National Evaluation of Targeted Mental Health in Schools (TaMHS)
Funded by the Department of Children, Schools and Families
PI: Miranda Wolpert
About the project
The importance of ramdomisation
What is involved
How this will be achieved
Targeted Mental Health in Schools (TaMHS) is a three-year pathfinder programme aimed at supporting the development of innovative models of therapeutic and holistic mental health support in schools for children and young people aged five to 13 at risk of, and/or experiencing, mental health problems; and their families.
The national evaluation of Targeted Mental Health in Schools includes a one year randomised controlled trial (RCT) undertaken by the CAMHS Evidence Based Practice Unit at the Anna Freud Centre in collaboration with colleagues at Durham University, the University of Manchester, the University of Leicester, University of York and the Institute of Psychiatry, Kings College London [make links to the institutions named in this sentence. The CAMHS EPBU is based at the AFC]. The project is funded by the Department for Children Schools and Families (DCSF) and starts in April 2008, continuing to April 2011. This complements the three year naturalistic study of the pathfinder areas (2008-11) already underway and represents a major innovation in research in education and mental health in the UK. Click here for more information about these studies. More information about the Targeted mental Health in Schools project is available here.
The RCT involves Local Authority Areas being selected to implement TaMHS in 2009-10 using a process involving “stratified random selection” *N.B. This allows the researchers to compare outcomes for children in those LAs implementing TaMHS with those not yet implementing it, in order to draw meaningful conclusions about the impact of the TaMHS initiative.
The importance of randomisation
It is only via randomisation that we can even attempt to infer true causation, that is, can be most sure that the policy (in this case targeted mental health in schools) has really made a difference. The alternative approach will invariably be plagued with huge interpretive difficulties as to whether any detected “effects” reflect true causes or simply “masquerade” as cause when, in fact, some other factor is really responsible. For example, it may be that it is the most motivated/well-resourced/best organised authorities who choose to undertake TaMHS so any improvements in children in these areas may relate to this rather than the project itself. On the other hand, there is a risk that the potential benefits of the intervention will be under-estimated if areas that implement TaMHS are self selecting and already doing a lot in this field and a consequent lessening of potential improvement.
20 Local Authority Areas will be randomly selected to implement TaMHS in 2009-11
20 Local Authority Areas will be randomly selected to implement TaMHS in 2010-11
Of those implementing TaMHS in 2009:
- 10 will be randomly selected to receive a supplementary package of additional guidance, training and/or support (drawn together by the research team from lessons learnt from the evaluation in year one) .**N.B
- 10 will receive the ‘standard’ model of guidance and support being offered to all Authorities.
The11 LAs who applied to become pathfinders but were not successful will automatically be allocated to implement TaMHS in 2009. They will not be part of the RCT
The remaining LAs (ie those not already involved as pathfinders or already promised TaMHS for 2009) will be invited to take part in a RCT .
Of those that agree to take part in the RCT;
44 will be randomly allocated to implement TaMHS in 2009 and the rest in 2010.
Of the 44 allocated to implement TaMHS in 2009, 20 will be randomly selected to be part of the evaluation (of these 10 will receive the additional intervention and 10 not)
Of those allocated to implement TaMHS in 2010 20 will be randomly selected to be part of the evaluation
*Note on stratification
To ensure appropriate spread, LAs will be matched (stratified) before being randomly allocated. The exact nature of the stratification will be agreed with DCSF colleagues but is likely to include some or all of the following criteria: : size of LA, population diversity, levels of deprivation, track record with other new initiatives and geographical location.
**Note on “experimental intervention”
The aim of this further randomisation is to review whether this additional support (the “experimental intervention”), drawn from the learning from the year one pathfinders, would have an additional impact on outcomes for children in comparison to the other ‘models’ adopted by the pathfinders as a whole. It would also help understand which elements of the ‘learning’ from year one, can be replicated in other areas, and as such provide a further opportunity to review ‘what works’.
