A Qualitative Investigation of Children and Young People’s Experiences of Three Universal Classroom-based Mental Health Literacy Interventions in England

Abstract School-based mental health literacy interventions seek to improve knowledge, reduce stigma, and enhance help-seeking. However, little evidence exists for their effectiveness in the English school setting and there has been limited qualitative research thus far exploring implementation and the core components required to produce positive outcomes. This study aimed to address these gaps in existing research. Ninety-five students aged 8 to 14 years took part in focus groups across 12 schools in England in 2019. Twenty-six had participated in The Mental Health and High School Curriculum Guide (The Guide), 34 in Youth Aware of Mental Health (YAM), and 35 in Strategies for Safety and Wellbeing (SSW), as part of two randomised controlled trials. The focus groups asked students about their experiences of and opinions on the interventions. The data were analysed drawing on reflexive thematic analysis. Participants reported several perceived impacts from the three interventions, including increased knowledge and awareness of mental health difficulties, and new real world problem-solving skills. Although the interventions were perceived to provide a fun, relaxed, and safe space that reduced stress, sometimes participants found the content boring, and certain topics upsetting and anxiety-provoking. Interactive, practical, and discussion-based activities were preferred, and participants wanted more personal and relatable content. Issues such as timetabling and behaviour management were mentioned as barriers to engagement. Ultimately, what was common across all three interventions was that children and young people appreciated the time dedicated to talking about mental health and found the space offered to discuss real world problems novel compared to normal lessons. Schools need to be enabled to create this space within the school day and staff empowered and supported to lead discussions on topics that can be difficult to talk about.