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Embarking of school mental health research: the efficacy of mental health interventions

school mental health research
By Adam Gillett MA, (Assistant Principal – Inclusion), Penistone Grammar School

The MA in Leadership of School Mental Health & Wellbeing has been one of the best things I have done in my professional career, but writing the dissertation was probably the hardest. The structure of the course is so well done and the assignments so focused that when given free rein at first, I felt a little lost. Where do you start on a subject you are passionate about and which has so many areas to explore?

The best thing I did was speak to my mentor Dean and use him to sound out some ideas. I did this too with family, friends and colleagues and bounced ideas around. I would recommend this to anyone; externalising your thoughts really helps knock the edges off them and ideas gain more clarity. Dean’s advice was key too; make it something which will have an impact on your own setting. This, more than anything, directed my thinking and made me more forensic in my approach.

Efficacy of mental health interventions in schools

I finally settled on investigating the efficacy of the mental health interventions we had in place at the large secondary I worked at. This involved researching, first and foremost, what tools were out there in terms of assessing impact. It quickly became clear that this was an under-researched area and would allow me sufficient scope to explore. 

Efficacy studies on child mental health are problematic, in part because of the difficulty of observing and measuring a child’s state of development and mental health, and then explicitly linking it to a mental health intervention. This initial literature review is a really important step as it starts to shape the direction you are going to go. 

Mapping out how you are going to conduct your study is vital; at first I took a scatter gun approach, searching for anything and everything which was linked. However, after the dissertation conference (well worth the time, it is a vital source of advice) I took a more measured approach, working through a list of focus areas.

As there wasn’t an ‘off the shelf’ model of evaluation for school based mental health interventions, I focused on developing one. I developed a formula which would use entry and exit questionnaire data, compare it to the cost of the intervention and then provide a key for how effective it was.

Covid, lockdowns and school mental health support

And then COVID hit! Leading Inclusion in a large secondary (1800 students) in a socio-economically deprived area with tough young children is tough at the best of times but COVID, alongside a Masters, proved immensely taxing. However, the support from the university was great and we were encouraged and helped to look at how we could adjust our studies to fit in with the next context we were working in.

Luckily, we had been collecting entry and exit data for the past couple of years. There were a number of issues with the data and I had designed a new version which I would have used for my research. However, this was no longer possible and so I used the data I had, recognising its weaknesses as part of my study.

I had data on several of our interventions: Student support officer, non-teaching head of year, peer mentoring, art therapy, one to one traditional talking therapy, group therapy and CAMHS counselling. Students scored out of ten how they felt entering and how they felt at the end of the intervention. The difference between the two provided a score. These could then be added together and averaged. Equally, all the costs for each intervention were added together. This included room costs, staffing, resources and so on. I then used the below formula –

Cost of Intervention (CI) ÷ Mean intervention score (MIS) = Impact Rating (IR)

For example, if an intervention costs £500 per session, and the mean intervention score is 3.45, the impact rating score will be 144.9. 

From this I could clearly identify in our setting which interventions had the biggest impact for the lowest cost. I think we need to see something of the findings otherwise colleagues will be wondering what you found. You can generalise these if you wish to: e.g. we found that using staff for interventions is more effective than using external providers, etc.

This led to a complete shift in our approach to mental health interventions. We became evidence driven as an organisation, ensuring we assessed the impact of all our interventions moving forward. We also found that the biggest impact on students was from our own staff doing one to one mentoring. 

 

Intervention

Key Rating Score (1 being the best down to 5)

CAMHS

2

Art Therapy

5

MindSpace (Individual)

2

MindSpace (Group)

2

Mentoring

1

 

Surprisingly, this was more successful than a one to one sessions with a mental health professional. It was also enlightening to assess the cost of each intervention; we rarely do a cost-benefit analysis in education but they are commonplace in business. From this I could justify our spending to both the Principal and Governors and also request further funding as I had the evidence to support it. This was a seismic shift not only for the school but for me as a leader in education. 

I concluded my dissertation with the below principles for further study and I think they are worth sharing here as they may be of use before people start their own dissertation journeys. I made a lot of mistakes, as will everyone, but I think one of the key points is to get started. Often the fear is worse than the reality and once I began, I found my passion and drive for the subject took over.

Principles for future study

As this study was a starting point, below are summarised some guidance for how future studies based upon a cost-effectiveness model can and should (where possible) be conducted. 

Infographic_Principles for future study on school mental health interventions

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Finally, comparisons should be made between the cost and the impact to work out the effectiveness, which may then be used as a basis for future procurement and decision making.

 All the best for your study!

Adam Gillett
Adam Gillett

Assistant Principal - Inclusion
Penistone Grammar School

Masters in Leadership of School Mental Health and Wellbeing: the next cohort starts in September 2021

It’s time to empower education professionals to support the mental health needs of the whole school community. School leaders taking our qualification develop the confidence and skills to effectively support mental health needs of pupils and educators.

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