In this blog, Tricia Jessiman and Judi Kidger from the University of Bristol discuss their work exploring the aspects of school culture that impact young people’s mental health and the role that young people can play in changing it for the better.
Schools have long been recognised as a key influence on children and young people’s health. In the 1980s the World Health Organisation’s (WHO) Ottawa Charter encouraged a new approach to health education, moving away from a narrow focus on knowledge about disease and healthy behaviour, to include the development of skills and competencies in students to manage and control health behaviours and influence their environment. Today, health promoting schools are those that deliver health education via the curriculum, but also have an environment and ethos that supports health and wellbeing. This includes involving all those communities linked with the school; students, school staff, families and the wider community, recognising the importance of this wider environment in supporting children and young people’s health.
Put simply, the school environment can influence young peoples’ health just as much, or perhaps even more than, health education delivered within the curriculum. Consider learning about the importance of a healthy diet in class then walking to a school canteen at lunchtime serving food high in salt, fat and sugars with limited access to fresh fruit and vegetables. Or learning about mental health in PHSE lessons in a school where the relationships and interactions between staff and students are negative, unsupportive, or even bullying in nature.
In our work, we are particularly interested in the influence of the school culture and environment on student mental health. Much research has been undertaken on discreet mental health interventions delivered in schools, which generally focus on improving students’ resilience or psychosocial skills. These often have little or no impact, possibly because they do not address aspects of the wider school environment that may be damaging to student mental health. We wanted to explore a different approach; how might students be empowered to understand and influence how their school environment impacts their mental wellbeing?
Our study team includes researchers from the Universities of Bristol, Lancaster, Newcastle and Cambridge and the work is funded through the NIHR SPHR Public Mental Health programme. We have been working with secondary schools in the South West to deliver a Participatory Action Research (PAR) intervention. Groups of students and staff come together to think about the culture in their own schools, and come up with ideas about what changes might be made to develop a school environment that better supports student mental health. These PAR groups are encouraged to implement these changes and undertake light-touch research to understand if they have had any influence on students in the school. The groups follow the Participatory Action Research Cycle: Plan, Do, Observe, Reflect and are supported by a facilitator from the young people’s mental health charity ‘Off the Record’.
The study was originally planned to run in four schools across a whole school year, starting in September 2020. The pandemic quickly put paid to that and like most research teams we had to amend and adapt our plans. Recruiting schools was hard (as has been discussed in a previous blog post by Rhiannon Barker and Greg Hartwell); we couldn’t have students from different year groups involved because of the need to maintain ‘bubbles’ and social distancing; and face-to-face meetings were impossible whilst schools were closed. Nevertheless, we managed to get started with four PAR groups across three secondary schools, who began to meet twice per half-term from Spring 2021 through to the end of the calendar year. The groups were comprised of between six and nine students from the same year group (we had two groups from Y8, and one each from Y10 and Y12). As the intervention crossed the summer break the students moved up a year and unfortunately we lost one Y8 group due to difficulties with school staffing and timetabling.
Our role as a study team was to support and train the facilitators to understand what is known about school culture, and lead them through each stage of the PAR cycle. We also undertook some qualitative research with students, staff and parents in each school to explore what factors they perceived to be important to school culture, and its influence on student mental health. Participants identified four broad dimensions of school culture:
- Structural and contextual factors include physical aspects of the school buildings, the geographical setting, and the diversity of the student intake, particularly around ethnicity and socio-economic status.
- The academic and organisational dimension includes how culture is led and prioritised by school leaders, pedagogical aspects including teaching/learning styles and the curriculum, academic performance, and staff composition.
- The community dimension refers to the quality of the relationships within and across key stakeholders in any school; students, parents (or carers), and school staff.
- Finally, safety and support includes how schools support student emotional and psychological wellbeing, such as activities that promote good mental health and targeted support for mental health difficulties, as well as aspects of physical safety.
Our research found that these four dimensions are strongly interrelated. For example ethnic diversity amongst students and staff influences community factors; lack of minority representation amongst staff is seen to be a risk for negative relationships with some students, and drives the emphasis we saw on inclusive practice in all three schools. Our study strongly suggests that anyone seeking to shape and improve school culture as a means of promoting student mental health may have better results if improvements are addressed across all four dimensions rather than prioritising one or two.
We are also conducting a qualitative process evaluation of the PAR groups to determine whether a Participatory Action Research approach is feasible and effective as a methodology for instigating positive change to school culture. The study is expected to report later in 2022, and we hope to produce some guidance for schools on the PAR approach, and an online workshop for stakeholders from schools and other organisations with an interest in health promotion in education settings in March 2022 – watch this space!
It has been a pleasure to observe the PAR groups and see what students think is important to school culture, and the ideas and changes they have come up with to improve it. These have included covering more content about Black history in the history curriculum; lobbying for more discussion about world events during tutor time; creating spaces for students to hang posters showing role models from ethnic minority backgrounds; developing and delivering a student questionnaire on mental health; delivering a student-led assembly on mental health, and organising a ‘social action’ day to raise money for and awareness of challenges facing children and young people from different communities around the world. Based on our early findings, we believe our study will support previous work that suggests that interventions which focus on socio-cultural elements of school life, and which involve students actively in the process, are important for student health and wellbeing.
Workshop
We are holding a workshop for anyone working in and with schools on Tuesday 29 March, 4.00 – 6.00pm to share our learning from the PAR study. Click here for further details and to book a place.
References
Kaluzeviciute, G., Jessiman, T., Burn, A.M., Ford, T., Geijer–Simpson, E., Kidger, J., Limmer, M., Ramsay, S.E. and Spencer, L., 2021. Participatory Action Research on School Culture and Student Mental Health: A Study Protocol. International Journal of Qualitative Methods, 20,p.16094069211047753
Find out more about Tricia and her work on the public mental health programme here.
