Self-care strategies used by Children and Young People (CYP)

In August 2019, the Anna Freud Centre published a report (Garland, Dazell, & Wolpert, 2019) describing the experiences of CYP in their use of self-care strategies for their anxiety and/or depression, as well as the views of parents and carers. The report highlighted that there was a dearth of research into more widely available self-care strategies that were not delivered by mental health professionals. 

How did the researchers conduct the study?

Two anonymous online surveys were delivered – one for CYP between 11-25 years old who self-reported experiencing anxiety and/or depression, and another for parents and carers of a child who has experienced anxiety and/or depression. Respondents were asked whether they (or child of parent and/or carer) had used (or not) a list of 85 approaches to self-care, whether they would recommend them (or not), or to indicate that they (or their child) had not used a particular approach. The survey also collected qualitative responses. 

What were the results of the study?

Commonly used/recommended strategies

Both groups advocated use of strategies such as listening to music, watching TV or a film, and going outside, amongst others. CYP individually specified that they would use strategies such as maintaining personal hygiene and walking, whereas parents and carers specified strategies such as socialising and spending time outside in nature.

Not recommended/used again 

Both groups specified that they would not recommend/use eating more/a lot, spending time alone, and avoiding thinking about a difficult situation, amongst others as a strategy for managing their low mood and/or anxiety. CYP individually specified that they would not use strategies such as daydreaming and distraction, and parents and carers highlighted strategies such as avoiding conflict and gaming, amongst others. 

Qualitative responses

What is important to you when selecting a strategy?

All groups highlighted that freedom, support from others, as well as accessibility were important factors for consideration when selecting a self-care strategy. CYP also felt that they did not want to put any stress on others. 

Why do they work for you?

All groups highlighted that self-selection, distraction and support were key factors as to why the strategies selected worked. As a group, CYP also specified that being alone, routine, and no pressure were also factors. Parents and carers highlighted the increased confidence or enjoyment that the self-care strategies brought to their child.

Further research

Responses were varied and the groups felt that creative activities (e.g., art), sport and exercise (e.g., dance), as well as social strategies should be further investigated, amongst others.

Conclusions

The report concluded that further, detailed evaluations of self-care strategies were needed (what works, or does not, and why), as well as for the research agenda to be informed by the lived experience of CYP, parents and carers. The current work described is ongoing and feedback can be given here

Blog post written by Dr Rachel Moss, Research Associate for the Office for Students funded PGR Wellbeing project, based within the School of Education and Sociology (EDSOC) at the University of Portsmouth. 

The wellbeing of NHS staff and learners – the Mental Wellbeing Commission report and relevance in Higher Education

In February 2019, the Mental Wellbeing Commission published a set of recommendations for the NHS concerning the wellbeing of NHS staff and learners (The Executive Summary can be viewed here and the Full Report here). The recommendations for the report recognise the importance of supporting the wellbeing of learners within an NHS setting, and staff members generally.

What were the key themes outlined in the report?

Twelve themes emerged from panel discussions with staff working within the NHS, bereaved families (of those who had ended their life during their employment with the NHS), with organisations demonstrating best practice, and via site visits. Themes that emerged covered preparing for transitions (through school, to further/higher education and beyond), the need for self-care/caring for the carers, taking a break, and the role of technology amongst others.

What did the report recommend?

The commission published 33 recommendations for local NHS trusts to adopt. The primary recommendation focused on the creation of a workforce “Wellbeing Guardian”, who would be responsible for the wellbeing and mental health of their staff at a board-level, in every NHS organisation, from a national to local level.

Other recommendations within the report included the creation of a Workplace Wellbeing Leader, supporting transitions, as well as quick access referral pathways for staff (e.g., for psychological therapy). The commission recognised that more could be done to support wellbeing for staff, and this could include further provision of peer support, as well as safe psychologically safe and confidential spaces.

What is the relevance within Higher Education?

At present, the mental health and wellbeing of students is of focus within Higher Education and a variety of initiatives have been developed (e.g., UKRI Mental Health Research Networks; UUK StepChange Framework), or are in development (e.g., University Mental Health Charter), which are designed to improve this.

However, little attention is being paid to the staff members in Higher Education who may be supporting students, despite public calls for staff members to be more informed and to support the early identification and prevention of mental health conditions in students (e.g., Vitae recommendations for Postgraduate Researcher Supervisors).  The Commissions statement of “who cares for the people who care for the nation’s health” (p.17, Executive Summary), becomes one of “who cares for staff members who support the mental health and wellbeing needs of students?” and the general query of “how can staff be best supported” when applied within a Higher Education context.

The wellbeing and mental health needs of staff members in Higher Education should not be ignored (e.g., “More academics and students have mental health problems than ever before”). Levels of burnout are higher than the general working population and comparable to healthcare workers. In addition, staff members in Higher Education settings are reported to have poorer levels of wellbeing compared to types of employment such as health and social work, in areas of work demands and change management amongst others (RAND, 2018). Indeed, a recent Government review (Thriving at Work (2017)) tasked employers with adopting mental health core standards. National and local initiatives are needed to support the mental health and wellbeing of staff members, alongside improving offers of student support.

Blog post written by Dr Rachel Moss (Twitter: @DrRMoss), Research Associated on the PGR Wellbeing project at the University of Portsmouth (School of Education and Sociology).

 

The Healthy Minds programme in schools

Evidence suggests that half of mental health conditions start before the age of 14, and up to three quarters by the mid-twenties. Schools may be well placed to improve the wellbeing of their pupils, and to improve their quality of life, through delivery of effective Personal, Social, and Health Economic (PSHE) education. Researchers at the London School of Economics, in partnership with Bounce Forward, and the Education Endowment Foundation, secured funding to develop a model to improve the quality of life of pupils.

What were CYP taught in the Healthy Minds Curriculum?

The Healthy Minds curriculum was a four-year course consisting of one hour weekly lessons (113 over four years), designed for children and young people aged between 11- 15 (Years 7 – 10 in English Secondary Schools). Fourteen core modules were taught to students, and covered important general life skills such as resilience, mental health, and social and emotional learning. Each lesson was structured, with teaching materials, support, and training available per module (a total of 19 training days for the curriculum).

How was the Healthy Minds curriculum trailed?

Study recruitment in the intent-to-treat trial began in 2013-2014 and was phased over two years, with involvement of 34 schools, and 39 school-cohorts. Schools were recruited into in the treatment arm (3,021 students involved) or in the control (1,613 students involved). The study team were interested in evaluating whether the curriculum had an impact on CYP health-related quality of life outcomes (e.g., emotional wellbeing), and utilised the Child Health Questionnaire-CF87, as well as the Short Mood and Feelings Questionnaires, Life satisfaction ladder (0-10), and the Child Anxiety Related Disorders Questionnaire, to assess their aims. Data was collected at three points during the trial – at the beginning of the CYP school involvement (2013-2014), two years later (2015-2016) and at the end of their involvement (2017-2018).

What did the research find?

The initial analysis focusses on five outcomes – global health, life satisfaction, physical health, emotional health, and behaviour. Key outcomes from the preliminary analysis were:

  • Students who completed the programme had higher attainment in global health (by 10 percentiles, out of 100), compared to children in the control group, with improvements noted after two years of teaching the curriculum.
    • Similar results were observed for physical health, and life satisfaction.
  • An improvement in child anxiety-related disorders was noted for scores of pain disorder, separation anxiety, and school avoidance.
What was the impact of the trail?

The authors hail the Healthy Minds curriculum as an effective, evidence-based approach to teaching life skills in secondary schools. Moreover, the approach is described as low cost to schools, at £23.50 per pupil, per year. The full interim report for Healthy Minds, from researchers based within the London School of Economics, can be viewed here. The impact of the Healthy Minds curriculum on education outcomes (e.g., GCSE grades) will be published in 2020.

Blog post written by Dr Rachel Moss (Twitter: @DrRMoss), Research Associated on the PGR Wellbeing project at the University of Portsmouth (School of Education and Sociology).