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A feasibility study for implementing Mental Health Support Teams in Further Education Institutions

2019-20 Social Science Plus (£11,000)
Research question
Following the green paper, Transforming Children and Young People’s Mental Health (2017), Mental Health Support Teams (MHSTs) are being introduced to support schools in meeting pupils’ mental health needs. This study addresses three key challenges for this initiative: i) cross-disciplinary collaboration; ii) evidence-based practice; iii) the inclusion of the Further Education (FE) sector. Research questions addressed are:

1) What is the current provision for student mental health in FE sites and is it evidence-based?

2) What is the feasibility of implementing MHSTs, in collaboration with Educational Psychologists, in FE contexts? The key areas of focus for feasibility studies1 are:

  • Acceptability
  • Demand
  • Implementation
  • Practicality
  • Adaptation
  • Expansion
  • Limited efficacy testing

Focus, rationale and societal relevance
The last 10 years have witnessed a rapid increase in young people with mental health problems2. Adolescence is a critical period, defining subsequent career, educational and health trajectories.

A principle government response to young people’s mental health needs, MHSTs, currently target schools. However, the FE sector has high levels of need: approximately 20,000 14-15 year olds attend FE to follow vocational courses, they are often disaffected and disengaged from school; FE students are more socially disadvantaged than their peers in schools; FE supports the learning of new arrivals to the UK, those leaving care, young offender institutions and mental health inpatient services.

MHSTs are supervised by expert NHS mental health staff and offer a bridge with Child and Adolescent Mental Health services (CAMHs). However, effective mental health provision in schools should include universal whole school, as well as secondary and tertiary provision3, and this means teacher involvement. The interface between health and education in the MHST trailblazing sites has highlighted a number of strategic challenges4. Collaboration between health and education disciplines in work with young people in education settings seems indicated here and is consistent with the UCL Mental Health Strategic Review.

Finally, school based interventions for mental health5 are widespread6 but typically not evidence-based, and teacher training and consultation have been relatively limited7. The implementation of MHSTs in inclusive educational settings offers a unique opportunity to support a coherent and evidence-based approach, but a cross-disciplinary feasibility study is a necessary first step.

Research design and methodology
The methodology is a mixed methods, feasibility study based on a model for implementation of evidence based public health interventions8.

Participants
Three/ four FE institutions in London and Home Counties will be selected. FE students (with and without mental health issues), teachers and professionals working in FE responsible for mental health, will be interviewed. Local external providers will be interviewed, including: CAMHs, Social Care teams and Educational Psychologists.

Approximately 20 interviews will be conducted per institution. Some student interviews will be with groups, at risk students will be interviewed individually.

Data collection
Mental health provision audits will be conducted for each institution, based on the Association of Colleges audit document9.Trainee Education Mental Health Practitioners (EMHPs) and Educational Psychologists (EPs) will conduct the semi-structured interviews (under supervision, as part of their training), to undertake a needs analysis and exploration of existing provision (universal, secondary and tertiary) and referral.

An online survey with the wider student and staff population will be conducted to measure inclusivity, perceived need and existing provision, informed by Harris (2019). Good response rates will be a priority to ensure a representative sample, supported by links with FE staff and incentivisation (monetary and motivational) of students.

Analysis
Interviews will be analysed thematically, embedded within a case study structure by institution. Examination of provision will involve critical appraisal of the evidentiary basis for interventions and links with referral services.

Survey data will be analysed quantitatively.

Research team

Social Scientist Principle Investigator
Professor Jane Hurry, Professor of Psychology of Education, Psychology and Human Development, Institute of Education

Non-Social Science Co-Investigator
Professor Jessica Deighton, Professor in Child Mental Health, Psychology and Language Sciences, Brain Sciences, SLMS

Additional Collaborators
Vivian Hill (Educational Psychologist, Chair, Educational and Child Psychologists, British Psychological Society)
Professor Tony David, Institute of Mental Health, UCL
Dr Laura Crane, Department of Psychology and Development, IOE
Professor Emla Fitzsimons, Department of Social Science, IOE
Dr Praveetha Patalay, Joint appointment between the MRC Unit of Lifelong Health and Ageing, UCL Faculty of Population Health Sciences and Centre for Longitudinal Studies, IOE
Dr Daniel Hayes, Evidence Based Practice Unit, UCL and Anna Freud Centre
Dr Melissa Cortina, Evidence Based Practice Unit, UCL and Anna Freud Centre

External partners

British Psychological Society (Expert Reference Group for the mental health of children and young people)
Association of Colleges (AOC) 

References
1 Bowen, D. J., Kreuter, M., Spring, B., Cofta-Woerpel, L., Linnan, L., Weiner, D., . . . Fernandez, M. (2009). How we design feasibility studies. American Journal of Preventive Medicine, 36, 452-457. doi:10.1016/j.amepre.2009.02.002


2 Pitchforth et al., 2018, Psychological Medicine; Hargreaves et al., 2018, Psychological Medicine; Harris, 2019, Centre for Mental Health https://www.centreformentalhealth.org.uk/sites/default/files/2019-01/Cen...

 

3Carroll & Hurry, 2018, Emot Behav Diffs; Vostanis et al., 2013, Child and Adolescent Mental Health

 

4 BPS, 2019.

 

5 Similar large scale surveys for FE are not available, symptomatic of its ‘Cinderella’ status. Morrison et al., (2010, Perspectives in Public Health) report in a survey of 33 FE colleges that 45% had ‘some sort’ of provision for students with long term mental health needs, but provide no further detail. 

 

6 Patalay et al., 2016, Child and Adolescent Mental Health

 

7 Vostanis et al., 2013, Child and Adolescent Mental Health


8 Bowen, D. J., Kreuter, M., Spring, B., Cofta-Woerpel, L., Linnan, L., Weiner, D., . . . Fernandez, M. (2009). How we design feasibility studies. American Journal of Preventive Medicine, 36, 452-457. doi:10.1016/j.amepre.2009.02.002


9 AOC, 2017. Supporting student mental health and wellbeing: a resource pack. https://www.aoc.co.uk/sites/default/files/Supporting%20Student%20Mental%...