‘After the novelty wears off’: Understanding the sustainability of mental health programmes in schools
Year: 2023
Type: dissertation
Abstract: Despite increasing emphasis on schools to deliver mental health support, \ninterventions are often not sustained beyond initial funding and research. While \nsustainability has been explored in healthcare settings, there is limited research on \nfactors influencing sustained delivery of interventions in schools. This thesis sought \nto understand intervention sustainability in a school context, drawing on data from \ntwo large randomised controlled trials (Education for Wellbeing). \nStudy 1 was a qualitative study of staff expectations for sustaining interventions at \nthe end of the trial period. Staff reported a range of plans and processes around \ncontinuing delivery (or not), with varying degrees of autonomy and influence in their \nschools. \nStudy 2 was a systematic literature review of the barriers and facilitators to sustaining \nschool-based mental health programmes. Themes at both the school and wider \nsystem levels were identified (e.g. leadership, staff engagement, intervention \ncharacteristics, external support). \nStudy 3 explored staff perceptions of factors influencing sustained delivery of \ninterventions one year after the research trial. Staff reported a number of barriers \nand facilitators to sustained delivery (e.g. prioritisation, adaptation, school ethos). \nStudy 4 used survey data to investigate factors that predicted sustained delivery of \ninterventions. Nearly half of staff participants reported using no intervention \nresources nine months after the trial period. While a range of implementation factors \nwere not associated with sustainment, primary schools and those participating in the \ntrial before the COVID-19 pandemic had increased odds of sustaining delivery. \nStudy 5 explored patterns of implementation over time and highlighted variation in \nschools’ sustainability journeys. While some schools embedded interventions into \ntheir usual practice, others experienced drastic change within their setting or \nintroduced different programmes after the trial. \n \nFinally, Study 6 brought together key stakeholders to explore potential solutions for \nsustaining interventions. Together, findings informed recommendations for \npolicymakers, school leaders, intervention developers, and researchers.
Author: Moore, Anna
Institution: University College London
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7045305587