BackgroundMany children and young people experiencing mental health difficulties (MHD) do not access care, often due to inadequate identification. Schools have a unique potential to improve early identification; however, evidence is limited regarding the acceptability of school-based identification programmes. This study aimed to examine parents’ beliefs about the acceptability of school-wide MHD screening in primary schools.MethodsWe collaborated with experts in school-based mental health to develop a questionnaire to measure parental attitudes toward school-wide MHD screening. The questionnaire contained 13 items relating to acceptability; three open-text boxes for comments on harms, benefits, and screening in general; and four questions that captured demographic information. Parents of children attending four primary schools in Cambridgeshire and Norfolk completed the questionnaire. We calculated counts, percentages, and means for each statement, and analysed responses to open-ended questions using content analysis.ResultsTwo hundred ninety parents returned the questionnaire across the four schools (61% response rate). In the 260 questionnaires analysed, a total of 254 parents (98%) believed that it is important to identify MHD early in life, and 251 (97%) believed that schools have an important role in promoting pupils’ emotional health. The majority of parents (N = 213; 82%) thought that screening would be helpful, although 34 parents (13%) thought that screening would be harmful. Perceived harms of screening included inaccurate identification, stigmatisation, and low availability of follow-up care. There was no clear consensus regarding how to obtain consent or provide feedback of screening results. There were no significant differences in responses according to ethnicity, gender, age, or school.ConclusionsResults suggest that most parents within the socio-demographic context of our study will accept MHD screening within primary schools, and that school-based screening is viable from the perspective of parents. The comments provided about potential harms as well as suggestions for programme delivery are relevant to inform the development and evaluation of acceptable and sustainable school-based identification models. Implementation and scale-up of such programmes will require further understanding of the perspectives of mental health professionals, school staff, and the general public as well as further evaluation against the established standards for identification programmes.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6279-7) contains supplementary material, which is available to authorized users.
One in eight children aged 5–19 years in the UK suffer from a psychiatric disorder, while fewer than 35% are identified and only 25% of children access mental health services. Whilst government policy states that primary schools are well-placed to spot the early warning signs of mental health issues in children, the implementation of early identification methods in schools remains under-researched. This study aims to increase understanding of the acceptability and feasibility of different early identification methods in this setting. Four primary schools in the East of England in the UK participated in a qualitative exploration of views about different methods that might enhance the early identification of mental health difficulties (MHDs). Twenty-seven staff and 20 parents took part in semi-structured interviews to explore current and future strategies for identifying pupils at risk of experiencing MHDs. We presented participants with four examples of identification methods selected from a systematic review of the literature: a curriculum-based approach delivered to pupils, staff training, universal screening, and selective screening. We used NVivo to thematically code and analyse the data, examining which models were perceived as acceptable and feasible as well as participants’ explanations for their beliefs. Three main themes were identified; benefits and facilitators; barriers and harms, and the need for a tailored approach to implementation. Parents and staff perceived staff training as the most acceptable and feasible approach to systematic identification, followed by a curriculum-based approach. Universal and selective screening garnered mixed responses. Findings suggest that a systematic and tailored approach to early identification would be most acceptable and feasible, taking into consideration school context. Teacher training should be a core component in all schools.
Objectives Mindfulness research in education has focused on its potential to support student well‐being. There is a paucity of research on the interaction between mindfulness and academic performance (AP). This qualitative study builds on results of the largest randomised control trial of mindfulness in education to date which suggested mindfulness can have mixed effects on academic performance. A more in‐depth understanding of the relationship between mindfulness and academic performance is therefore needed to ascertain if, how and for which students mindfulness facilitates academic performance. The objective of the study was to capture students’ perceptions of the impact of mindfulness on their academic performance. Methods Thematic analysis was applied to data obtained by six in‐depth interviews from three higher and three lower performing undergraduate participants in the mindfulness intervention arm of the Mindful Student Study randomised control trial. Results Three themes emerged, whereby five students described mindfulness having a positive impact on their academic performance. One student felt mindfulness had an initial negative impact on academic performance. All students felt mindfulness enhanced self‐awareness and self‐regulation of their thinking, feelings and behaviours, and our analysis suggests students perceived these processes underpinned the effect of mindfulness on academic performance. Conclusion Differences in students’ psychological distress and study habits may determine the differing initial impact of mindfulness on academic performance.
Objective There is a dearth of practice‐based evidence of adapted or ‘DBT‐informed’ transdiagnostic models, which could provide services and clinicians with information of what works and for whom, in which settings. This paper aims to bridge this gap by exploring the client experience of a 12‐week transdiagnostic dialectical behaviour therapy (DBT) group programme in a private psychiatric hospital. Method Five participants with varied clinical diagnoses and previous therapeutic experiences were interviewed following completion of one or more of the same adapted DBT programme, comprising of the standard four modules over 12 weeks, including a weekly skills group and 1:1 therapy. Interpretative phenomenological analysis (IPA) was applied to give voice to the clients’ lived experience of the group. Results Three master themes were identified: ‘Pre DBT: Crisis & Desperation’; ‘In‐session: Belonging’; and ‘The Real World: Living’, each characterised by four sub‐themes, highlighting helpful and hindering factors of clients’ current and previous therapeutic experiences. Conclusion Overall this version of DBT in a transdiagnostic setting was experienced as helpful and positive by participants; main outcomes included being able to build a life worth living, feel hope and joy, build DBT skills into a lifestyle, and develop reflective practice. Implications for clinical practice, service delivery and policy are also discussed. The article aims to provide clinicians with practice‐based evidence to inform the delivery of DBT as well as supporting the case for the use of DBT with various disorders, thus paving the way for future research in this area.
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