Moore, Anna;
(2023)
‘After the novelty wears off’: Understanding the sustainability of mental health programmes in schools.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
Despite increasing emphasis on schools to deliver mental health support, interventions are often not sustained beyond initial funding and research. While sustainability has been explored in healthcare settings, there is limited research on factors influencing sustained delivery of interventions in schools. This thesis sought to understand intervention sustainability in a school context, drawing on data from two large randomised controlled trials (Education for Wellbeing). Study 1 was a qualitative study of staff expectations for sustaining interventions at the end of the trial period. Staff reported a range of plans and processes around continuing delivery (or not), with varying degrees of autonomy and influence in their schools. Study 2 was a systematic literature review of the barriers and facilitators to sustaining school-based mental health programmes. Themes at both the school and wider system levels were identified (e.g. leadership, staff engagement, intervention characteristics, external support). Study 3 explored staff perceptions of factors influencing sustained delivery of interventions one year after the research trial. Staff reported a number of barriers and facilitators to sustained delivery (e.g. prioritisation, adaptation, school ethos). Study 4 used survey data to investigate factors that predicted sustained delivery of interventions. Nearly half of staff participants reported using no intervention resources nine months after the trial period. While a range of implementation factors were not associated with sustainment, primary schools and those participating in the trial before the COVID-19 pandemic had increased odds of sustaining delivery. Study 5 explored patterns of implementation over time and highlighted variation in schools’ sustainability journeys. While some schools embedded interventions into their usual practice, others experienced drastic change within their setting or introduced different programmes after the trial. Finally, Study 6 brought together key stakeholders to explore potential solutions for sustaining interventions. Together, findings informed recommendations for policymakers, school leaders, intervention developers, and researchers.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | ‘After the novelty wears off’: Understanding the sustainability of mental health programmes in schools |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2023. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10169800 |
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