Review: Delivering mental health support within schools and colleges - a thematic synthesis of barriers and facilitators to implementation of indicated psychological interventions for adolescents.


Journal

Child and adolescent mental health
ISSN: 1475-357X
Titre abrégé: Child Adolesc Ment Health
Pays: England
ID NLM: 101142157

Informations de publication

Date de publication:
02 2021
Historique:
accepted: 24 02 2020
pubmed: 17 6 2020
medline: 26 10 2021
entrez: 17 6 2020
Statut: ppublish

Résumé

Increasing the role of schools and colleges in the provision of mental health services for young people has the potential to improve early intervention and access to treatment. We aimed to understand what factors influence the successful implementation of indicated psychological interventions within schools and colleges to help guide increased provision of mental health support within education settings. Systematic search for studies that have reported barriers or facilitators to the implementation of indicated interventions for adolescent emotional disorders delivered within schools and further education/sixth form colleges (CRD42018102830). Databases searched were EMBASE, MEDLINE, PsycINFO, CINAHL, British Nursing Index, ASSIA, ERIC and British Education Index. A thematic synthesis of factors reported to impact implementation was conducted. Two thousand five hundred and sixty-nine records and 177 full texts were screened. Fifty studies were identified for inclusion, all of which were of school-based interventions. Eleven analytic themes were developed encompassing intervention characteristics, organisational capacity, training and technical assistance, provider characteristics and community-level factors. Findings indicate the need to select appropriate interventions, consider logistical challenges of the school context and provide training and supervision to enable staff to deliver interventions with fidelity. However, structural and environmental support is required for these facilitators to have the greatest impact on successful implementation. Implementing indicated school-based mental health interventions is challenging. Those involved in planning school-based mental health initiatives must be alert to the impact of factors on multiple interacting levels. There is a lack of research on implementing mental health support within further education and sixth form colleges. Increased utilisation of schools and colleges as a setting for early intervention has been proposed as a means of improving access to mental health treatment, but successful implementation of mental health interventions within educational settings is challenging. Based on a synthesis of current evidence, we recommend that young people and education professionals should be involved in the selection of school-based interventions to ensure they are acceptable and practical to deliver within the logistical constraints of the school environment. Those delivering interventions within schools, as well as staff involved in identifying young people who might benefit from these interventions, must receive high-quality ongoing training and support. Senior school leaders play an important role in championing mental health interventions and developing a school culture that prioritises mental well-being. Health and education policy should be designed to promote a cross-sector focus on the emotional health of young people. There is a lack of evidence on the implementation of indicated psychological interventions within sixth form and further education colleges.

Sections du résumé

BACKGROUND
Increasing the role of schools and colleges in the provision of mental health services for young people has the potential to improve early intervention and access to treatment. We aimed to understand what factors influence the successful implementation of indicated psychological interventions within schools and colleges to help guide increased provision of mental health support within education settings.
METHODS
Systematic search for studies that have reported barriers or facilitators to the implementation of indicated interventions for adolescent emotional disorders delivered within schools and further education/sixth form colleges (CRD42018102830). Databases searched were EMBASE, MEDLINE, PsycINFO, CINAHL, British Nursing Index, ASSIA, ERIC and British Education Index. A thematic synthesis of factors reported to impact implementation was conducted.
RESULTS
Two thousand five hundred and sixty-nine records and 177 full texts were screened. Fifty studies were identified for inclusion, all of which were of school-based interventions. Eleven analytic themes were developed encompassing intervention characteristics, organisational capacity, training and technical assistance, provider characteristics and community-level factors. Findings indicate the need to select appropriate interventions, consider logistical challenges of the school context and provide training and supervision to enable staff to deliver interventions with fidelity. However, structural and environmental support is required for these facilitators to have the greatest impact on successful implementation.
CONCLUSIONS
Implementing indicated school-based mental health interventions is challenging. Those involved in planning school-based mental health initiatives must be alert to the impact of factors on multiple interacting levels. There is a lack of research on implementing mental health support within further education and sixth form colleges.
KEY PRACTITIONER MESSAGE
Increased utilisation of schools and colleges as a setting for early intervention has been proposed as a means of improving access to mental health treatment, but successful implementation of mental health interventions within educational settings is challenging. Based on a synthesis of current evidence, we recommend that young people and education professionals should be involved in the selection of school-based interventions to ensure they are acceptable and practical to deliver within the logistical constraints of the school environment. Those delivering interventions within schools, as well as staff involved in identifying young people who might benefit from these interventions, must receive high-quality ongoing training and support. Senior school leaders play an important role in championing mental health interventions and developing a school culture that prioritises mental well-being. Health and education policy should be designed to promote a cross-sector focus on the emotional health of young people. There is a lack of evidence on the implementation of indicated psychological interventions within sixth form and further education colleges.

Identifiants

pubmed: 32543016
doi: 10.1111/camh.12381
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

34-46

Subventions

Organisme : Department of Health
ID : HS&DR/17/09/31
Pays : United Kingdom

Informations de copyright

© 2020 The Authors. Child and Adolescent Mental Health published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

Références

Anderson, J.K., Ford, T., Soneson, E., Coon, J.T., Humphrey, A., Rogers, M., … & Howarth, E. (2019). A systematic review of effectiveness and cost-effectiveness of school-based identification of children and young people at risk of, or currently experiencing mental health difficulties. Psychological Medicine, 49, 9-19.
Association of Colleges. (2018). Mental Health & Wellbeing: A collection of college case studies.
*Bei, B., Byrne, M.L., Ivens, C., Waloszek, J., Woods, M.J., Dudgeon, P., … & Allen, N.B. (2013). Pilot study of a mindfulness-based, multi-component, in-school group sleep intervention in adolescent girls. Early Intervention in Psychiatry, 7, 213-220.
*Bernstein, E.R. (2010). Transportability of Evidence-Based Anxiety Interventions to a School Setting: Evaluation of a Modularized Approach to Intervention. Madison, WI: University of Wisconsin-Madison.
*Berry, K., & Hunt, C.J. (2009). Evaluation of an intervention program for anxious adolescent boys who are bullied at school. Journal of Adolescent Health, 45, 376-382.
*Burke, M., Prendeville, P., & Veale, A. (2017). Educational Psychology in Practice theory, research and practice in educational psychology an evaluation of the “FRIENDS for Life” programme among children presenting with autism spectrum disorder. Educational Psychology in Practice, 33, 435-449.
*Butler-Hepler, K. (2013). A longitudinal exploration of factors impacting outcomes for native American students participating in CBITS: Looking beyond quantitative analysis. Missoula, MT: The University of Montana.
Caldwell, D.M., Davies, S.R., Hetrick, S.E., Palmer, J.C., Caro, P., López-López, J.A., … & Stockings, E. (2019). School-based interventions to prevent anxiety and depression in children and young people: A systematic review and network meta-analysis. The Lancet Psychiatry, 6, 1011-1020.
*Chu, B.C., Crocco, S.T., Esseling, P., Areizaga, M.J., Linder, A.M., & Skriner, L.C. (2016). Transdiagnostic group behavioural activation and exposure therapy for youth anxiety and depression: Initial randomised controlled trial. Behavior Research and Therapy, 76, 65-75.
*Chu, B.C., & Weissman, A.S. (2009). An initial description and pilot of group behavioral activation therapy for anxious and depressed youth. Cognitive and Behavioral Practice, 16, 408-419.
*Cooley, M.R., Boyd, R.C., & Grados, J.J. (2004). Feasibility of an anxiety preventive intervention for community violence exposed African-American children. The Journal of Primary Prevention, 25, 105-123.
*Cooper, M., Rowland, N., Mcarthur, K., Pattison, S., Cromarty, K., & Richards, K. (2010). Randomised controlled trial of school-based humanistic counselling for emotional distress in young people: Feasibility study and preliminary indications of efficacy. Child and Adolescent Psychiatry and Mental Health, 4, 1-13.
*Crisp, H.L., Gudmundsen, G.R., & Shirk, S.R. (2006). Transporting evidence-based therapy for adolescent depression to the school setting. Education and Treatment of Children, 29, 287-309.
Deighton, J., Lereya, S.T., Casey, P., Patalay, P., Humphrey, N., & Wolpert, M. (2019). Prevalence of mental health problems in schools: Poverty and other risk factors among 28,000 adolescents in England. British Journal of Psychiatry, 215, 565-567.
Department of Health (2017). Transforming Children and Young People’s Mental Health Provision: a. Green Paper.
Department of Health and Social Care (2019). NHS Long Term Plan.
*Drmic, I.E., Aljunied, M., & Reaven, J. (2017). Feasibility, acceptability and preliminary treatment outcomes in a school-based CBT intervention program for adolescents with ASD and anxiety in Singapore. Journal of Autism and Developmental Disorders, 47, 3909-3929.
Durlak, J.A., & Dupre, E.P. (2008). Implementation matters: A review of research on the influence of implementation on program outcomes and the factors affecting implementation. American Journal of Community Psychology, 41, 327-350.
*Ehntholt, K.A., & Smith, P.A. (2005). School-based cognitive-behavioural therapy group intervention for refugee children who have experienced war-related trauma. Clinical Child Psychology and Psychiatry, 10, 235-250.
Fazel, M., Hoagwood, K., Stephan, S., & Ford, T. (2014). Mental health interventions in schools in high-income countries. The Lancet Psychiatry, 1, 377-387.
Fazel, M., Patel, V., Thomas, S., & Tol, W. (2014). Mental health interventions in schools in low-income and middle-income countries. The Lancet Psychiatry, 1, 388-398.
*Feldman, E.S. (2007). Implementation of the cognitive behavioural intervention for trauma in schools (CBITS) with Spanish-speaking, immigrant middle-school students: is effective, culturally competent treatment possible within a public school setting? Madison, WI: University of Wisconsin-Madison.
*Fitzgerald, A., Rawdon, C., & Dooley, B. (2016). A randomized controlled trial of attention bias modification training for socially anxious adolescents. Behaviour Research and Therapy, 84, 1-8.
Frith, E. (2016). Children and Young People’s Mental Health: State of the Nation.
*Gartenberg, A.S. (2017). School-based CBT for anxiety in adolescents with high-functioning autism spectrum disorders: A comparison of the pragmatic case studies of brian and bridgette. Camden, NJ: Rutgers, The State University of New Jersey.
Gee, B., Orchard, F., Carroll, B., Reynolds, S., Clarke, T., Martin, D., … & Pass, L. (2020) Effectiveness of indicated school-based interventions for adolescent depression and anxiety: A meta-analytic review. Journal of Child Psychology and Psychiatry.
*Ginsburg, G.S., & Drake, K.L. (2002). School-based treatment for anxious African-American adolescents: A controlled pilot study. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 768-775.
*Greca, A.M., Ehrenreich-May, J., Mufson, L., & Chan, S. (2016). Preventing adolescent social anxiety and depression and reducing peer victimization: Intervention development and open trial. Child and Youth Care Forum, 45, 905-926.
Gronholm, P.C., Nye, E., & Michelson, D. (2018). Stigma related to targeted school-based mental health interventions: A systematic review of qualitative evidence. Journal of Affective Disorders, 240, 17-26.
Haby, M.M., Chapman, E., Clark, R., Barreto, J., Reveiz, L., & Lavis, J.N. (2016). What are the best methodologies for rapid reviews of the research evidence for evidence-informed decision making in health policy and practice: A rapid review. Health Research Policy and Systems, 14, 83.
*Hunt, C., Crino, R., & Erskine, A. (2009). Randomized controlled trial of an early intervention programme for adolescent anxiety disorders. Australian and New Zealand Journal of Psychiatry, 43, 300-304.
*Jaycox, L.H., Langley, A.K., Stein, B.D., Wong, M., Sharma, P., Scott, M., & Schonlau, M. (2009). Support for students exposed to trauma: A pilot study. School Mental Health, 1, 49-60.
*Kaplinski, H.C. (2007). Client characteristics and barriers to treatment in cognitive-behavioral therapy for adolescent depression. Denver, CO: University of Denver.
*Lamb, J.M., Puskar, K.R., Serika, S.M., & Corcoran, M. (1998). School-based intervention to promote coping in rural teens. American Journal of Maternal Child Nursing, 4, 187-194.
*Liberman, R.P., & Robertson, M.J. (2005). A pilot, controlled skills training study of schizotypal high school students. Verhaltenstherapie, 15, 176-180.
*Listug-Lunde, L., Vogeltanz-Holm, N., & Collins, J. (2013). A cognitive-behavioral treatment for depression in rural American Indian middle school students. American Indian and Alaska Native Mental Health Research: the Journal of the National Center, 20, 16-35.
*Livheim, F., Hayes, L., Ghaderi, A., Magnusdottir, T., Högfeldt, A., Rowse, J., … & Tengström, A. (2015). The effectiveness of acceptance and commitment therapy for adolescent mental health: Swedish and Australian pilot outcomes. Journal of Child and Family Studies, 24, 1016-1030.
*Masia, C.L., Klein, R.G., Storch, E.A., & Corda, B. (2001). School-based behavioral treatment for social anxiety disorder in adolescents: Results of a pilot study. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 780-786.
*Masia-Warner, C., Colognori, D., Brice, C., Herzig, K., Mufson, L., Lynch, C., … & Klein, R.G. (2016). Can school counselors deliver cognitive-behavioral treatment for social anxiety effectively? A randomized controlled trial. The Journal of Child Psychology and Psychiatry, 11, 1229-1238.
*Masia-Warner, C., Klein, R.G., Dent, H.C., Fisher, P.H., Alvir, J., Albano, A.M., & Guardino, M. (2005). School-based intervention for adolescents with social anxiety disorder: Results of a controlled study. Journal of Abnormal Child Psychology, 33, 707-722.
*McCarty, C.A., Violette, H.D., & Mccauley, E. (2011). Feasibility of the positive thoughts and actions prevention program for middle schoolers at risk for depression. Depression Research and Treatment, 2011, 1-9.
*Melnyk, B.M., Kelly, S., & Lusk, P. (2014). Outcomes and feasibility of a manualized cognitive-behavioral skills building intervention: Group COPE for depressed and anxious adolescents in school settings. Journal of Child and Adolescent Psychiatric Nursing, 27, 3-13.
*Messinger, J.W., Trémeau, F., Antonius, D., Mendelsohn, E., Prudent, V., Stanford, A.D., & Malaspina, D. (2011). Avolition and expressive deficits capture negative symptom phenomenology: implications for DSM-5 and schizophrenia research. Clinical Psychology Review, 31, 161-168.
Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G., Altman, D., Antes, G., … & Tugwell, P. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Medicine, 6, e1000097.
*Morsette, A., van den Pol, R., Schuldberg, D., Swaney, G., & Stolle, D. (2012). Advances in school mental health promotion cognitive behavioral treatment for trauma symptoms in American Indian youth: preliminary findings and issues in evidence-based practice and reservation culture. Advances in School Mental Health Promotion, 5, 51-62.
*Mowatt, H.S. (2017). School-based implementation of a prevention of depression program with urban at-risk adolescents. Indiana, PA: Indiana University of Pennsylvania.
*Mufson, L., Dorta, K.P., Wickramaratne, P., Nomura, Y., Olfson, M., & Weissman, M.M. (2004). A randomized effectiveness trial of interpersonal psychotherapy for depressed adolescents. Archives of General Psychiatry, 61, 577-584.
NHS England (2019). New mental health support in schools and colleges and faster access to NHS care. Available from: https://www.england.nhs.uk/mental-health/cyp/trailblazers/ [last accessed 29 July 2019].
Nilsen, P. (2015). Making sense of implementation theories, models and frameworks. Implementation Science, 10, 1-13.
Ofsted. (2019). The education inspection framework: draft for consultation.
*Oros, E. (2016). The effectiveness of dialectical behavior therapy- based group skills training in a traditional high school setting. Greeley, CO: University of Northern Colorado.
*Pass, L., Sancho, M., Brett, S., & Jones, M. (2018). Brief Behavioural Activation (Brief BA) in secondary schools: A feasibility study examining acceptability and practical considerations. Educational and Child Psychology, 35, 10-20.
Paulus, F.W., Ohmann, S., & Popow, C. (2016). Practitioner Review: School-based interventions in child mental health. The Journal of Child Psychology and Psychiatry, 12, 1337-1359.
*Pearson, K.E. (2017). Effects of anxiety treatment using coping cat on problem behaviors in the classroom. Pittsburgh, PA: Duquesne University.
*Pella, J.E., Ginsburg, G.S., Casline, E., Pikulski, P.J., & Drake, K.L. (2018). Children’s perceptions of barriers to session attendance in school-based treatment for anxiety. School Mental Health, 10, 417-427.
Proctor, E.K., Landsverk, J., Aarons, G., Chambers, D., Gilsson, C., & Mittman, B. (2009). Implementation research in mental health services: An emerging science with conceptual, methodological, and training challenges. Administration and Policy in Mental Health and Mental Health Services Research, 36, 24-34.
Public Health England (2015). Promoting children and young people’s emotional health and wellbeing. A whole school and college approach. 1-38. Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/414908/Final_EHWB_draft_20_03_15.pdf [last accessed 2 August 2019].
QSR International (2012). NVivo Qualitative Data Analysis Software.
Rapee, R.M., Wignall, A., Sheffield, J., Kowalenko, N., Davis, A., Mcloone, J., & Spence, S.H. (2006). Adolescents’ reactions to universal and indicated prevention programs for depression: perceived stigma and consumer satisfaction. Prevention Science, 7, 167-177.
*Rickard, E.D., Brosnan, E., Laoide, A.O., Wynne, C., Keane, M., Mccormack, M., & Sharry, J. (2016). A first-level evaluation of a school-based family programme for adolescent social, emotional and behavioural difficulties. Clinical Child Psychology and Psychiatry, 21, 603-617.
*Riley, A. (2012). Exploring the effects of the ‘Seasons for Growth’ intervention for pupils experiencing change and loss. Educational and Child Psychology, 29, 38-53.
*Robinson, J., Hetrick, S., Cox, G., Bendall, S., Yung, A., & Pirkis, J. (2015). The safety and acceptability of delivering an online intervention to secondary students at risk of suicide: findings from a pilot study. Early Intervention in Psychiatry, 9, 498-506.
*Rohde, P., Stice, E., Shaw, H., & Gau, J.M. (2014). Cognitive-behavioral group depression prevention compared to bibliotherapy and brochure control: Nonsignificant effects in pilot effectiveness trial with college students. Behaviour Research and Therapy, 55, 48-53.
*Ruffolo, M.C., & Fischer, D. (2009). Using an evidence-based CBT group intervention model for adolescents with depressive symptoms: Lessons learned from a school-based adaptation. Child and Family Social Work, 14, 189-197.
*Schoenfeld, N.A., & Mathur, S.R. (2009). Effects of cognitive-behavioral intervention on the school performance of students with emotional or behavioral disorders and anxiety. Behavioral Disorders, 34, 184-195.
*Scotti, J.F. (2014). School-based DBT skills groups for adolescent eating disorders and body image concerns: A pilot study. Missoula, MT: The University of Montana.
Sekhon, M., Cartwright, M., & Francis, J.J. (2017). Acceptability of healthcare interventions: An overview of reviews and development of a theoretical framework. BMC Health Services Research, 17, 88.
Soneson, E., Howarth, E., Ford, T., Humphrey, A., Jones, P. B., Thompson Coon, J., … & Anderson, J.K. (2020). Feasibility of school-based identification of children and adolescents experiencing, or at-risk of developing, mental health difficulties: A systematic review. Prevention Science. https://doi.org/10.1007/s11121-020-01095-6
*Stasiak, K., Hatcher, S., Frampton, C., & Merry, S.N. (2014). A pilot double blind randomized placebo controlled trial of a prototype computer-based cognitive behavioural therapy program for adolescents with symptoms of depression. Behavioural and Cognitive Psychotherapy, 42, 385-401.
*Stein, B.D. (2011). Helping children cope with violence and trauma. Santa Monica, CA:RAND Health.
*Stein, B.D., Jaycox, L.H., Kataoka, S.H., Wong, M., Elliott, M.N., & Fink, A. (2003). A mental health intervention for schoolchildren exposed to violence. JAMA - Journal of the American Medical Association, 290, 603-611.
*Stice, E., Rohde, P., Shaw, H., & Gau, J. (2011). An effectiveness trial of a selected dissonance-based eating disorder prevention program for female high school students: Long-term effects. Journal of Consulting and Clinical Psychology, 79, 500-508.
Thomas, J., & Harden, A. (2008). Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research Methodology, 8, 45.
Turner, C. (2018). Ofsted is considering new assessment to ensure schools look after pupils’ mental health and wellbeing.
Veritas Health Innovation. (n.d.). Covidence systematic review software. Melbourne, Australia.
Vizard, T., Pearce, N., Davis, J., Sadler, K., Ford, T., Goodman, A., … & McManus, S. (2018). Mental Health of Children and Young People in England, 2017: Emotional Disorders. https://doi.org/10.7748/paed2009.06.21.5.28.c7079
Werner-Seidler, A., Perry, Y., Calear, A.L., Newby, J.M., & Christensen, H. (2017). School-based depression and anxiety prevention programs for young people: A systematic review and meta-analysis. Clinical Psychology Review, 51, 30-47.
*Woods, B., & Jose, P.E. (2011). Effectiveness of a school-based indicated early intervention program for Māori and Pacific adolescents. Journal of Pacific Rim Psychology, 5, 40-50.
Wormald, C. (2018). Collaboration to improve mental health support for young people.
*Young, J.F., Benas, J.S., Schueler, C.M., Gallop, R., Gillham, J.E., & Mufson, L. (2016). A randomized depression prevention trial comparing interpersonal psychotherapy-Adolescent skills training to group counseling in schools. Prevention Science, 17, 314-324.
*Young, J.F., Mufson, L., & Gallop, R. (2010). Preventing depression: A randomized trial of interpersonal psychotherapy-adolescent skills training. Depression and Anxiety, 27, 426-433.
Zhao, Y., & Frank, K.A. (2003). Factors affecting technology uses in schools: An ecological perspective. American Educational Research Journal, 40, 807-840.

Auteurs

Brioney Gee (B)

Research & Development Department, Norfolk and Suffolk NHS Foundation Trust, Norwich, UK.
Norwich Medical School, University of East Anglia, Norwich, UK.

Jon Wilson (J)

Research & Development Department, Norfolk and Suffolk NHS Foundation Trust, Norwich, UK.
Norwich Medical School, University of East Anglia, Norwich, UK.
Grenada General Hospital, St. George's University, St. George's, Grenada.

Tim Clarke (T)

Research & Development Department, Norfolk and Suffolk NHS Foundation Trust, Norwich, UK.
Norwich Medical School, University of East Anglia, Norwich, UK.

Sophie Farthing (S)

Research & Development Department, Norfolk and Suffolk NHS Foundation Trust, Norwich, UK.

Ben Carroll (B)

Research & Development Department, Norfolk and Suffolk NHS Foundation Trust, Norwich, UK.

Christopher Jackson (C)

Research & Development Department, Norfolk and Suffolk NHS Foundation Trust, Norwich, UK.

Kahfee King (K)

Grenada General Hospital, St. George's University, St. George's, Grenada.

Jamie Murdoch (J)

School of Health Sciences, University of East Anglia, Norwich, UK.

Peter Fonagy (P)

Anna Freud National Centre for Children and Families, London, UK.
Division of Psychology and Language Sciences, University College London, London, UK.

Caitlin Notley (C)

Norwich Medical School, University of East Anglia, Norwich, UK.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH