An Overview of International Literature on School Interventions to Promote Mental Health and Well-being in Children and Adolescents

The association between experiences of religious discrimination, social-emotional and sleep outcomes among youth in Australia

Background

Religious-based hate crimes are on the rise worldwide. However, the relationship of religious discrimination on health and well-being, especially earlier on the lifecourse, is largely understudied. This study examines the prevalence of religious discrimination and the relationship it has on social-emotional adjustment and sleep outcomes among a diverse sample of students in Australia.

Methods

Data came from Speak Out Against Racism, a population-representative cross-sectional study of 4664 public school students in grades 5–9 in Australia in 2017. An adaption of the Adolescent Discrimination Distress Index (ADDI), was used to derive four measures of religious discrimination (peer, school, societal and the sum of those as a “total” score). The Strengths and Difficulties Questionnaire measured the total difficulties, conduct, emotional, and prosocial behavior subscales. Measures of sleep outcomes included duration, latency, and disruption.

Results

27 % (95 % CI 22.82, 31.12) of students reported experiences of direct total religious discrimination with higher levels being reported by students identifying as a religious minority. There was strong evidence that experiences of religious discrimination (across all four sources) was related to all measures of socioemotional adjustment and sleep outcomes.

Discussion

Religious discrimination is an understudied form of social disadvantage that has implications for adolescents’ development, health and well-being. Conclusion: More programs, particularly in the school-context, address religious-based discrimination may reduce inequities in health.

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There is a noted gap in population health research examining how religion operates as a structural determinant of health.

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The relationship between discrimination and indicators of health and wellbeing have been understudied among young children.

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Religious discrimination is associated with poor indicators of social-emotional adjustment across all four measures.

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Religious discrimination is associated with adverse sleep outcomes (duration and latency) among young school-aged children.

A qualitative exploration of 14 to 17-year old adolescents' views of early and preventative mental health support in schools

BACKGROUND

Preventative interventions may be effective in reducing and preventing symptoms of mental ill health in children and young people. However, there is a paucity of research in this area that explores the views of young people. This paper reports on a qualitative study to inform the future development of attractive and appropriate early and preventative school-based mental health interventions.

METHODS

Semi-structured interviews were conducted with a purposive sample of 12 young people aged 14-17 in North East England. Interviews were audio-recorded, transcribed, anonymised and analysed following a thematic approach.

RESULTS

Four key themes were identified, relevant to those providing, designing and commissioning early and preventative mental health interventions in schools: 'mental health literacy', 'risk factors for wellbeing decline', 'experience of school-based support' and 'recommendations for future support'.

CONCLUSIONS

Young people have varying levels of mental health literacy, but are able to identify academic stress, bullying and the transition from primary to secondary school as leading causes of worry. Young people want more regular and in-depth mental health education, tailored levels of support in school and improved training for teachers.

Improving socio-emotional health for pupils in early secondary education with Pyramid: A school-based, early intervention model

BACKGROUND

Policymakers are focusing increased attention on the role of schools to promote and support children's mental health, and evidence-based models of good practice are in demand. Pyramid Club is a school-based, socio-emotional intervention, demonstrably effective with primary-aged pupils.

AIMS

This study extends previous Pyramid Club evaluations by examining effectiveness with pupils in early secondary education; service users' perceptions and experiences were investigated to increase understanding of Pyramid's impact, thus supporting enhanced practice.

SAMPLE

Participants (n = 126) comprised selected pupils, aged 11-14 (52 males; 74 females), who completed the 10 week programme (Pyramid group) and a non-intervention comparison group. Club leaders (n = 23) were trained, Pyramid volunteers.

METHODS

A mixed-methods design was implemented. The Strengths and Difficulties Questionnaire (SDQ), informant-rated version (Goodman, 1997, J Child Psychol Psychiat, 38, 581) and self-report version (Goodman, Meltzer, & Bailey, 1998, Europ Child Adolesc Psychiatry, 7, 125), was used to measure socio-emotional well-being: pre-club (baseline assessment), post-test (within 2 weeks of programme completion), and at 12-month follow-up (informant-rated version only). Focus groups were conducted separately with Pyramid pupils and Club leaders.

RESULTS

Findings from informants and self-reports identified significant improvements for the Pyramid group in total difficulties and on pertinent SDQ subscales (e.g., emotional symptoms and peer relationship problems) at post-test. Improvements were sustained at 12-month follow-up. Comparison pupils demonstrated minimal change over time. Thematic analysis of qualitative data supported the quantitative findings and provided valuable insights into the Pyramid Club experience.

CONCLUSIONS

Findings contribute to evidence-based, preventative models for the early adolescent population and support the social validity of Pyramid Club.

The Effects of "VelaMente?!" Project on Social Functioning of People With Severe Psychosocial Disabilities

INTRODUCTION

Physical activity helps to improve several clinical outcomes of people with severe psychosocial disabilities. The aims of this study were; 1) to assess the efficacy of a psychosocial rehabilitative intervention focused on sailing in a crew on: a) social functioning; b) severity of the psychosocial disability; c) general functioning; d) dysregulation of biorhythms of people with severe psychosocial disabilities, and 2) to evaluate the attenders' satisfaction about the project.

METHODS

A randomized waitlist controlled trial with parallel groups was carried out involving 51 people with severe psychosocial disabilities. The intervention was a 3 months-lasting course to learn sailing in a crew. Just after the randomization, a group began the sailing course and the other group (wait list) attended the sailing course after 3 months of treatments as usual. Before and after the sailing course, as well as the waiting list period, all attenders were assessed by HoNOS, GAF, CGI-S and BRIAN. At the end of the sailing course, they completed also a self-report satisfaction questionnaire.

RESULTS

Social functioning significantly improved after the sailing course (HoNOS total score "time X group": p=0.011), mainly because of the improvement of psychopathological symptoms (HoNOS symptoms score "time X group": p=0.003). Furthermore, participants greatly appreciated the rehabilitative program based on sailing in a crew.

CONCLUSIONS

When compared to more traditional rehabilitative activities that are usually carried out in mental health services, a psychosocial rehabilitative intervention based on sailing in a crew significantly improve the social functioning of people with severe psychosocial disabilities.

Temporal patterns and predictors of bullying roles among adolescents in Vietnam: a school-based cohort study

Although many cross-sectional studies have examined bullying experiences and correlated factors among adolescents in schools, relatively little is known about the extent to which bullying roles are stable or fluid over time. This short-term quantitative longitudinal study in Vietnam examined temporal patterns and predictors of bullying roles over an academic year. A total of 1424 middle and high school students aged 12-17 years completed two anonymous, self-administered questionnaires six months apart in 2014 and 2015. Young people were classified into different bullying roles as follow: not-involved (38.9%), victims only (24%), bullies only (6.6%), and bully-victims (40.4%) across the two times. About 60% of all surveyed students experienced bullying either as victim, bully, or bully-victim during the year. Of these students, nearly three in four indicated unstable bullying roles over time. Multivariate multinomial logistic regressions indicated factors ranging from individual (age, gender, and mental health) to family (social support, parental supervision and monitoring, witnessing parental violence, and conflict with siblings), school (perceived social support, teachers' attempt to stop bullying at school), and peers (social support, students' attempt to stop bullying at school) have significant associations with levels of bullying involvement. Implications for bullying prevention programs nationally and internationally are discussed.

Enhancing the Emotional and Social Skills of the Youth to Promote their Wellbeing and Positive Development: A Systematic Review of Universal School-based Randomized Controlled Trials

Background:

The acquisition of social and emotional skills is associated with positive youth development, character education, healthy lifestyle behaviours, reduction in depression and anxiety, conduct disorders, violence, bullying, conflict, and anger. School-based interventions aimed to enhance these skills go beyond a problem-focused approach to embrace a more positive view of health; they could also improve the youth’s wellbeing.

Aim:

To describe the main features and to establish the effectiveness of universal school-based RCTs for children and the youth, aimed to promote their psychosocial wellbeing, positive development, healthy lifestyle behaviours and/or academic performance by improving their emotional and social skills.

Methods:

Systematic review by searching for relevant papers in PubMed/Medline with the following key words: “mental health” OR “wellbeing” OR “health promotion” OR “emotional learning” OR “social learning” OR “emotional and social learning” OR “positive youth development” OR “life skills” OR “life skills training” AND “school”. Interval was set from January 2000 to April 2014.

Results:

1,984 papers were identified through the search. Out of them 22 RCTs were included. While most interventions were characterized by a whole-school approach and SAFE practices, few studies only used standardized measures to assess outcomes, or had collected follow-up data after ≥ 6 months. The results of all these trials were examined and discussed.

Conclusion:

Universal school-based RCTs to enhance emotional and social skills showed controversial findings, due to some methodological issues mainly. Nevertheless they show promising outcomes that are relatively far-reaching for children and youth wellbeing and therefore are important in the real world.