School-based interventions: what works for young people’s health and wellbeing?

From the wellbeing evidence, including our work with LSE on Origins of Happiness, we know that emotional health in childhood matters for later adult wellbeing. While it isn’t only schools who care about children and young people’s mental health they do impact it, and can make a difference from primary age upwards. 

Understanding ‘what works’ in this area is as important as understanding what helps young people achieve academic success and get good jobs – and is one of our WISER priorities in Wellbeing at the Heart of Policy.

The inclusion of wellbeing in the DfE’s Schools Policy Appraisal Handbook is a welcome step towards measurement of wellbeing in schools at a national level. We are working with the Children’s Society mapping what measures and tools are being used in the UK to measure the wellbeing of children and young people from their own perspective. The material compiled will allow for better benchmarking and comparison, and so better understanding of ‘what works’ to improve children’s wellbeing, ultimately leading to improved child wellbeing.

Projects like the #BeeWell pilot in Greater Manchester and Well Schools that we are advisors for, offer schools the opportunity to get involved in actively supporting the wellbeing of their pupils.

In this blog our What Works Network colleagues at the Early Intervention Foundation outline the findings from their review of the evidence on the effectiveness of school-based interventions designed to address young people’s emotional and behavioural needs. 

Schools are ideally positioned to support young people’s mental health and wellbeing and to intervene early before problems become ingrained and difficult to reverse. They are acutely aware that young people’s mental health affects their learning and ability to engage academically, hence their commitment to addressing pupils’ social, emotional, physical and academic needs. It is essential, however, that what is delivered in schools is informed by the evidence base. 

At the Early Intervention Foundation, our mission is to ensure that effective early intervention is available and used to improve the lives of children and young people, in particular, those most at risk of experiencing poor outcomes. Given the important role schools play in supporting young people’s mental health, we conducted a review of the latest evidence on the effectiveness of school-based interventions designed to address young people’s emotional and behavioural needs during their adolescent years. 

Our review provides a unique insight into what works in schools. It draws together evidence from across 34 systematic reviews published since 2010 and 97 primary studies published over the last three years. It covers three core areas including interventions designed to: 

• Enhance young people’s mental health and wellbeing. 
• Reduce or prevent mental health difficulties including depression and anxiety. 
• Reduce or prevent behavioural difficulties including aggression, bullying and conduct problems. 

In addition to understanding what works, our review examined who these interventions are most effective for, and under what conditions. This information is essential in advancing our understanding of how interventions should be delivered in schools in order to have an impact on young people’s mental health outcomes. 

What works to enhance young people’s mental health and wellbeing? 

We identified a range of approaches being implemented and evaluated in secondary schools including:

• Social and emotional skills-based interventions.
• Positive psychology interventions.
• Mindfulness-based interventions.
• Positive youth development interventions.
• Mental health literacy interventions. 

The evidence is strongest for universal social and emotional learning curriculum-based interventions which have been shown to have good evidence of enhancing wellbeing and preventing depression and anxiety in the short term. 

The MindOut Programme is a good example of an evidence-based SEL intervention delivered to young people aged 15-18 years in secondary school. The programme is implemented in Ireland through the Social, Personal and Health Education curriculum. Over the course of 13 weekly sessions, students engage in a number of skills-building activities such as identifying and managing emotions, coping with challenges, overcoming negative thinking, communication skills, empathy and relationship skills. The results from a cluster randomised control trial in Ireland provide evidence that teacher-delivered social and emotional learning interventions can be successfully embedded within a school curriculum and have a positive impact on young people’s mental health and wellbeing outcomes. 

Implications of findings from evidence review

We have identified several approaches and interventions with good evidence of improving young people’s wellbeing, reducing symptoms of depression and anxiety or reducing aggressive behaviour and bullying victimisation. It is crucial that evidence-based programmes are prioritised over the vast array of programmes and resources that are available to schools, many of which lack evidence of effectiveness or have evidence of no impact. 

As part of this, schools need to be provided with the necessary support to develop teachers’ knowledge and skills in supporting young people’s mental health. The roll-out of the mental health support teams (MHST) in England provides a real opportunity to enhance teachers’ skills and confidence in being able to respond to young people’s mental health and behavioural needs. 

The findings from this review have an important role to play in guiding evidence-informed decisions to advance school mental health in the coming years. At EIF, we are building on our evidence review by producing guidance for secondary school staff on supporting young people’s emotional and behavioural needs (March 2022).