Can teen mental health problems be prevented in school?
A new approach teaches at-risk adolescents social and emotional skills and strategies
Authors
Worldwide, there is growing concern about rising rates of mental health problems among young people. Whilst the reasons for this increase are complex, research consistently shows that more young people are experiencing mental health difficulties today than in the past. Given data suggesting that 1 in 4 young people in England has a mental health disorder, parents, carers, educators, policymakers and young people want interventions that can prevent the onset or worsening of mental health problems in adolescence.
“Offering support for mental health problems before they emerge is a challenge.”
But offering support for mental health problems before they emerge is a challenge. Which mental health problems will young people go on to experience? Where is the best place to deliver interventions? Should prevention be targeted at all young people, or just at those deemed at risk?
A new approach to teen mental health prevention
Our intervention ReSET – building resilience through socio-emotional training – offers a new approach. The core idea behind ReSET is that emotions and social relationships are closely interlinked, and the interaction between them can positively or negatively impact mental health. For example, a young person who has a negative interpretation of an interaction that their friend thought was neutral may experience considerable ongoing anxiety. On the other hand, an unexpected compliment might boost an adolescent’s mood, causing them to do something nice for a friend in return. Over time, these interactions can either have a protective effect or create risk for mental health problems by accumulating positive or negative experiences.
“Emotions and social relationships are closely interlinked, and the interaction between them can positively or negatively impact mental health.”
We chose to focus on young people who have already shown some signs of mental health difficulties because there is some evidence that delivering interventions to all young people may not be a good approach. In fact, this may even be harmful, because not all young people need help. ReSET helps young people who show early signs of struggling to develop skills and strategies to manage their emotional and social lives. It is delivered at school, so young people can attend sessions during the school day, as they might be less likely to access support outside of school. We work closely with the schools to make sure that young people do not miss key lessons.
How the intervention works
Groups of up to 10 young people aged 12 to 14 years come together to practice new skills and strategies over 8 weekly sessions, facilitated by a trained mental health practitioner. The practitioner helps young people apply the skills to their everyday lives, with support from peers. Since up to 10 young people can participate at once, fewer staff resources are required than for the typical 1:1 support offered by interventions in clinics.
As this was a completely new intervention, it was important to test it under carefully controlled conditions to understand whether it was helpful and whether it improved young people’s mental health. To do this, we carried out a randomised controlled trial involving 560 young people to compare outcomes of students who took part and those who did not but were similarly showing signs of mental health difficulties.
The great news is that 12 months after the programme, students who had taken part had lower rates of mental health problems than those who had not taken part. This was especially clear in the case of symptoms of anxiety and depression; this positive result was likely due to the fact that the group provided these young people with a space to speak to peers with similar experiences and find solutions to common issues. However, ReSET did not reduce attentional or behavioural problems. Overall, ReSET has potential as an effective, school-based intervention to support young people’s mental health, particularly by reducing the likelihood of developing anxiety or depression.
We now plan to work with families and schools to consider how this intervention might be delivered in a wider range of settings and to a more diverse group of young people. We also want to understand whether and why this new intervention works better for some people than others, and how schools might be best supported to deliver it. Ultimately, we hope that ReSET will become available as a tool for supporting the mental health of a wide variety of young people.
Footnotes
If you work in a school in the UK and might be interested in running ReSET in your school, contact us at: [email protected]
Authors