Dr Jack Andrews and Mrs Emma Macey explore the evidence base for wellbeing programmes in schools and consider the implications for Winchester College and the education sector more broadly.
E: Can you tell me a little about your background and what influenced your interest in researching the impact of school‑based wellbeing programmes?
J: I finished my PhD in 2021 at UCL – and that was primarily focused on the mental health consequences of risk-taking in teenagers – before moving to Sydney to start a postdoc at UNSW and the University of Sydney. This work investigated universal school interventions, those which are delivered to all students in a school or year group. These interventions are used by schools to try to improve mental health. I was fascinated by findings – including our own – indicating that sometimes these universal interventions made things worse; the young people involved in mental health interventions tended to report higher rates of mental health problems compared to those in the control group. So, I wrote a grant proposal to the Wellcome Trust in London to explore these effects further, and that's how I ended up leading this current programme of work at Oxford. If we can identify the mechanisms influencing negative effects in certain school interventions, like social contagion of mood and mental health, we can begin to consider how to improve wellbeing in schools.
E: And some of your work was undertaken when you were employed by the Department for Education?
J: Yes, I previously spent some time working as a social researcher looking at how we can deliver school interventions for wellbeing at scale across the country, and also looking at the role of school expulsions and school absences on mental health outcomes among young people. This was a really insightful experience which also highlighted how difficult it can be to make changes to education policy on a national scale.
E: The timing of your work is interesting. Am I right in thinking that your doctoral work commenced before the pandemic, but concluded during the pandemic?
Do you think that some of the declines in mental health reported in the press in the last few years were associated with the impact of the pandemic, or do you think it is something more fundamental, like changes in how, and by whom, mental health is assessed?
J: Yes, exactly. The pandemic certainly made things worse, on average. However, the long‑term effects are yet to be understood. This makes it hard to determine whether there are more people with poor mental health owing to events like the pandemic, or whether there are more people being diagnosed owing to changes in the way we have reported and assessed mental health in recent years. It is probably a combination. If you were to go to a clinical psychologist or psychiatrist for a mental health assessment, they would assess symptoms like persistent low mood, loss of sleep, or low appetite alongside functional impairment. That’s the extent to which those symptoms impact your ability to function day-to-day.
When researchers assess mental health in the general population through surveys, they rarely ask this question about functioning. Our work has shown that researchers usually just ask about, and report on, symptoms, which is problematic because we're not fully assessing what it is to have a mental health disorder. People have this idea of high functioning depression, which is where you have high symptoms, but you function perfectly fine. And conversely, there's also evidence to suggest that you can have low levels of symptoms that wouldn't be picked up as a mental health problem, but they can impair you quite dramatically. Without studying the two together, we don't get a full picture of young people at risk.
E: It has always troubled me that so many of the pupil wellbeing surveys offered to schools are self-report and are rarely considered alongside functional data like attendance rates, co-curricular engagement, homework submission and so forth. It is, of course, relevant how an adolescent feels, but during adolescence, hormones and thus feelings, can fluctuate enormously. Well-intentioned schools relying exclusively on self-report survey data for decision-making could therefore implement wellbeing programmes without first fully understanding the needs of their pupils. What can schools do about it?
J: It seems like there's a lot you can do as a boarding school, particularly by fostering a positive environment. You have the benefit of seeing the young people consistently over a longer period of time, and in different settings, so you can monitor them and see how they act with their friends both in a classroom setting, but also in a more relaxed setting in a boarding house. The staff have close contact with pupils and know whether they need to intervene. And the evidence we are now seeing suggests it is this targeted support that is more appropriate in managing mental health than large scale interventions involving all pupils, each with differing needs.
