Implementation and sustainability of public health approaches for mental health and wellbeing in schools

Aims: With increasing prevalence of emotional difficulties in children and young people in England, there is a growing emphasis on prevention programs delivered in school settings. The Education for Wellbeing program is working with around 400 schools in England to evaluate five universal mental health and wellbeing interventions Here, we present an overview of the Education for Wellbeing program and describe patterns across different school settings in barriers and facilitators to sustaining intervention delivery Methods: This study draws on interviews with staff and pupils from eight schools over multiple timepoints, including during the COVID- 19 pandemic. Qualitative methods were used to cluster schools with similar 'journeys' over a three-year period in terms of staff members' experiences of intervention delivery and perceived barriers and facilitators to sustaining delivery Results: The analysis demonstrated patterns in schools' journeys over time, each underpinned by a range of barriers and facilitators to the sustainability of the interventions. Four clusters of schools were identified each representing one overarching pattern: 'Spreading and embedding', 'Trialled and moved on', 'Everything's changed', and 'Built into the curriculum for now' Conclusion(s): The variety in schools' experiences highlights the complexity of both school settings and the process of implementing and sustaining interventions. These findings suggest that the environment and conditions into which a public health intervention is placed may be as, if not more, important than the intervention itself, and provoke important questions regarding future research and intervention development.

Potential mechanisms by which cash transfer programmes could improve the mental health and life chances of young people: A conceptual framework and lines of enquiry for research and policy

Mental health is inextricably linked to both poverty and future life chances such as education, skills, labour market attachment and social function. Poverty can lead to poorer mental health, which reduces opportunities and increases the risk of lifetime poverty. Cash transfer programmes are one of the most common strategies to reduce poverty and now reach substantial proportions of populations living in low- and middle-income countries. Because of their rapid expansion in response to the COVID-19 pandemic, they have recently gained even more importance. Recently, there have been suggestions that these cash transfers might improve youth mental health, disrupting the cycle of disadvantage at a critical period of life. Here, we present a conceptual framework describing potential mechanisms by which cash transfer programmes could improve the mental health and life chances of young people. Furthermore, we explore how theories from behavioural economics and cognitive psychology could be used to more specifically target these mechanisms and optimise the impact of cash transfers on youth mental health and life chances. Based on this, we identify several lines of enquiry and action for future research and policy.Copyright © The Author(s), 2023. Published by Cambridge University Press.