A major school-based mental health trial has identified the best ways to support the mental health and wellbeing of primary and secondary school children.
Researchers found that helping students normalise their everyday emotions is the ‘most promising’ intervention in the Education for Wellbeing trial. Meditation and mindfulness techniques were also helpful for many pupils.
The Department for Education published the full findings, which show the need for a ‘whole school approach’ and consistent and frequent intervention practices.
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Since the study started in 2018, the number of children and young people seeking mental health help in England has more than doubled. However, there has been a real lack of clarity over which school-based mental health interventions work best, highlighting the need for evidence-based interventions.
AWARE and INSPIRE
University College London (UCL) and the mental health charity Anna Freud led a large-scale research programme, to explore school-based mental health interventions.
The study included two randomised controlled trials, (AWARE and INSPIRE), involving researchers from multiple UK universities who evaluated five interventions to improve mental health awareness and well-being in schools. Over 30,000 students from 513 English primary and secondary schools participated in the study from 2018 to 2024.
In the AWARE trial, researchers randomly assigned schools to one of three conditions: (1) implementing five role-play lessons to enhance students’ understanding of mental health and reduce suicide rates, (2) providing a teacher training programme to improve staff knowledge of mental health, or (3) continuing standard practice.
The INSPIRE trial was similar, and researchers randomly assigned schools to one of three interventions: an eight-lesson plan building skills to manage mental health, improve personal safety, and identify support networks; training pupils in relaxation techniques such as meditation, which were embedded into the school day; or training pupils in mindfulness techniques, which were embedded into the school day. Alternatively, they resumed regular practice.
Interventions
Three of the five interventions, including teaching children about safety and wellbeing strategies, relaxation, and mindfulness techniques, showed promise for school use if implemented consistently and frequently.
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Teaching children about safety and wellbeing strategies worked well for primary and secondary school pupils. The tools learnt enabled students to normalise everyday emotions like stress and sadness and differentiate them from mental illness. In primary schools, understanding safety and wellbeing significantly improved mental health literacy among younger children.
The researchers recommended using relaxation techniques as an intervention in primary school. A daily five-minute relaxation session led by teachers significantly reduced emotional difficulties and particularly benefited children from minority ethnic groups. However, this intervention did not work well in secondary schools, and frequent implementation led to increased emotional difficulties among pupils.
Daily five-minute mindfulness-based exercises were more effective in secondary schools and significantly reduced emotional difficulties. However, in primary schools, regular implementation of mindfulness techniques increased emotional difficulties, particularly for children with special educational needs or pre-existing emotional challenges.
Mental health challenges
Chief Investigator Jess Deighton, Professor in Child Mental Health and Wellbeing at UCL, said: ‘Schools have a critical role to play in the wellbeing of children and young people and, with the right tools, can even help to prevent mental health challenges.’
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She added: ‘With results from this landmark study, staff now have much-needed guidance to support them in building the mental health and wellbeing of students.’
