title: Supporting adolescent emotional health in schools: a mixed methods study of student and staff views in England.
abstract: BACKGROUND
  Schools have been identified as an important place in which to support adolescent emotional health, although evidence as to which interventions are effective remains limited. Relatively little is known about student and staff views regarding current school-based emotional health provision and what they would like to see in the future, and this is what this study explored.
  
  
  METHODS
  A random sample of 296 English secondary schools were surveyed to quantify current level of emotional health provision. Qualitative student focus groups (27 groups, 154 students aged 12-14) and staff interviews (12 interviews, 15 individuals) were conducted in eight schools, purposively sampled from the survey respondents to ensure a range of emotional health activity, free school meal eligibility and location. Data were analysed thematically, following a constant comparison approach.
  
  
  RESULTS
  Emergent themes were grouped into three areas in which participants felt schools did or could intervene: emotional health in the curriculum, support for those in distress, and the physical and psychosocial environment. Little time was spent teaching about emotional health in the curriculum, and most staff and students wanted more. Opportunities to explore emotions in other curriculum subjects were valued. All schools provided some support for students experiencing emotional distress, but the type and quality varied a great deal. Students wanted an increase in school-based help sources that were confidential, available to all and sympathetic, and were concerned that accessing support should not lead to stigma. Finally, staff and students emphasised the need to consider the whole school environment in order to address sources of distress such as bullying and teacher-student relationships, but also to increase activities that enhanced emotional health.
  
  
  CONCLUSIONS
  Staff and students identified several ways in which schools can improve their support of adolescent emotional health, both within and outside the curriculum. However, such changes should be introduced as part of a wider consideration of how the whole school environment can be more supportive of students' emotional health. Clearer guidance at policy level, more rigorous evaluation of current interventions, and greater dissemination of good practice is necessary to ensure adolescents' emotional health needs are addressed effectively within schools.
authors.affiliation: Department of Social Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol BS8 2PS, UK. judi.kidger@bristol.ac.uk
authors.forename: Judi
authors.initials: J
authors.lastname: Kidger
authors.forename: Jenny L
authors.initials: JL
authors.lastname: Donovan
authors.forename: Lucy
authors.initials: L
authors.lastname: Biddle
authors.forename: Rona
authors.initials: R
authors.lastname: Campbell
authors.forename: David
authors.initials: D
authors.lastname: Gunnell
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000592:standards*; D002648:Child; D004739:England; D005178:Faculty; D005260:Female; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008603:Mental Health; D008605:Mental Health Services / Q000592:standards*; D012572:School Health Services / Q000592:standards*; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires