Selecting mental health interventions

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There has been a rise in mental health issues for staff and students in schools and, although there are many interventions available, it can be difficult to see the wood for the trees. Samantha Garner provides starting points for schools that are looking to expand their mental health interventions for students and staff, to help schools evaluate their effectiveness and fit.

Summary

  • Mental health promotion activities can be implemented effectively by teachers and can have a significant impact on psychosocial and academic performance.
  • School-based interventions are most effective if they are completely and accurately implemented.
  • As well as having interventions at individual/group levels, schools also need whole-school interventions/programmes.
  • Consider need, logistics and costs, and continue to evaluate the programme to allow quick action on improvements.

It cannot be denied that we have seen a rise in mental health issues for staff and students in the past few years. This increase has come at the same time as a period of austerity during which cuts have been made and many schools have seen a decline in support from external agencies. The government brought out a Green Paper aiming to improve the mental health of children and young people. It has been criticised for not going far enough, and we are yet to see the impact of the proposals being put in place.

As a result, many settings are looking to source their own interventions to support the mental health and well-being of their students and staff. However, how does a school know what it needs and what is available?

Also, considering that one of the key elements for success is to have high-quality interventions and implementation, it is crucial that background research and planning are carried out before buying any intervention.

Fear not! This article will provide some basic starting points and will, I hope, mean that the interventions you choose will be suitable and successful. A quick proviso here though: there isn’t going to be one intervention that ‘fixes’ everything. It is not possible. Also, even if you have many interventions in place, there will still be students who require additional external support. Schools will require a combination of interventions that can work together to provide early support for students and staff.

What is the research on school-based interventions?

The Association for Child and Adolescent Mental Health says that:

‘Prevention and mental health promotion programmes and activities can be effectively implemented by teachers and can have a significant impact on psychosocial and academic performance.’

It also says that:

‘School-based interventions are most effective if they are completely and accurately implemented.’

(Weare & Nind, 2011)

‘In statistical terms, the effect of most interventions is small to moderate, but when applied in real-world settings the effects are much larger.’

(Weare & Nind, 2011)

‘The characteristics of the most effective interventions include:

  • focusing on positive mental health
  • delivering a mix of universal and targeted approaches
  • starting early with the youngest children
  • long-term interventions which embed within the whole school’s approach, including changes to the curriculum and teaching skills, and linking with academic learning
  • working with and educating parents
  • community involvement and coordinated work with outside agencies.’

(Weare & Nind, 2011)

Some of the most popular and evidenced forms of intervention are those which are based on cognitive behavioural therapy (CBT) as recommended for use in schools by the Department for Education and the NHS.

What do we want?

First, you have to decide what you want – be wary of looking at what’s available and making it fit to your needs. What are your main concerns regarding mental health and well-being in your school? For example, do you currently have a high level of a particular mental health issue such as self-harm, or are you concerned following the death by suicide of a student or member of the local community? Do you have a high level of exam anxiety among students?

As well as having interventions at individual/group levels, as mentioned earlier you will also need whole-school interventions/programmes. Supporting mental health is not about fixing the problems with the child; it is about raising awareness and looking at how we can be a positive rather than a negative influence.

“Just because something may be costly per student doesn’t mean that it isn’t worthwhile”

How do we want it to work logistically?

You then have to consider the logistics of running/implementing the interventions/programmes. Do you have school staff who can be given time and training to facilitate programmes, or do you want to outsource completely?

Think about the types of support available, for example:

  • internal counsellors
  • external counsellors
  • play therapists
  • art therapists
  • educational psychiatrists
  • mental health programmes facilitated by staff
  • mental health programmes facilitated by external professionals
  • family/parent support programmes
  • self-help workbooks to be completed by students
  • whole-school well-being programmes
  • visiting experts/speakers who can run well-being days or similar.

Which combination of these would meet your needs?

Costs

You also have to be pragmatic and talk costs. Education budgets are massively stretched and money is limited, so cost is an important consideration.

As well as the initial cost, think about the likely ongoing costs. Can these be sustained? Consider not just the cost of the intervention, but also the cost of the staff time involved in running/supporting the intervention.

It is important to work out the cost per student. How many students will benefit from the intervention? If not many students are accessing the intervention and it is expensive, how cost effective is it? Would it be more cost effective to invest in a preventative programme that benefits more students?

However, just because something may be costly per student doesn’t mean that it isn’t worthwhile, and it could provide additional value. For example, a school counsellor can be expensive but, as well as helping individual students, can provide group work and staff guidance, and can advise of common student issues they are dealing with so the school can look at whole-school interventions.

Implement, evaluate, improve

Whatever intervention you put in place, ensure that you evaluate its effectiveness. Is it working? If not, why not and what do you need to do differently?

Look at what the programme/intervention is trying to improve and/or support. How will you measure this? Most commonly, pre- and post-intervention questionnaires are used.

This article is only a starting point and I hope it has given you some food for thought. It is right that schools are looking at supporting mental health and well-being as it is the basis of all learning. Students can’t learn effectively unless they are in a good place mentally.

Further information

  • ‘Mental health promotion and problem prevention in schools: what does the evidence say?’ Weare and Nind, OUP, 2011: http://bit.ly/Weare-Nind

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About Author

Sam Garner

Sam Garner is an education consultant with specialist expertise in access arrangements and mental health in schools. She is a freelance trainer, and regularly speaks in schools to parents, staff and students (www.garnereducation.co.uk). She has also written a series of brief targeted CBT programmes designed to be run by school staff with students, including Exam Anxiety and Self Harming (www.rebalanceprogramme.com).

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