New research from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London has found that providing 16-18 year olds with a day-long course in Cognitive Behavioral Therapy (CBT) was both a clinically and cost-effective means of improving their mental health.

The trial, known as Brief Educational workshops in Secondary Schools Trial (BESST) and published in The Lancet Psychiatry, was successfully adapted from the DISCOVER program, which was designed to help adults manage their feelings of stress. The study has been funded by the National Institute for Health and Care Research (NIHR).

Around one in 12 young people in England currently experience anxiety or depression. Despite this, the large majority remain untreated, and almost a quarter (24%) have no contact with specialist Child and Adolescent Mental Health Services (CAMHS).

This study recruited 900 students from 57 schools in England. Half were provided with signposting to mental health services and the standard care their school would usually provide. The other half were invited to a day-long workshop on CBT coping techniques for managing mood, anxiety, and stress, and provided with follow up phone calls to help incorporate those skills into real-life situations.

Researchers found that participants who attended the workshop showed significant improvements in their depression, anxiety, wellbeing and resilience after a six-month follow up.

Dr June Brown said, “One of our main challenges was to adapt an adult therapeutic intervention which would be attractive and engaging for teenagers. In addition, previous studies have either been aimed at all students, some of whom aren’t necessarily in need of assistance, while others have taken a more targeted approach that potentially stigmatises those who might need support. Giving students the opportunity to self-refer means that we work with students who recognise that they’d like help.

“Our study shows that this intervention can be delivered at low cost by mental health professionals who can bridge the gap between schools and CAMHS.”

Professor Ben Carter, “The ultimate success of this has laid the groundwork for these workshops to be rolled out nationwide to provide an early intervention against depression and anxiety.” 

Karen Crowe, Senior Tutor for the Sixth Form & Curriculum Leader for Psychology at St Nicholas Catholic High School in Cheshire said, “Our school seeks to prioritise mental wellbeing and promote strategies that improve students’ mental health. We believe it is important to teach students how to become self-regulating individuals who can manage their own stress, which is why the school fully supported the BESST trial. We value techniques that provide students with skills to resolve problems, cope better with expectations, and build confidence, so the trial’s aims perfectly complement our school’s mission and ethos.”

Olivia Black, a student at St Nicholas Catholic High School who took part in the BESST trial said, “The study gave me new ways to manage my stress and remain productive during my studies. It was such a helpful process that allowed me to develop my personal strategies for maintaining good mental health. The skills and confidence gained from this trial motivated me to help start up our ‘breathing space’ initiative where sixth formers support younger students with their mental health.”

Can a brief accessible CBT programme in schools improve the mental health of 16–18-year-olds? Clinical and cost-effectiveness of a cluster randomised controlled trial in Brief Educational Workshops in Secondary Schools Trial (BESST) (DOI 10.1016/S2215-0366(24)00101-9) (June Brown, Kirsty James, Stephen Lisk, James Shearer, Sarah Byford, Paul Stallard, Jessica Deighton, David Saunders, Jynna Yarrum, Peter Fonagy, Timothy Weaver, Irene Sclare, Crispin Day, Claire Evans, Ben Carter) was published in Lancet Psychiatry. 

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A constant battle finds that racism has far-reaching impacts on parents, their children, and the relationships between them. Based on IoPPN research with both parents and teenagers from UK racialised communities, the briefing finds that both past and present experiences of racism can affect mental health across generations of a family.

The study provides more evidence that racism has a profound and negative impact on a person’s mental health. One participant described the daily fight against racism as “a constant battle that knocks you”. Parents referred to the “heavy” sadness of seeing their child experience racism at school, and one participant described “always [being] in that high-stress sensitive state because you’re always being triggered”. Another participant referred to the heightened fear for themselves and their family caused by racist threats on social media following England’s loss at Euro 2020.

A constant battle finds that daily experiences of racism also influence parent-child relationships, with parents attempting to limit their children’s exposure to racism and having to answer their children’s questions about racism.

The briefing calls on the Government to commit to tackling all forms of racism through a cross-government strategy. It also says that the Department for Health and Social Care and NHS England should fully resource work with racialised communities to design more racially equitable mental health support.

Kadra Abdinasir, Associate Director of Policy at Centre for Mental Health, said: “We know that racism harms people’s mental health and can have a lasting impact. This research builds on earlier studies demonstrating the trauma racism causes, while also highlighting the shared and distinct experiences of parents and teenagers in the UK. Like other forms of trauma, racial trauma requires a deep understanding and action from a broad range of practitioners and policymakers to better protect and support those affected.”

The research is the culmination of the TRADE Project (Transmission of experiences of Racism, Anxiety and Depression in families), which has been reviewing existing research and talking with parents and adolescents whose communities have historically experienced racism to better understand how experiences of racism can affect mental health, and how these negative experiences can transmit between generations. The TRADE Project is funded by the Economic and Social Research Council (ESRC) Emerging Minds Network, which is supported by UK Research and Innovation (UKRI).

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