One-day stress workshops in schools for older teenagers ‘cut depression’

One-day stress workshops delivered to 16 to 18-year-olds in schools cut depression and boost wellbeing, according to a new study.

Experts from King’s College London, who led the research across England, said there was a need to plug the gap in mental health support for older children.

They examined the effect of one-day workshops delivered by mental health support teams, who are already working in schools and colleges under a joint venture between NHS England and the Department for Education.

It comes after former children’s commissioner Anne Longfield said last month the Government needed to “rocket-boost” mental health support for youngsters, adding there was a “mental ill health epidemic ravaging schools”.

She warned that half of pupils in England – four million children – will still not have access to mental health support teams in their school under the Government’s plans, while the waiting lists for children’s NHS mental health services are “chronic”.

In the new study from King’s, teenagers aged 16 to 18 referred themselves to cognitive behavioural therapy (CBT) workshops to help them deal with conditions such as depression, stress and anxiety.

During the session, each of which had up to 16 students, teenagers were taught what the triggers of stress are, such as exams, relationships and family problems.

They then worked with mental health staff to establish strategies to manage their feelings, such as mindfulness, improving sleep, managing time and challenging negative thoughts.

Each session had one senior therapist and two junior therapists, with 15 mental health support teams in total working in the North West, West Midlands, London and the South West.

Overall, 900 students in 57 schools with sixth-forms took part. The trial was split so the workshops could be properly tested, with 26 receiving the workshops and 31 schools delivering usual care to pupils.

The results showed that the workshops led to a reduction in depressive symptoms, as measured by a standardised questionnaire.

Writing in the Lancet Psychiatry, the researchers said there was “a significant reduction in depressive symptoms” in those receiving the workshops versus those in the control group.

A similar positive effect was found for anxiety and wellbeing using a standardised scale, and there was a measurable effect on resilience.

However, there was no effect on improving sleep.

Ben Carter, professor of medical statistics at the Institute of Psychiatry at King’s College, said that for the third of students reporting depression symptoms at the start of the study, there was also a “clinically important” reduction in depression.

“We found a higher effect and much more (of an) effect than we expected in this group of individuals,” he said.

The authors of the study said that because mental health support teams are already in around a third of areas of England, the rollout of the the one-day workshops would be easier.

Dr June Brown, associate professor in clinical psychology at the Institute of Psychiatry, said: “The headline message is that the mental health of older adolescents can be improved when mental health support teams are trained to deliver accessible day-long stress workshops in schools.”

Of all the students in the study, 20% had sought help from GPs previously for their mental health while 30% had received counselling or other therapy.

The teenagers were aged 17 on average, just over half were white and the others were from different ethnic backgrounds.

In their paper, the researchers added: “More than half of adult mental health conditions have first onset before the age of 15 years, and almost three-quarters by the age of 18 years.

“Emotional disorders of anxiety and depression are especially common in the adolescent years, causing marked distress and daily interference for about
one in 12 (8%) young people in England, with an increased risk of self-harm and suicidality among those with mental health conditions.”

The team said it is estimated that 60% of children and young people with a diagnosable mental health condition do not receive any care through specialist child and adolescent mental health services (CAMHS) in the UK.

Of their study, they concluded: “The Besst (Brief Educational workshops in Secondary Schools Trial) study is a large, rigorous school-based study of an intervention aimed at reaching and addressing depression and anxiety among adolescents.

“Only a few such studies have been conducted in the UK. Our findings indicate that the Discover intervention is clinically effective for the overall sample of students.

“Further, in the sample with elevated depressive symptoms at baseline, we found a moderate and clinically meaningful effect.

“The Discover intervention also had a higher probability of being cost-effective than did treatment-as-usual with this group.”

Professor Stella Chan, from the University of Reading, said: “This is a very important clinical trial addressing one of the most urgent mental health challenges.”

She said the key findings were encouraging, but added: “It should however be highlighted that while the reduction in symptoms was statistically significant, meaning that the change was above and beyond a chance level, the effect sizes were only modest.

“It is therefore crucial for further research to find out how long the beneficial effects last, and what booster sessions or other support would help sustain mental health.”

Margaret Mulholland, Send and inclusion specialist at the Association of School and College Leaders (ASCL), said: “While CBT may be helpful for some students, others will require more personal, targeted support.

“It’s therefore important that these workshops are seen as an additional resource and not an alternative to providing more nuanced support for pupils with complex needs.”