This report presents a comprehensive review of the existing evidence on school-based approaches to mental health. It covers

• what is meant by mental health and wellbeing, and why this is important
• the respective roles of school and mental health professionals
• whether approaches should address individual ‘deficits’ and/or school environments
• how schools and policymakers can act.

Assessing the evidence, the authors find that school-based interventions tend to have small-to-moderate effects on both wellbeing and mental illness outcomes, with interventions focused on individual children more consistently effective than those that address the whole school environment. While the evidence for whole-school approaches (WSAs) is more mixed, at least in part because they have frequently been poorly implemented, the authors identify several key features of high-quality implementation of WSAs:

• a sound theoretical base
• a focus on intended outcomes
• giving priority to interventions that are easiest to implement in the setting
• explicit guidelines, possibly manualised
• complete and accurate implementation.

They also find evidence that universal mental health programmes can improve academic performance as well as mental health outcomes; that the often compromised educational outcomes of pupils with mental health difficulties require particular attention in both research and practice; and that there is an important association between teacher wellbeing and student wellbeing.

On the basis of both their review of the research evidence, and their understanding of the contexts of practice and education policy, the authors offer a number of conclusions and proposals.

• Schools would benefit from having a policy for tier 1 and 2 approaches to mental health. The evidence is beginning to suggest that this should include evidence-informed approaches for SEL and WSAs to support the development of consistent sustainable structures with a good fit to the school.
• Schools should monitor the efficacy of interventions.
• Education and health professionals should work in partnership, constantly exchanging expertise in order to effect useful change.
• Teachers should receive support to address the mental health of their students. This support should include opportunities for developing knowledge and skills, but also acknowledgement of the emotional labour involved and clear structures for any proposed school-wide changes.

This report arose from the BERA event, President Roundtable Seminar Series: Wellbeing – Schools and Pupil Mental Health: Do We Fix the Child or Do We Fix the School?, held online on 4 December 2020. 

That event was part of an ongoing series of events, the BERA Presidential Roundtables, that provide compelling research reviews on topics that are directly relevant to researchers, practitioners, policymakers and wider society, particularly topics that are recurrent concerns in education.