Supporting young people’s mental health in schools: an exploration of the factors influencing help-seeking, and of the efficacy of an internet-based Cognitive Behavioural Therapy (iCBT) programme for reducing anxiety.

Abstract

Literature review: The mental health of children and young people has become an increasing concern, both in the UK and globally (WHO, 2018). However, many young people around the world are not accessing the professional support they require (Rickwood & Thomas, 2012). Recently, there has been increased pressure on schools to provide effective mental health provision and support for their pupils; however, problems with service underutilisation continue to exist in this context. A systematic review of the international literature was conducted, with the aim of identifying key factors influencing young people’s help-seeking for mental health concerns in schools. The findings highlight a number of barriers and facilitators at the pupil, provision, and environmental/societal level. Prominent barriers included stigma, poor mental health literacy, lack of confidence in providers, a preference for self-reliance, and logistical issues. In contrast, good pupil-staff relationships, Rogerian staff qualities, appropriate referral routes, and pupil autonomy could facilitate help-seeking. Symptom severity and confidentiality acted as a barrier or facilitator depending on the mental health problem, the pupils’ context, or school’simplementation of confidentiality procedures. These studies highlight the global importance of schools for challenging stigma, raising awareness of mental health, and adopting whole-school approaches to effectively support and enhance their pupils’ wellbeing.
Empirical paper: Anxiety has been identified as one of the most common youth mental health problems worldwide (Polanczyk et al., 2015). Despite this, many young people in the UK are not accessing the professional support they need (NHS, 2018). Internet-based Cognitive Behavioural Therapy (iCBT) has received growing interest for supporting anxious youth, with emerging evidence of its effectiveness for young people aged 7-18 (Grist et al., 2018). The following study aimed to explore the effectiveness of a school-based iCBT programme for reducing anxiety, as well as possible secondary benefits associated with the programme, such as enhanced self-efficacy and school attendance. In total, 54 pupils (aged 11- 14) from eight mainstream secondary schools were allocated to the waitlist control or intervention group, before completing questionnaires at pre-intervention (T1), post-intervention (T2) and follow-up (T3); their parents and ‘Key Staff Members’ (KSM) also completed corresponding anxiety and attendance questionnaires. Mixed model ANOVAs revealed no significant between-group differences on anxiety, self-efficacy or attendance. However, both groups showed significant decreases in overall, generalised, and panic anxiety (KSM- and parent- reported) between T1 and 2. Only KSM-reported differences in generalised anxiety were sustained at T3. Implications for educational psychology and avenues for future research are discussed.

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ORCID for Sarah Kirby: orcid.org/0000-0003-1759-1356

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