According to the World Health Organisation (2018) there is a high and increasing rate of mental and behavioural health problems among adolescents in Europe and half of all mental health problems in adulthood have their onset during or before adolescence. Evidence from the UK suggests that as many as 1 in 4 adolescent girls report high levels of depressive symptoms, which has increased the pressures on schools in particular to offer more support (Deighton et al, 2018; Gunnell et al, 2018). Although the UK Government has pledged to improve access to mental health provision in schools and colleges, research has shown although educational leaders are willing to address the issues, lack of funding and expertise in schools and colleges are significant barriers (NatCen, 2017). This paper examines whether interventions in a programme designed to improve young people’s mental health and resilience have been effective in one English city and attempts to offer lessons and implications for schools and communities in Europe and elsewhere.

The paper brings together findings from a four-year study of a large scale, locally-designed programme, located in a city in the West Midlands in England with high levels of disadvantage and children and young people at risk. The programme’s aims include supporting children and young people to increase their resilience; raising awareness of mental health issues; and preventing the development of lifelong mental health problems. The programme comprises school and community projects and interventions, co-produced with participants, with the aim of influencing both policy and practice. 

The theoretical framework for the research reflects the programme’s emphasis on co-production, adopting a strengths-based approach (O’Neill, 2003; Boyle et al, 2010) to explore issues of resilience and mental health. This paper combines quantitative and qualitative data from the first two years of the research to address three of the study’s central research questions: 

• How have the central concepts of resilience and mental health been conceptualised in the programme?
• What effect have interventions had on the mental health and wellbeing of individual children and young people?
• Can the interventions be associated with the development of behaviours and mechanisms which increase resilience and protect young people against the development of mental health disorders?

The study adopts a mixed methods approach (Mertens, 2007). The data collected includes repeated student-level surveys of resilience, behaviour and wellbeing using validated rating scales (Ravens-Sieberer & Cieza, 2000; Ungar & Liebenberg, 2011; Theron et al, 2015) in the 30 primary, secondary and special schools involved in the programme and qualitative explorations of its implementation and impact. The qualitative strand uses Q methodology and semi-structured interviews with children, young people and participating adults in the programme’s four target communities and a sample of participating schools. The research focuses on the implementation of the programme’s interventions as well as their impacts. As well as reporting findings from the first two years of the research, the paper examines the methodological challenges involved in integrating multiple data sources into a assets-based, participatory approach and in working with children and young people to assess the impact of their engagement in initiatives in sensitive areas such as mental health and wellbeing. Limitations of the research include its sample and location in a single area in England, although efforts have been made to present it as a case study with implications for other contexts.

The discussion of the findings focuses on two main areas. The first outlines the ways resilience and mental health are being approached in schools and communities and the extent to which they vary according to interventions and schools’, organisations’ and communities’ levels of engagement in the programme. The second outlines findings in relation to impact of the programme on the resilience and mental health and wellbeing of the children and young people and the contextual factors which affect this, combining resilience data with the outcomes of in-depth qualitative work with children, young people and adults. As such, the lessons from this large scale programme may be able to influence the development of similar initiatives elsewhere.

Boyle, D., Slay, J., and Stephens, L. (2010) Public services inside out: Putting co-production into practice. London: NESTA Deighton, J., Lereya, T. Patalay, P., Casey, P., Humphreys, N. and Wolpert, M. (2018) Mental Health Problems in 11-14 year-olds: Results from the first HeadStart annual survey of 30,000 children. London: Evidence Based Practice Unit. Gunnell, D., Kidger, J. and Elvidge, H. (2018) Adolescent mental health in crisis, BMJ, 361, 1-2. Mertens, D. M. (2007). Transformative paradigm: Mixed methods and social justice. Journal of Mixed Methods Research, 1(3), 212-225. NatCen Social Research & the National Children’s Bureau Research and Policy Team (2017) Supporting Mental Health in Schools and Colleges Summary report. London: Department for Education. O'Neil, D. (2003) Clients as researchers: The benefits of strengths-based research, in Ravens-Sieberer, U. and Cieza, A. (eds.) (2000) Lebensqualität und Gesundheitsökonomie in der Medizin – Konzepte, Methoden, Anwendung. München: Ecomed-Verlag. Theron, L.C., Liebenberg, L. and Ungar, M. (eds.) (2015) Youth Resilience and Culture. Commonalities and Complexities. Heidelberg: Springer Dordrecht. Ungar, M., and Liebenberg, L. (2011). Assessing resilience across cultures using mixed methods: Construction of the child and youth resilience measure, Journal of Multiple Methods in Research, 5,2 126-149. World Health Organization (2018) Adolescent mental health in the European Region: Factsheet for World Mental Health Day 2018. Copenhagen: WHO.