Aleisha M. Clarke

A systematic review of the effectiveness of mental health promotion interventions for young people in low and middle income countries

BackgroundThis systematic review provides a narrative synthesis of the evidence on the effectiveness of mental health promotion interventions for young people in low and middle-income countries (LMICs). Commissioned by the WHO, a review of the evidence for mental health promotion interventions across the lifespan from early years to adulthood was conducted. This paper reports on the findings for interventions promoting the positive mental health of young people (aged 6–18 years) in school and community-based settings.MethodsSearching a range of electronic databases, 22 studies employing RCTs (N = 11) and quasi-experimental designs conducted in LMICs since 2000 were identified. Fourteen studies of school-based interventions implemented in eight LMICs were reviewed; seven of which included interventions for children living in areas of armed conflict and six interventions of multicomponent lifeskills and resilience training. Eight studies evaluating out-of-school community interventions for adolescents were identified in five countries. Using the Effective Public Health Practice Project (EPHPP) criteria, two reviewers independently assessed the quality of the evidence.ResultsThe findings from the majority of the school-based interventions are strong. Structured universal interventions for children living in conflict areas indicate generally significant positive effects on students’ emotional and behavioural wellbeing, including improved self-esteem and coping skills. However, mixed results were also reported, including differential effects for gender and age groups, and two studies reported nonsignficant findings. The majority of the school-based lifeskills and resilience programmes received a moderate quality rating, with findings indicating positive effects on students’ self-esteem, motivation and self-efficacy. The quality of evidence from the community-based interventions for adolescents was moderate to strong with promising findings concerning the potential of multicomponent interventions to impact on youth mental health and social wellbeing.ConclusionsThe review findings indicate that interventions promoting the mental health of young people can be implemented effectively in LMIC school and community settings with moderate to strong evidence of their impact on both positive and negative mental health outcomes. There is a paucity of evidence relating to interventions for younger children in LMIC primary schools. Evidence for the scaling up and sustainability of mental health promotion interventions in LMICs needs to be strengthened.

What Makes Teachers Tick? Sustaining Events in New Teachers' Lives.

To investigate what keeps teachers motivated on a day‐to‐day basis, we traced the importance of routinely encountered affective episodes. Significant research on emotions already highlights the relative importance of positive versus negative episodes, the importance of perceived origins of events and the need to differentiate between the frequency and affective intensity of episodes. Survey reports from 749 recently qualified primary teachers in Ireland strongly suggest the absence of positive experiences undermines commitment and efficacy rather than the occurrence of negative events. Furthermore, while remote structural factors may heavily influence teaching, it is the perception of events at micro‐level that impinge most strongly on motivation. Finally, the importance of particular experiences was, crucially, more related to their frequency than intensity. A major implication for teachers’ job satisfaction is the suggestion that while adverse episodes may be inevitably experienced, positive events (tha...

Context matters in programme implementation

Purpose – This paper seeks to report on the evaluation of Zippys Friends, an international emotional wellbeing programme, for primary school children in disadvantaged schools in Ireland. The paper aims to present case studies of the profile and ethos of two specific schools participating in the programme, their links with the local community, the degree of parental involvement and the factors that influence programme implementation in the local context.Design/methodology/approach – Within the framework of the overall evaluation study, which employs a randomised controlled design, two schools self‐selected to participate in case studies. Employing interviews and group discussions, the case study method was used to explore the views of teachers, pupils, parents and key informants from the wider community on the delivery of the programme within the context of a whole school approach.Findings – The findings from two contrasting schools are presented, a large urban school with a multi‐cultural profile in an a...

Evaluating the implementation of a school-based emotional well-being programme: a cluster randomized controlled trial of Zippy’s Friends for children in disadvantaged primary schools

Schools are recognized as one of the most important settings for promoting social and emotional well-being among children and adolescents. This clustered randomized controlled trial evaluated Zippys Friends, an international school-based emotional well-being programme, with 766 children from designated disadvantaged schools. The purpose of this study was to evaluate the immediate and long term impact of the programme and to determine the impact of implementation fidelity on programme outcomes. Teachers reported emotional literacy outcomes using the Emotional Literacy Checklist, and emotional and behavioural outcomes using the Strengths and Difficulties Questionnaire. Controlling for the hierarchical structure of the data, path analysis using structural equation modelling revealed that the programme had a significant positive impact on the childrens emotional literacy scores including significant improvements in the subscale scores of self-awareness (P < 0.001), self-regulation (P < 0.01), motivation (P < 0.001) and social skills (P < 0.001) at post-intervention. These results were maintained at 12-month follow-up (P < 0.01). The programme, however, did not have a significant impact on childrens emotional and behavioural problems. Analysis of programme fidelity indicated that high fidelity was directly related to improved emotional literacy scores at post-intervention.

Implementing Mental Health Promoting Schools

This chapter examines the promotion of children’s positive mental health within the health promoting schools framework. The chapter provides an overview of implementation components critical to health promoting schools practice. Following this, research on the implementation of the Zippy’s Friends emotional wellbeing programme for primary school children is presented. This study is provided as an example of a multi-method evaluation approach, combining the use of a clustered randomised control design with qualitative approaches documenting the process of implementation, and case studies exploring the contextual factors that influence the process and outcomes. Key findings from this evaluation study are presented and the implications for researching the implementation of interventions within a health promoting schools approach are considered.

Promoting Social and Emotional Well-Being in Schools.

Purpose The purpose of this paper is to provide a critical perspective on the international evidence on promoting young people’s social and emotional well-being in schools. The challenges of integrating evidence-based interventions within schools are discussed and the need for innovative approaches to research and practice are considered in order to support more sustainable approaches that can be embedded into the everyday practice of school systems. Design/methodology/approach A common elements approach to intervention development and implementation is explored. A case study is presented on piloting this approach with post-primary students, based on consultations with students and teachers concerning their needs in supporting youth social and emotional well-being. Findings The integration and sustainability of evidence-based social and emotional skills programmes within the context of whole school systems is far from clearly established. Research on the use of a common elements approach to evidence-based treatment and youth prevention programmes is presented and the application of this method to the development and implementation of social and emotional learning interventions is considered. Preliminary case study findings are presented exploring this approach in school-based intervention development for post-primary school students. Research limitations/implications The potential of adopting a common elements approach is considered; however, more rigorous research is needed to identify the most potent strategies for social and emotional skills development. Originality/value Identifying a common set of evidence-based strategies for enhancing adolescents’ social and emotional skills could lead to innovative approaches to intervention delivery that would extend the impact and reach of evidence-based practice across diverse educational systems and school settings.

Bridging the digital disconnect: Exploring the views of professionals on using technology to promote young people’s mental health

The increasing role of online technologies in young people’s lives has significant implications for professionals’ engagement with technologies to promote youth mental health and well-being. However, relatively little is known about professionals’ views on the role of technologies in supporting youth mental health. This article outlines key findings from a needs assessment survey carried out in Ireland that sought to determine the views of professionals working with young people on the use of online technologies in supporting young people’s mental health and well-being. A total of 900 professionals from across the education, health, and mental health professions completed an online survey. The findings demonstrate the importance of the internet as a resource for professionals working with young people, with over 98% of those surveyed expressing a readiness to use online resources to support young people’s mental health. The nature of preferred online technologies differed according to professional groupings, however, 63% of overall respondents indicated they would look for help on a dedicated mental health website. Guidelines on working with young people and their parents on the promotion of positive mental were requested with the most frequency. Among the barriers identified were concerns about access to reliable information that was relevant to specific professional roles, and the need for organizational support of professionals’ use of online evidence-based resources. Concerns were also expressed that online resources could replace face-to-face support services for young people, and the need for training professionals in their appropriate use. The results highlight the potential role of technology in assisting professionals through the provision of online training, reliable information, and practical resources on the promotion of positive youth mental health.

Positive educative programme: A whole school approach to supporting children’s well-being and creating a positive school climate: a pilot study

Purpose The purpose of this paper is to report on a process and impact evaluation of the Positief Educatief Programma (Positive Education Programme (PEP)), a whole school approach to supporting children’s well-being and creating a positive school climate in primary schools in the Netherlands. PEP adopts a competence skill enhancement approach with a focus on developing children’s positive emotions and strengths. Design/methodology/approach A process and impact evaluation was performed within the context of two schools piloting the programme. Employing questionnaires and interviews, the evaluation sought to examine the implementation of PEP, participants’ experiences with key components and the programme impact of PEP. Findings The findings reveal largely positive attitudes towards PEP. Staff and parents were positive about the core components of PEP. Results from standardised questionnaires provide preliminary evidence about the positive impact of PEP on children’s self-reported well-being and problem behaviour, teachers’ awareness of children’s strengths and overall school climate. The provision of practical strategies and activity-based resources was considered essential to the ongoing implementation of PEP. Research limitations/implications This study reports on findings from two implementation schools and therefore lacks generalisability. Further research using more robust research methods exploring the effectiveness of PEP when compared with “business as usual” is needed. Originality/value School frameworks aimed at creating a positive school climate and promoting well-being at the whole school level have not been carried out in the Netherlands to date. The results from this study provide a unique insight into the implementation and perceived impact of a whole school framework in the context of two primary schools.

Evaluating the implementation of an emotional wellbeing programme for primary school children using participatory approaches

Objective: This paper reports on the use of child participatory approaches to evaluate the implementation and impact of the Zippy’s Friends emotional wellbeing programme on children in disadvantaged primary schools in Ireland. Design:  As part of the overall evaluation study, which comprised a clustered randomised controlled trial, qualitative participatory approaches were utilised to explore children’s experiences of the Zippy’s Friends programme. Setting: From the overall sample of 44 primary schools (N = 717 pupils) that participated in the evaluation study, a subsample of 9 classes (n = 161 children) from the intervention and control groups was randomly selected to take part in child participatory workshops at pre-intervention, interim and post-intervention. Method: A semi-structured child participatory workshop consisting of three activities, including draw and write technique, feelings activity and group brainstorming, was used to explore the children’s experiences of the programme and its impact on their coping strategies and emotional literacy skills. Results: The results from the draw and write activity provided evidence of the positive impact of the programme on children’s use of problem-solving and support-seeking strategies in coping with certain problem situations. Findings from the participatory workshop also helped provide insight into how the programme impacted on children’s emotional literacy skills. Children in the intervention group had a broader range of vocabulary and understanding in relation to emotions concerning problem situations. In addition, children identified factors that, from their perspective, supported their engagement with the programme, including the use of narrative through story and the activity-based nature of the programme. Conclusion: The use of participatory approaches generated data that enriched our understanding of how children experienced and benefited from the programme from their own perspective, thereby providing insights that were untapped by other research methods in this study.