09 (6.93), t(739) = 13.78, p < 0.001; follow-up 11.27 (7.27), t(739) = 11.92, p < 0.001; parent: baseline 15.64 (6.49); post-intervention 11.90 (6.78), t(361 = 11.29, p < 0.001); follow-up 11.32 (7.19), t(361) = 11.29, p < 0.001). The reduction in SDQ scores was greater in the intervention compared to the comparator group (likelihood ratio test comparing models with time only versus time plus group-by-time interaction: χ2 (3) = 24.09, p < 0.001), and model-predicted SDQ scores were lower in the intervention than comparator group for 2 years post-baseline. A one-to-one counselling intervention delivered to children in UK primary schools predicted improvements in mental health that were maintained over a 2 year follow-up period.
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Affiliation(s)
- Katie Finning
- University of Exeter College of Medicine and Health, Exeter, UK.
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Cybulski L, Ashcroft DM, Carr MJ, Garg S, Chew-Graham CA, Kapur N, Webb RT. Management of anxiety disorders among children and adolescents in UK primary care: A cohort study. J Affect Disord 2022; 313:270-277. [PMID: 35803390 DOI: 10.1016/j.jad.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 06/29/2022] [Accepted: 07/01/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Anxiety disorders are common in childhood and adolescence but evidence-based guidance on their management is limited in the UK. In the absence of guidelines, we examined what treatment young people with anxiety disorders receive in primary care in the year following diagnosis. METHOD We delineated a cohort of individuals diagnosed with anxiety disorders aged 10-18 using the Clinical Practice Research Datalink (CPRD). We estimated the annual prevalence of antidepressant and anxiolytic prescribing and referrals to mental health services in the year following diagnosis between 2003 and 2019 via Poisson models, adjusted for age, gender, and practice-level deprivation. RESULTS 34,490 out of 52,358 (66 %) individuals were not prescribed or referred in the year following diagnosis. Those registered to practices in the most deprived compared to the least deprived areas were less likely to be referred (PR 0.80, 95%CI 0.76-0.84) and prescribed antidepressants (PR 0.77, 95%CI 0.72-0.82). Referrals increased 2003-2008 (22-28 %) and then declined until 2019 (28-21 %). Antidepressant prescribing decreased substantially between 2003 and 2005 (18-11 %) and then increased slightly between 2006 and 2019 (11-13 %). Anxiolytic prescribing declined between 2003 and 2019 (10-2 %). LIMITATIONS Prescriptions in the CPRD are not coupled with information about indication. Some prescriptions may therefore have been incorrectly attributed to the treatment of anxiety disorders. CONCLUSION The continued use of antidepressants necessitates the development of evidence-based guidance. The lower likelihood of being prescribed medication and/or referred among young people in more deprived practice populations, where incidence of anxiety disorder and other mental illnesses is higher, must also be investigated and rectified.
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Affiliation(s)
- Lukasz Cybulski
- Centre for Mental Health & Safety, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine, and Health, The University of Manchester and Manchester Academic Health Sciences Centre, Manchester, UK; National Institute for Health Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, Manchester, UK.
| | - Darren M Ashcroft
- National Institute for Health Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, Manchester, UK; Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester and Manchester Academic Health Sciences Centre, UK
| | - Matthew J Carr
- National Institute for Health Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, Manchester, UK; Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester and Manchester Academic Health Sciences Centre, UK
| | - Shruti Garg
- Division of Neuroscience & Experimental Psychology, Faculty of Biology, Medicine and Health, The University of Manchester & and Royal Manchester Children's Hospital, Central Manchester University Hospitals NHS Foundation, Manchester, UK
| | - Carolyn A Chew-Graham
- School of Medicine, Faculty of Medicine and Health Sciences, Keele University, Staffs, UK
| | - Nav Kapur
- Centre for Mental Health & Safety, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine, and Health, The University of Manchester and Manchester Academic Health Sciences Centre, Manchester, UK; National Institute for Health Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Roger T Webb
- Centre for Mental Health & Safety, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine, and Health, The University of Manchester and Manchester Academic Health Sciences Centre, Manchester, UK; National Institute for Health Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, Manchester, UK
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Atkinson C, Barrow J, Norris S. Assessment practices of educational psychologists and other educational professionals. EDUCATIONAL PSYCHOLOGY IN PRACTICE 2022. [DOI: 10.1080/02667363.2022.2109005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Cathy Atkinson
- Manchester Institute of Education, Ellen Wilkinson Building, University of Manchester, Manchester, UK
| | - Joanna Barrow
- Manchester Institute of Education, Ellen Wilkinson Building, University of Manchester, Manchester, UK
| | - Sarah Norris
- Real Group, 4 Victoria Parade, New Capital Quay, London, SE10 9FR
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Akram H, Bhutto MH, Chughtai MS. An analysis of business students’ stressors and their coping strategies in the post-pandemic era. DECISION 2022. [PMCID: PMC9365220 DOI: 10.1007/s40622-022-00319-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The COVID-19 pandemic has brought a dramatic change in teaching–learning practices in higher education across the world. The post-pandemic era with a new shift of teaching–learning phase raises the concern of students' psychological well-being, especially the novice, i.e., first-year undergraduate students, as first-year students often struggle to adjust to the new environment of higher institutions, thereby depressive symptoms are more prevalent among them. In this regard, a qualitative study was conducted followed by a dyadic approach to explore the symptoms of students’ psychological stressors, their causes, and provide essential remedies for coping with such behaviors in the post-pandemic era. The findings show that students’ stressors were commonly reported due to the academic workload, institutional regulations, lack of resources, and financial constraints. Regarding indications, unusual behavior, lack of confidence, improper sleep, and lack of motivation were identified as the primary symptoms of students’ stress. However, participants reported a lack of understanding regarding stress-related matters. Yet, students and faculty members try to adopt several strategies for reducing such stressors. By examining the perceived psychological stress, indications, and coping behaviors, this study enriches the literature by bridging pragmatic and theoretical gaps regarding students’ stressors of business management. Furthermore, the study mainly suggests that adequate institutional support should be provided to deal with students’ problems that cause stress. Also, universities should organize workshops or seminars to cultivate psychological health awareness among students and faculty members.
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Affiliation(s)
- Huma Akram
- Department of Education, Northeast Normal University, Changchun, China
| | - Maqsood H. Bhutto
- Jyväskylä University School of Business and Economics, University of Jyväskylä, Jyväskylä, Finland
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Barrow E, Thomas G. Exploring perceived barriers and facilitators to mental health help-seeking in adolescents: a systematic literature review. EDUCATIONAL PSYCHOLOGY IN PRACTICE 2022. [DOI: 10.1080/02667363.2022.2051441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Emma Barrow
- School of Environment, Education and Development, University of Manchester, Manchester, UK
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Fynn WI, Runacres J. Dogs at school: a quantitative analysis of parental perceptions of canine-assisted activities in schools mediated by child anxiety score and use case. INTERNATIONAL JOURNAL OF CHILD CARE AND EDUCATION POLICY 2022; 16:4. [PMID: 35300319 PMCID: PMC8897139 DOI: 10.1186/s40723-022-00097-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/07/2022] [Indexed: 06/14/2023]
Abstract
Canine-assisted activities in schools can benefit students' educational, emotional, and social needs. Furthermore, they could be an effective form of non-clinical mental health treatment for children and adolescents. In the United Kingdom, school dogs are growing in popularity, however, little is known about how parents perceive canine-assisted activities as a treatment option. This is important as parental perceptions can influence engagement, whilst lack of awareness can become a barrier to treatment. This study uses a cross-sectional design to quantitatively explore the acceptability of canine-assisted activities amongst UK-based parents (n = 318) of children aged six to 16 (M = 10.12, SD = 3.22). An online survey used a treatment evaluation to determine acceptability across three use-cases. These included a child reading to dogs to improve literacy skills, a child interacting one-to-one to foster greater self-esteem and social skills, and a classroom dog to improve student behaviour and motivation. Additionally, the scale for generalised anxiety disorder was used to rank child anxiety as high or low, where high was a score equal to or above the UK clinical borderline threshold. The results found canine-assisted activities were less acceptable for the behavioural than the reading and social use-cases. Furthermore, parents of children with high anxiety had higher acceptability scores than parents of children with low anxiety for the reading and social use-cases but not for the behavioural use case. These findings suggest that UK parents' acceptability of canine-assisted activities in schools is mediated by child anxiety score. Furthermore, that parents may be less aware of the benefits of classroom dogs than other types of school-based canine-assisted activities.
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Affiliation(s)
- Wendy Irene Fynn
- University of Derby, Enterprise Centre, Bridge Street, Derby, DE1 3LA UK
| | - Jessica Runacres
- University of Derby, Enterprise Centre, Bridge Street, Derby, DE1 3LA UK
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Mansfield R, Humphrey N, Patalay P. Educators' perceived mental health literacy and capacity to support students' mental health: associations with school-level characteristics and provision in England. Health Promot Int 2021; 36:1621-1632. [PMID: 33667299 PMCID: PMC8699399 DOI: 10.1093/heapro/daab010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Conceptual frameworks for school-based, preventive interventions recognise that educators' capacity is, in part, dependent on school-level characteristics. This study aimed to (i) examine the factor structure and internal consistency of the Mental Health Literacy and Capacity Survey for Educators (MHLCSE); (ii) assess responses in relation to supporting students' mental health; (iii) describe schools' mental health provision in terms of designated roles, training offered, and perceived barriers; (iv) investigate variance in MHLCSE outcomes explained by schools; and, (v) explore school-level predictors of educators' perceived MHL and capacity after controlling for individual-level characteristics. A multi-level, cross-sectional design involving 710 educators across 248 schools in England was used, and secondary analyses of baseline data collected as part of the Education for Wellbeing Programme were conducted. Mental health provision data was available for 206 schools, of which 95% offered training to some staff, and 71% had a designated mental health lead. Secondary schools offered significantly more training than primary schools. Significant barriers included lack of capacity in Child and Adolescent Mental Health Services (CAMHS) and within school, and communication challenges between agencies. The amount of training offered by schools significantly predicted educators' awareness and knowledge of mental health issues, treatments and services, legislation and processes for supporting students' mental health and comfort providing active support, with increased training predicting higher scores. However, little variance was explained by schools (1.7-12.1%) and school-level variables (0.7-1.2%). Results are discussed in relation to current mental health and education policy in England.
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Affiliation(s)
- Rosie Mansfield
- Centre for Longitudinal Studies, University College London, WC1E 6BT, UK
- Institute of Education, University of Manchester, M13 9PL, UK
| | - Neil Humphrey
- Institute of Education, University of Manchester, M13 9PL, UK
| | - Praveetha Patalay
- Centre for Longitudinal Studies, University College London, WC1E 6BT, UK
- MRC Unit for Lifelong Health & Ageing, University College London, WC1E 6BT, UK
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Mansfield R, Humphrey N, Patalay P, Moore A, Stapley E. Adaptation of a school-based mental health literacy curriculum: from Canadian to English classrooms. Glob Ment Health (Camb) 2021; 8:e39. [PMID: 34703613 PMCID: PMC8518024 DOI: 10.1017/gmh.2021.38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/16/2021] [Accepted: 09/10/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND School-based mental health literacy (MHL) interventions are increasingly trialled outside of the country in which they were developed. However, there is a lack of published studies that qualitatively explore their cultural adaptation. This study investigated the reasons for adaptations made and suggested to a Canadian MHL curriculum (The Guide) within the English school context. METHOD Semi-structured interviews were conducted with 11 school staff responsible for the planning and/or implementation of The Guide across three schools in the South East of England, as part of the Education for Wellbeing (EfW) feasibility study. Transcripts were analysed using a hybrid, deductive-inductive thematic analysis. RESULTS Adaptations made and suggested included dropping and emphasising content, and adapting language, examples and references. Most adaptations were proactive and related to The Guide's implementation methods, including developing more interactive and student-led approaches. Staff Capacity and Expertise, Timetabling, and Accessibility of Resources were identified as logistical reasons for adaptations. Philosophical reasons included Consistency of Messages, Student Characteristics, Reducing Stigma and Empowering Students, National and Local Context, and Appropriate Pedagogic Practices. CONCLUSION Overall, recommendations were for immediately implementable lesson plans informed by teachers' knowledge about best pedagogic practices in England. Adequate training, attended by both senior leadership and those implementing, was also emphasised. While ensuring that the core components are clear, MHL interventions should be developed with a necessary level of flexibility to accommodate contextual characteristics. Future research should ensure that adaptations are captured through process and implementation evaluations conducted alongside efficacy trials.
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Affiliation(s)
- Rosie Mansfield
- Centre for Longitudinal Studies, University College London, London, UK
- Manchester Institute of Education, University of Manchester, Manchester, UK
| | - Neil Humphrey
- Manchester Institute of Education, University of Manchester, Manchester, UK
| | - Praveetha Patalay
- Centre for Longitudinal Studies, University College London, London, UK
- MRC Unit for Lifelong Health and Aging, University College London, London, UK
| | - Anna Moore
- Evidence Based Practice Unit, Anna Freud National Centre for Children and Families, London, UK
| | - Emily Stapley
- Evidence Based Practice Unit, Anna Freud National Centre for Children and Families, London, UK
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Atkinson C, Kenneally O. A model for therapeutic educational psychology practice. EDUCATIONAL PSYCHOLOGY IN PRACTICE 2021. [DOI: 10.1080/02667363.2021.1933393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Cathy Atkinson
- Manchester Institute of Education, Ellen Wilkinson Building, University of Manchester, Manchester, UK
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Zafeiriou ME, Gulliford A. A grounded theory of educational psychologists’ mental health casework in schools: connection, direction and reconstruction through consultation. EDUCATIONAL PSYCHOLOGY IN PRACTICE 2020. [DOI: 10.1080/02667363.2020.1818553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Maria Evrydiki Zafeiriou
- Northamptonshire Educational Psychology Service, Northamptonshire County Council, Northampton, UK
- School of Psychology, University of Nottingham, Nottingham, UK
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Toth K, Samad L, Golden S, Johnston P, Hayes R, Ford T. What issues bring primary school children to counselling? A service evaluation of presenting issues across 291 schools working with Place2Be. COUNSELLING & PSYCHOTHERAPY RESEARCH 2020. [DOI: 10.1002/capr.12333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | | | | | | | - Rachel Hayes
- Institute of Health Research University of Exeter Medical School Exeter UK
| | - Tamsin Ford
- Department of Psychiatry University of Cambridge Cambridge UK
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Evans R, Parker R, Russell AE, Mathews F, Ford T, Hewitt G, Scourfield J, Janssens A. Adolescent self-harm prevention and intervention in secondary schools: a survey of staff in England and Wales. Child Adolesc Ment Health 2019; 24:230-238. [PMID: 31588199 PMCID: PMC6767699 DOI: 10.1111/camh.12308] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/24/2018] [Indexed: 12/03/2022]
Abstract
BACKGROUND Adolescent self-harm is a major public health concern. To date there is a limited evidence-base for prevention or intervention, particularly within the school setting. To develop effective approaches, it is important to first understand the school context, including existing provision, barriers to implementation, and the acceptability of different approaches. METHODS A convenience sample of 222 secondary schools in England and Wales were invited to participate in a survey, with a 68.9% (n = 153) response rate. One member of staff completed the survey on behalf of each school. Participants responded to questions on the existing provision of adolescent self-harm prevention and intervention, barriers to delivery, and future needs. RESULTS Adolescent self-harm is an important concern for senior management and teachers. However, emotional health and well-being is the primary health priority for schools. Health services, such as Child and Adolescent Mental Health Services, and on-site counselling are the main approaches schools currently use to address adolescent self-harm, with counselling cited as the most useful provision. Fifty-two per cent of schools have received some staff training on adolescent self-harm, although only 22% rated the adequacy of this training as high. Where schools do not have existing provision, respondents stated that they would like staff training, specialist student training, external speakers, posters and assemblies, although the latter four options were infrequently ranked as the most useful approaches. Key barriers to addressing adolescent self-harm were: lack of time in the curriculum; lack of resources; lack of staff training and time; and fear of encouraging self-harm amongst adolescents. CONCLUSIONS Adolescent self-harm is a priority for schools. Intervention might focus on increasing the availability of training to teaching staff.
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Affiliation(s)
- Rhiannon Evans
- DECIPHerSchool of Social SciencesCardiff UniversityCardiffUK
| | - Rachel Parker
- DECIPHerSchool of Social SciencesCardiff UniversityCardiffUK
| | | | - Frances Mathews
- University of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Tamsin Ford
- University of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Gillian Hewitt
- DECIPHerSchool of Social SciencesCardiff UniversityCardiffUK
| | | | - Astrid Janssens
- University of Exeter Medical SchoolUniversity of ExeterExeterUK
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Shelemy L, Harvey K, Waite P. Supporting students’ mental health in schools: what do teachers want and need? EMOTIONAL AND BEHAVIOURAL DIFFICULTIES 2019. [DOI: 10.1080/13632752.2019.1582742] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Lucas Shelemy
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Kate Harvey
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Polly Waite
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
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17
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School-based early intervention for anxiety and depression in older adolescents: A feasibility randomised controlled trial of a self-referral stress management workshop programme ("DISCOVER"). J Adolesc 2019; 71:150-161. [PMID: 30738219 DOI: 10.1016/j.adolescence.2018.11.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 11/29/2018] [Accepted: 11/30/2018] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Schools may provide a convenient intervention setting for young people with mental health problems generally, as well as for those who are unwilling or unable to access traditional clinic-based mental health services. However, few studies focus on older adolescents, or those from ethnic minority groups. This study aims to assess the feasibility of a brief school-based psychological intervention for self-referred adolescents aged 16-19 years. METHODS A two-arm cluster randomised controlled trial was conducted in 10 inner-city schools with block randomisation of schools. The intervention comprised a one-day CBT Stress management programme with telephone follow-up (DISCOVER) delivered by 3 psychology (2 clinical and 1 assistant) staff. The control was a waitlist condition. Primary outcomes were depression (Mood and Feelings Questionnaire; MFQ) and anxiety (Revised Child Anxiety and Depression Scale; RCADS-anxiety subscale). Data were analysed descriptively and quantitatively to assess feasibility. RESULTS 155 students were enrolled and 142 (91.6%) followed up after 3 months. Participants were predominantly female (81%) and the mean age was 17.3 years, with equal numbers enrolled from Year 12 and Year 13. Over half (55%) of students were from ethnic minority groups. Intraclass correlations were low. Variance estimates were calculated to estimate the sample size for a full RCT. Preliminary outcomes were encouraging, with reductions in depression (d = 0.27 CI-0.49 to -0.04, p = 0.021) and anxiety (d = 0.25, CI-0.46 to -0.04, p = 0.018) at follow-up. CONCLUSIONS Results support the feasibility of a school-based, self-referral intervention with older adolescents in a definitive future full-scale trial (Trial no. ISRCTN88636606).
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Soneson E, Childs-Fegredo J, Anderson JK, Stochl J, Fazel M, Ford T, Humphrey A, Jones PB, Howarth E. Acceptability of screening for mental health difficulties in primary schools: a survey of UK parents. BMC Public Health 2018; 18:1404. [PMID: 30577830 PMCID: PMC6303970 DOI: 10.1186/s12889-018-6279-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 11/28/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Many children and young people experiencing mental health difficulties (MHD) do not access care, often due to inadequate identification. Schools have a unique potential to improve early identification; however, evidence is limited regarding the acceptability of school-based identification programmes. This study aimed to examine parents' beliefs about the acceptability of school-wide MHD screening in primary schools. METHODS We collaborated with experts in school-based mental health to develop a questionnaire to measure parental attitudes toward school-wide MHD screening. The questionnaire contained 13 items relating to acceptability; three open-text boxes for comments on harms, benefits, and screening in general; and four questions that captured demographic information. Parents of children attending four primary schools in Cambridgeshire and Norfolk completed the questionnaire. We calculated counts, percentages, and means for each statement, and analysed responses to open-ended questions using content analysis. RESULTS Two hundred ninety parents returned the questionnaire across the four schools (61% response rate). In the 260 questionnaires analysed, a total of 254 parents (98%) believed that it is important to identify MHD early in life, and 251 (97%) believed that schools have an important role in promoting pupils' emotional health. The majority of parents (N = 213; 82%) thought that screening would be helpful, although 34 parents (13%) thought that screening would be harmful. Perceived harms of screening included inaccurate identification, stigmatisation, and low availability of follow-up care. There was no clear consensus regarding how to obtain consent or provide feedback of screening results. There were no significant differences in responses according to ethnicity, gender, age, or school. CONCLUSIONS Results suggest that most parents within the socio-demographic context of our study will accept MHD screening within primary schools, and that school-based screening is viable from the perspective of parents. The comments provided about potential harms as well as suggestions for programme delivery are relevant to inform the development and evaluation of acceptable and sustainable school-based identification models. Implementation and scale-up of such programmes will require further understanding of the perspectives of mental health professionals, school staff, and the general public as well as further evaluation against the established standards for identification programmes.
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Affiliation(s)
- Emma Soneson
- Department of Psychiatry, University of Cambridge, Herchel Smith Building, Cambridge, CB2 0SZ UK
| | - Jasmine Childs-Fegredo
- NIHR CLAHRC East of England, University of Cambridge, Institute of Public Health, Douglas House, 18 Trumpington Road, Cambridge, CB2 8AH UK
| | - Joanna K. Anderson
- NIHR CLAHRC East of England, University of Cambridge, Institute of Public Health, Douglas House, 18 Trumpington Road, Cambridge, CB2 8AH UK
| | - Jan Stochl
- Department of Psychiatry, University of Cambridge, Herchel Smith Building, Cambridge, CB2 0SZ UK
| | - Mina Fazel
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX UK
| | - Tamsin Ford
- University of Exeter Medical School, South Cloisters, St Luke’s Campus, Exeter, EX1 2LU UK
| | - Ayla Humphrey
- Department of Psychiatry, University of Cambridge, Herchel Smith Building, Cambridge, CB2 0SZ UK
| | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, Herchel Smith Building, Cambridge, CB2 0SZ UK
| | - Emma Howarth
- NIHR CLAHRC East of England, University of Cambridge, Institute of Public Health, Douglas House, 18 Trumpington Road, Cambridge, CB2 8AH UK
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Gronholm PC, Nye E, Michelson D. Stigma related to targeted school-based mental health interventions: A systematic review of qualitative evidence. J Affect Disord 2018; 240:17-26. [PMID: 30041074 DOI: 10.1016/j.jad.2018.07.023] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 05/22/2018] [Accepted: 07/08/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND School-based mental health services have been advocated to increase access to psychological support for children and adolescents. However, concerns have been raised about the potential stigma associated with selection of students and the visibility of school-based service contact. METHODS This review assessed findings from qualitative studies to identify potential stigmatising effects of participation in targeted school-based mental health interventions for students attending primary- or secondary-level education. Eight articles (reflecting seven studies) were identified through electronic database searches (PsycInfo, EMBASE, Medline, CINAHL, ERIC), supplemented by citation and reference searches and expert consultations. Data were synthesised according to established guidelines for thematic synthesis. RESULTS Three overarching themes were identified: "anticipated and experienced stigma", "consequences of stigma" and "mitigating strategies". These findings illustrate how pervasively stigma can compromise efforts to increase access to mental health care through targeted school-based provision, while also outlining strategies endorsed by students for alleviating the risk and/or impact of stigma. LIMITATIONS The findings need to be considered in view of the relative scarcity of surveyed evidence. Furthermore, as all evidence came from high-income and Western countries, the applicability to other contexts is unclear. CONCLUSIONS This synthesis reflects the first overview of qualitative evidence regarding stigmatising experiences and concerns associated with students' engagement with targeted school-based mental health interventions. The findings should inform efforts for mitigating stigma-related barriers to students' engagement in targeted mental health support, and serve to guide future research in this area.
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Affiliation(s)
- Petra C Gronholm
- Personal Social Services Research Unit, London School of Economics and Political Science, UK; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
| | - Elizabeth Nye
- Centre for Evidence-Based Intervention, Department of Social Policy & Intervention, University of Oxford, UK
| | - Daniel Michelson
- Centre for Global Mental Health, Department of Population Health, London School of Hygiene & Tropical Medicine, UK
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