Abstract
BackgroundSecondary school teachers are at heightened risk of psychological distress, which can lead to poor work performance, poor quality teacher-student relationships and mental illness. A pilot cluster randomised controlled trial (RCT) – the WISE study – evaluated the feasibility of a full-scale RCT of an intervention to support school staff’s own mental health, and train them in supporting student mental health.MethodsSix schools were randomised to an intervention or control group. In the intervention schools i) 8–9 staff received Mental Health First Aid (MHFA) training and became staff peer supporters, and ii) youth MHFA training was offered to the wider staff body. Control schools continued with usual practice. We used thematic qualitative data analysis and regression modelling to ascertain the feasibility, acceptability and potential usefulness of the intervention.ResultsThirteen training observations, 14 staff focus groups and 6 staff interviews were completed, and 438 staff (43.5 %) and 1,862 (56.3 %) students (years 8 and 9) completed questionnaires at baseline and one year later. MHFA training was considered relevant for schools, and trainees gained in knowledge, confidence in helping others, and awareness regarding their own mental health. Suggestions for reducing the length of the training and focusing on helping strategies were made. A peer support service was established in all intervention schools and was perceived to be helpful in supporting individuals in difficulty – for example through listening, and signposting to other services - and raising the profile of mental health at a whole school level. Barriers to use included lack of knowledge about the service, concerns about confidentiality and a preference for accessing support from pre-existing networks.ConclusionsThe WISE intervention is feasible and acceptable to schools. Results support the development of a full-scale cluster RCT, if steps are taken to improve response rates and implement the suggested improvements to the intervention.Trial registrationInternational Standard Randomised Controlled Trial Number: ISRCTN13255300 retrospectively registered 28/09/16.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3737-y) contains supplementary material, which is available to authorized users.
Highlights
For the staff outcomes, Linear regression models were performed to examine the mean outcome score (WEMWBS/PHQ) at follow up by arm, adjusted for baseline outcome score and school FSM, as the sample were originally stratified and paired according to this variable [1]
The models were adjusted for school year as age is likely to be associated with outcome and a missing data analysis revealed differences between arms in terms of year groups [2]
Once baseline scores and school level FSM were taken into account, there were no large differences between study arm for wellbeing or depression scores in the whole staff sample, or among teachers only, there were small trends favouring the intervention group
Summary
Linear regression models were performed to examine the mean outcome score (WEMWBS/PHQ) at follow up by arm, adjusted for baseline outcome score and school FSM, as the sample were originally stratified and paired according to this variable [1]. Linear regression models were performed examining the mean outcome score (WEMWBS / SDQ total difficulties) at follow up by arm, adjusted for baseline outcome score and FSM. The models were adjusted for school year as age is likely to be associated with outcome and a missing data analysis revealed differences between arms in terms of year groups [2].
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