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Mental Health Interventions in School Environments

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (15 November 2022) | Viewed by 39360

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Special Issue Editors

Dr. Mina Fazel

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Guest Editor

Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK
Interests: school mental health; implementation science

Prof. Dr. Marc Atkins

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Guest Editor

Institute for Juvenile Research, University of Illinois at Chicago, Chicago, IL 60612, USA
Interests: school and community mental health programmes

Prof. Dr. Sharon A. Hoover

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Guest Editor

National Center for School Mental Health, University of Maryland School of Medicine, Baltimore, MD 21201, USA
Interests: school mental health interventions

Dr. Daniel Michelson

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Guest Editor

School of Psychology, University of Sussex, Brighton BN1 9RH, UK
Interests: school- and community-based mental health interventions for children, adolescents and their families

Special Issue Information

Dear Colleagues,

This Special Issue will have a focus on the implementation of mental health interventions in the school environment. Studies with a focus on the barriers and facilitators of bringing about interventions as well as those with a multi-modal focus are particularly welcome. Interventions can be for the promotion, prevention and treatment of mental disorders in school-aged populations and taking their context into consideration, including peer, educator, school, family and community factors. This Special Issue plans to be of practical use to researchers trying to apply rigorous mixed methods research to the field and also to those working in schools, including mental health practitioners, educators and the host of third sector and other statutory agencies convening on the school location, with the aim of ensuring that services delivered to address mental health problems are acceptable, accessible and sustainable.

Dr. Mina Fazel
Prof. Dr. Marc Atkins
Prof. Dr. Sharon A. Hoover
Dr. Daniel Michelson
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

school
mental health
intervention
implementation
adolescent
community

Published Papers (11 papers)

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Research

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13 pages, 783 KiB

Open AccessArticle

Partnerships at the Interface of Education and Mental Health Services: The Utilisation and Acceptability of the Provision of Specialist Liaison and Teacher Skills Training

by Mina Fazel, Emma Soneson, Elise Sellars, Gillian Butler and Alan Stein

Int. J. Environ. Res. Public Health 2023, 20(5), 4066; https://doi.org/10.3390/ijerph20054066 - 24 Feb 2023

Cited by 4 | Viewed by 2075

Abstract

Partnerships between school staff and mental health professionals have the potential to improve access to mental health support for students, but uncertainty remains regarding whether and how they work in practice. We report on two pilot projects aimed at understanding the implementation drivers of tailored strategies for supporting and engaging front-line school staff in student mental health. The first project provided regular, accessible mental health professionals with whom school staff could meet and discuss individual or systemic mental health concerns (a school ‘InReach’ service), and the other offered a short skills training programme on commonly used psychotherapeutic techniques (the School Mental Health Toolbox; SMHT). The findings from the activity of 15 InReach workers over 3 years and 105 individuals who attended the SMHT training demonstrate that school staff made good use of these services. The InReach workers reported more than 1200 activities in schools (notably in providing specialist advice and support, especially for anxiety and emotional difficulties), whilst most SMHT training attendees reported the utilisation of the tools (in particular, supporting better sleep and relaxation techniques). The measures of acceptability and the possible impacts of the two services were also positive. These pilot studies suggest that investment into partnerships at the interface of education and mental health services can improve the availability of mental health support to students. Full article

(This article belongs to the Special Issue Mental Health Interventions in School Environments)

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18 pages, 1702 KiB

Open AccessArticle

Feasibility and Acceptability of a Remote Stepped Care Mental Health Programme for Adolescents during the COVID-19 Pandemic in India

by Kanika Malik, Tejaswi Shetty, Sonal Mathur, James E. Jose, Rhea Mathews, Manogya Sahay, Preeti Chauhan, Pooja Nair, Vikram Patel and Daniel Michelson

Int. J. Environ. Res. Public Health 2023, 20(3), 1722; https://doi.org/10.3390/ijerph20031722 - 17 Jan 2023

Cited by 1 | Viewed by 2085

Abstract

Remote mental health services were rapidly deployed during the COVID-19 pandemic, yet there is relatively little contemporaneous evidence on their feasibility and acceptability. This study assessed the feasibility and acceptability of a stepped care mental health programme delivered remotely by lay counsellors to adolescents in New Delhi, India, during a period of ‘lockdown’. The programme consisted of a brief problem-solving intervention (“Step 1”) followed by a tailored behavioural module (“Step 2”) for non-responders. We enrolled 34 participants (M age = 16.4 years) with a self-identified need for psychological support. Feasibility and acceptability were assessed through quantitative process indicators and qualitative interviews (n = 17 adolescents; n = 5 counsellors). Thirty-one (91%) adolescents started Step 1 and 16 (52%) completed the planned Step 1 protocol. Twelve (75%) of the Step 1 completers were non-responsive. Eight (67%) non-responsive cases started Step 2, all of whom met response criteria when reassessed at 12 weeks post-enrolment. Adolescents favoured voice-only sessions over video-calls due to privacy concerns and difficulties accessing suitable devices. Counsellors noted challenges of completing remote sessions within the allotted time while recognising the importance of supervision for developing competence in new ways of working. Both adolescents and counsellors discussed the importance of working collaboratively and flexibly to fit around individual preferences and circumstances. Disentangling pandemic-specific barriers from more routine challenges to remote delivery should be a focus of future research. Full article

(This article belongs to the Special Issue Mental Health Interventions in School Environments)

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17 pages, 364 KiB

Open AccessArticle

Early Identification of Social, Emotional, and Behavioral Difficulties by School Staff: A Qualitative Examination of Dutch Primary School Practices

by Marloes L. Jaspers-van der Maten, Els W. M. Rommes and Ron H. J. Scholte

Int. J. Environ. Res. Public Health 2023, 20(1), 654; https://doi.org/10.3390/ijerph20010654 - 30 Dec 2022

Viewed by 1988

Abstract

About 16% of Dutch children are reported to have social, emotional, and behavioral difficulties (SEBDs). SEBDs generate distress and pose risks for various negative outcomes; thus, their timely identification is deemed important to respond appropriately to children’s needs and avoid such negative outcomes. Primary schools are considered convenient places to implement early SEBD identification, but the ways in which schools achieve this in practice may be inadequate, although the issue remains under-researched. Although there are several systematic school-based early identification methods (e.g., universal or selective screening), primary schools predominantly rely on school staff to recognize children at risk for, or experiencing, SEBDs. As differences in identification practices could impact whether and when (signs of) SEBDs are identified, this study aimed to increase our understanding of differences in identification practices used by school staff and their potential implications for early identification effectiveness. Thirty-four educational and clinical professionals working at nine primary schools participated in in-depth semi-structured interviews. We used MAXQDA to thematically code and analyze the data. Our analysis of these interviews illustrated that schools’ identification practices differed on three elements: the frequency of observations, maintaining a four-eyes principle, and the utilization of specialist knowledge. We argue that differences in these elements have potential consequences for the timeliness and quality of SEBD identification. Full article

(This article belongs to the Special Issue Mental Health Interventions in School Environments)

15 pages, 1405 KiB

Open AccessArticle

Educator-Informed Development of a Mental Health Literacy Course for School Staff: Classroom Well-Being Information and Strategies for Educators (Classroom WISE)

by Jaime C. Semchuk, Shannon L. McCullough, Nancy A. Lever, Heather J. Gotham, Jessica E. Gonzalez and Sharon A. Hoover

Int. J. Environ. Res. Public Health 2023, 20(1), 35; https://doi.org/10.3390/ijerph20010035 - 20 Dec 2022

Cited by 2 | Viewed by 4098

Abstract

Educators play a critical role in promoting mental health and well-being with their students. Educators also recognize that they lack knowledge and relevant learning opportunities that would allow them to feel competent in supporting student mental health. As such, educators require resources and training to allow them to develop skills in this area. The Mental Health Technology Transfer Center (MHTTC) Network partnered with the National Center for School Mental Health at the University of Maryland School of Medicine to develop Classroom Well-Being and Information for Educators (WISE), a free, three-part mental health literacy training package for educators and school staff that includes an online course, video library, and resource collection. The Classroom WISE curriculum focuses on promoting positive mental health in the classroom, as well as strategies for recognizing and responding to students experiencing mental health related distress. This paper describes the curriculum development process, including results of focus groups and key informant interviews with educators and school mental health experts. Adoption of Classroom WISE can help educators support student mental health and assist in ameliorating the youth mental health crisis. Full article

(This article belongs to the Special Issue Mental Health Interventions in School Environments)

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13 pages, 338 KiB

Open AccessArticle

Promoting Mental Health Help-Seeking Behaviors by Mental Health Literacy Interventions in Secondary Education? Needs and Perspectives of Adolescents and Educational Professionals

by Lindy Beukema, Janne M. Tullius, Lies Korevaar, Jacomijn Hofstra, Sijmen A. Reijneveld and Andrea F. de Winter

Int. J. Environ. Res. Public Health 2022, 19(19), 11889; https://doi.org/10.3390/ijerph191911889 - 20 Sep 2022

Cited by 2 | Viewed by 2739

Abstract

Mental health literacy (MHL) interventions in secondary schools may help to improve competencies that adolescents require to stay mentally healthy and seek help if mental health problems arise. These MHL interventions should be tailored to the needs of adolescents and educational professionals (EPs) to reach sustainable implementation and long-term effectiveness. However, evidence is lacking on these needs. Thus, our aim was to explore their experiences with, and perspectives on, mental health help seeking and needs regarding MHL interventions. We performed online focus group discussions and interviews with adolescents (n = 21; 13–19 years) and EPs (n = 12) and analyzed the data using directed content analysis. We identified three themes related to mental health help seeking: (1) Limited MHL competencies of adolescents, (2) Limited competencies of EP to provide mental health support, and (3) Limited mental health promotion in the school environment. We further identified three themes regarding MHL interventions: (1) Addressing basic mental health knowledge and skills, (2) Interactive and easily accessible, and (3) Sustainable implementation. Improving the MHL competencies of adolescents and EPs, and creating a mental health-literate school environment can promote adolescents’ mental health help seeking. Our findings highlight the importance of developing MHL interventions that are tailored to both adolescents’ and EPs needs. Full article

(This article belongs to the Special Issue Mental Health Interventions in School Environments)

12 pages, 545 KiB

Open AccessArticle

Resilience in Teachers: Validation of the Spanish Version of the CD-RISC10© Scale in Early Childhood, Primary and Special Education Teachers

by Raquel Flores-Buils, Antonio Caballer-Miedes and Rosa Mateu-Pérez

Int. J. Environ. Res. Public Health 2022, 19(17), 11020; https://doi.org/10.3390/ijerph191711020 - 03 Sep 2022

Cited by 1 | Viewed by 1716

Abstract

Schools are a fundamental context for processes of promotion and generation of resilience, since they focus not only on aspects of academic development, but also of personal and social development. Resilience in the teacher has a dual function. On the one hand, as resilient professionals, teachers can foster the development of resilience in their students; on the other hand, teaching resilience facilitates their own personal and professional well-being. Despite research highlighting the benefits of resilience in education, there is scarce research focused on assessing resilience in teachers. Thus, the aim of this paper is to analyze the psychometric properties of the Spanish version of Connor and Davidson’s 10-item resilience scale (CD-RISC 10©) in a sample of 290 teachers. A confirmatory factorial analysis (CFA) is performed, which shows that the 10 items on the CD-RISC 10© Resilience Scale form a one-dimensional structure, with high reliability, McDonald’s Omega coefficient (ω = 0.80) and Cronbach’s alpha coefficient (α = 0.87). The results obtained in this work support the use of the scale for the assessment of resilience in teachers of Infant, Primary and Special Education, which is considered very useful, not only to know their degree of resilience, but also to assess the effectiveness of training programs. Full article

(This article belongs to the Special Issue Mental Health Interventions in School Environments)

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12 pages, 749 KiB

Open AccessArticle

Effectiveness of a Mindfulness-Based Group Intervention for Chinese University Students with Sleep Problems

by Lin Fu, Shuang Wei, Jin Cheng, Xueqi Wang, Yueyue Zhou, Yi Li and Hao Zheng

Int. J. Environ. Res. Public Health 2022, 19(2), 755; https://doi.org/10.3390/ijerph19020755 - 10 Jan 2022

Cited by 2 | Viewed by 2501

Abstract

The increasing prevalence of sleep disorders among university students should be taken seriously. Group counseling involving a mindfulness-based strategy may help prevent students from developing insomnia and subsequent mental health disorders. This study aimed to evaluate the ameliorating effects of a mindfulness-based group intervention on sleep problems and emotional symptoms in university students in China. Twenty-one university students (16 females, 22.71 ± 4.28 years) who were not on medication were recruited and assigned to the intervention group based on the criterion of high levels of sleep problems. Additionally, twenty-four university students (19 females, 24.50 ± 0.93 years) were included as a nonrandomized control group. Individuals in the intervention group participated in a two-hour group intervention once a week for eight sessions. All participants completed self-reported questionnaire baseline tests, postintervention tests, and one-month follow-ups on mindfulness, sleep quality, anxiety and depressive symptoms. Repeated-measures ANOVA was performed. The results revealed significant intervention effects, with significant differences observed between the two groups in mindfulness and sleep quality. However, there was no significant effect of the intervention on anxiety and depressive symptoms. This study contributes to a better understanding of the effectiveness of mindfulness-based intervention in addressing sleep problems in university students. Full article

(This article belongs to the Special Issue Mental Health Interventions in School Environments)

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Review

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23 pages, 1771 KiB

Open AccessReview

Barriers and Facilitators to Sustaining School-Based Mental Health and Wellbeing Interventions: A Systematic Review

by Anna March, Emily Stapley, Daniel Hayes, Rosa Town and Jessica Deighton

Int. J. Environ. Res. Public Health 2022, 19(6), 3587; https://doi.org/10.3390/ijerph19063587 - 17 Mar 2022

Cited by 27 | Viewed by 8287

Abstract

Despite an increasing focus on schools to deliver support and education around mental health and wellbeing, interventions are often not sustained beyond initial funding and research. In this review, the barriers and facilitators to sustaining mental health and wellbeing interventions in schools are explored. A systematic review was conducted using keywords based on the terms: ‘sustainability’, ‘school’, ‘intervention’, ‘mental health’, and ’emotional wellbeing’. Six online databases (PsycINFO, Embase, MEDLINE, British Education Index, ERIC, and Web of Science) and relevant websites were searched resulting in 6160 unique references. After screening, 10 articles were included in the review and extracted data were qualitatively synthesized using thematic analysis. Data synthesis led to the identification of four sustainability factors at the school level (school leadership, staff engagement, intervention characteristics, and resources) and one at the wider system level (external support). These factors were separated into 15 themes and discussed as barriers and facilitators to sustainability (for example, school culture and staff turnover). Most articles included no definition of sustainability, and nearly all barriers and facilitators were discussed at the school level. The findings suggest that more longitudinal and theory-driven research is required to develop a clearer picture of the sustainability process. Full article

(This article belongs to the Special Issue Mental Health Interventions in School Environments)

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Other

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24 pages, 1805 KiB

Open AccessSystematic Review

Investigating the Role of Friendship Interventions on the Mental Health Outcomes of Adolescents: A Scoping Review of Range and a Systematic Review of Effectiveness

by Tanya Manchanda, Alan Stein and Mina Fazel

Int. J. Environ. Res. Public Health 2023, 20(3), 2160; https://doi.org/10.3390/ijerph20032160 - 25 Jan 2023

Cited by 7 | Viewed by 5078

Abstract

Friendships are crucial in adolescent development. This paper presents a scoping review, followed by a systematic review, to assess friendship interventions and their impacts on the mental health outcomes of adolescents aged 12–24 years. Studies were included if they incorporated a friend or authentic social group in an intervention dedicated to improving mental health outcomes and well-being. Twenty-four studies were included in the scoping review, and eighteen in the systematic review. Data from 12,815 adolescents were analysed; three prominent themes emerged. The most common theme was promoting mental health literacy, followed by supporting help-seeking, and friendship-building/combating isolation. Most evaluations focused on the individual who had received the intervention, rather than their wider friends who would have been potential contacts and experienced any altered interactions. Of the studies focusing on friendship-building, all had positive short-term outcomes but inconclusive long-term effects. Two studies recruited friends from an individual’s authentic social group. While opportunities for improving mental health literacy and help-seeking emerged as key themes, the role of friends in mental health interventions has only been included in a small number of studies. Given that friends are a key point of contact for many adolescents, a better understanding of their domains of influence, particularly on mental health, will potentially enhance interventions. Full article

(This article belongs to the Special Issue Mental Health Interventions in School Environments)

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20 pages, 1196 KiB

Open AccessConference Report

Identifying Future Study Designs for Mental Health and Social Wellbeing Associated with Diets of a Cohort Living in Eco-Regions: Findings from the INSUM Expert Workshop

by Friederike Elsner, Lea Ellen Matthiessen, Dominika Średnicka-Tober, Wolfgang Marx, Adrienne O’Neil, Ailsa A. Welch, Richard Peter Hayhoe, Suzanne Higgs, Marja van Vliet, Ephimia Morphew-Lu, Renata Kazimierczak, Rita Góralska-Walczak, Klaudia Kopczyńska, Thea Steenbuch Krabbe Bruun, Beatriz Philippi Rosane, Susanne Gjedsted Bügel and Carola Strassner

Int. J. Environ. Res. Public Health 2023, 20(1), 669; https://doi.org/10.3390/ijerph20010669 - 30 Dec 2022

Cited by 1 | Viewed by 2799

Abstract

Diets influence our mental health and social wellbeing (MHSW) in multiple ways. A rising community concept, Eco-Regions, has gained interest. The research project “Indicators for assessment of health effects of consumption of sustainable, organic school meals in Ecoregions” (INSUM) aims to develop future-oriented research approaches to measure the potential health effects of more sustainable and healthy diets. This first part of the project focuses on MHSW with the goal to identify suitable study designs and indicators. The methodology is based on a 2-day workshop with an interdisciplinary group of experts. This paper describes commonly applied research methods on the nexus between diet and MHSW as presented by the experts and summarises key points from the discussions. The results show that the dominating tool to investigate MSHW is questionnaires. Questionnaires vary largely depending on the research design, such as participants or distribution channels. Cohort studies addressing families and including in-depth interventional and/or experimental studies may be suitable for an Eco-Region investigation. Those MHSW studies can be conducted and combined with measurements of somatic health effects. We conclude that indicators should be seen as complementary rather than independent. Explorative research designs are required to investigate complex Eco-Regions. Full article

(This article belongs to the Special Issue Mental Health Interventions in School Environments)

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12 pages, 722 KiB

Open AccessCommentary

‘Shall We Send a Panda?’ A Practical Guide to Engaging Schools in Research: Learning from Large-Scale Mental Health Intervention Trials

by Anna March, Emma Ashworth, Carla Mason, Joao Santos, Rosie Mansfield, Emily Stapley, Jessica Deighton, Neil Humphrey, Nick Tait and Daniel Hayes

Int. J. Environ. Res. Public Health 2022, 19(6), 3367; https://doi.org/10.3390/ijerph19063367 - 12 Mar 2022

Cited by 7 | Viewed by 4135

Abstract

The substantial time that children and young people spend in schools makes them important sites to trial and embed prevention and early intervention programmes. However, schools are complex settings, and it can be difficult to maintain school engagement in research trials; many projects experience high levels of attrition. This commentary presents learning from two large-scale, mixed-methods mental health intervention trials in English schools. The paper explores the barriers and challenges to engaging schools in promotion or early intervention research and offers detailed recommendations for other researchers. Full article

(This article belongs to the Special Issue Mental Health Interventions in School Environments)

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