Important new evidence published today: large-scale DofE trial (N=12,166) found that two universal MH awareness interventions, in secondary schools, led to an *increase* in emotional symptoms at long term (9-12 month) follow up tinyurl.com/4ffday8y Thread below /1 - ThreadSky

lucyfoulkes.bsky.social • 13 days ago

Important new evidence published today: large-scale DofE trial (N=12,166) found that two universal MH awareness interventions, in secondary schools, led to an *increase* in emotional symptoms at long term (9-12 month) follow up

https://tinyurl.com/4ffday8y

Thread below

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willlawn.bsky.social•12 days ago

Really interesting work, thank you. Do you mind sharing why you think we see these negative consequences of these whole school interventions? (I'm sure you cover this well in your papers, bit I'm a bit lazy sorry!!!)

naomiekas.bsky.social•13 days ago

What are the hypothesized mechanisms for the increase? Also curious whether this includes some of the broader emotion-focused stuff (how to label emotions and regulate them etc.) that is happening in primary school.

blindfish.bsky.social•13 days ago

But you (and the DfE) could also point out that the CACE estimation report also found "In contrast to null ITT effects, compliance effects were observed for YAM, indicating that when actually delivered, the intervention produces significant reductions in emotional difficulties."

blindfish.bsky.social•13 days ago

Surely a reading of this data could be "English schools do not have the capacity/will/motive to deliver MH interventions as required"

Rather then the more overarching interpretation that Mental Health interventions create more problems then they solve.

blindfish.bsky.social•13 days ago

Maybe the problem isn't with Mental Health interventions but with the system they are being pushed onto.

In RSE we sometimes talk about how "Bad RSE can be worse then no RSE".

lucyfoulkes.bsky.social•12 days ago

I see what you mean but I think both points can be true at the same time, no? School interventions can’t be separated from their real-life implementation – so this research found both a) it’s difficult to implement school interventions fully/optimally, and...

lucyfoulkes.bsky.social•12 days ago

b) the suboptimal, most realistic version of implementation can have negative outcomes

blindfish.bsky.social•12 days ago

Absolutely, but if they tested programmes which are recognised as successful in other contexts (which is my understanding of the history of YAM and The Guide). Shouldn't we start by questioning what is happening in our system that means a programme that works overseas, underperformed in the UK.

ademainalors.bsky.social•13 days ago

How did they control for increase awareness of symptoms and increased language to describe symptoms, which would then show up in future surveys? Especially in kids, something like depression isn't going to be readily distinguishable from something like stomach flu without education.

lucyfoulkes.bsky.social•13 days ago

They didn't, because you can't.. When self-report emotional symptoms increase, it could be because the respondent is a) genuinely experiencing more symptoms, b) more accurately reporting previously under-reported symptoms and/or c) over-interpreting milder experiences
Scale used shown in pic

lynnpickerell.bsky.social•12 days ago

A great thread - thanks for sharing your research. This highlights the problem inherent in trad self-report measures. Perhaps the act of completing the measures creates a fundamental difference in self reflection from pre to post. Do we need more creative and/or qualitative methods of evaluation?

joannahorrocks.bsky.social•13 days ago

Then why claim that the intervention led to worse MH?

lucyfoulkes.bsky.social•13 days ago

With more space I would have added the ‘self-reported’ before ‘emotional symptoms’. Character count v limited on social media unfortunately.

jess-deighton.bsky.social•13 days ago

Thanks Lucy for sharing. There’s a lot to unpack in this research: positives and negatives. It’s important we pay attention to both. Agree it’s crucial we have this kind of robust long term research. We will have events in the coming weeks to talk through but here are the pre prints: https://osf.io/kxug7/

lucyfoulkes.bsky.social•12 days ago

Great thanks for this Jess - looking forward to hearing/reading more!

lucyfoulkes.bsky.social•13 days ago

(NB There were some short-term positive effects on intended help seeking in one of the interventions, but this was not sustained at follow up, so I focus on the negative long-term effects here)

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lucyfoulkes.bsky.social•13 days ago

This adds to a now-decent body of evidence that universal MH interventions are sometimes harmful, summarised below

In 2023, we posed the question that universal MH interventions might make things worse, and we summarised papers that had found negative effects to date.

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https://tinyurl.com/ttk4fxaw

lucyfoulkes.bsky.social•13 days ago

We have since conducted a scoping review, led by Carolina Guzman-Holst, of universal school CBT and mindfulness interventions. We found that 9% had at least one negative effect, or 33.33% of high-quality trials. Accepted for publication, preprint available here

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https://osf.io/preprints/psyarxiv/we6bz_v1

lucyfoulkes.bsky.social•13 days ago

NB It wasn’t included in the scoping review because of the DBT focus, but while running the review this paper came out, finding negative effects from a universal DBT-based school intervention

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lucyfoulkes.bsky.social•13 days ago

Most recently, @jackandrews.bsky.social and I have written this commentary, arguing that we think the evidence is now sufficiently good that we should stop doing universal MH interventions in schools. We focus on those that teach therapeutic concepts eg CBT, mindfulness

https://tinyurl.com/394mr5hs

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lucyfoulkes.bsky.social•13 days ago

The DofE findings out today add further weight to this, showing long-term negative effects from interventions with more generic awareness content (i.e. not based on a therapeutic modality like CBT). See below for a summary of the content:

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duncanjee.bsky.social•13 days ago

Thanks for sharing this important information

eleanorchats.bsky.social•13 days ago

Fyi @drshirleyr.bsky.social this is very interesting.

drshirleyr.bsky.social•13 days ago

Thanks Eleanor - I also just heard Jess Deighton on @Radio4 talking about another trial helping YP recognise diff between symptoms and negative feelings

drshirleyr.bsky.social•13 days ago

Hilariously it’s the same study 😂😂

jess-deighton.bsky.social•13 days ago

Hi Shirley 😀 The findings relate to different interventions within the same trial. The radio interview referred to strategies for safety and wellbeing - an intervention that was found to be helpful. Other interventions included highlighted by Lucy were not found to be so helpful in the longer term

drshirleyr.bsky.social•13 days ago

Hi Jess! Thanks so much for the pick up. Hope you are ok and that life is good

jess-deighton.bsky.social•13 days ago

All good thank you. I hope everything is well with you too. Really nice to find you on here!

drshirleyr.bsky.social•13 days ago

And do you know what - I remember bidding (unsuccessfully obviously) for this grant 😂😂

elcuadernodorado.bsky.social•13 days ago

📌

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