title: A pilot cluster randomised controlled trial of a support and training intervention to improve the mental health of secondary school teachers and students - the WISE (Wellbeing in Secondary Education) study.
abstract: Secondary school teachers are at heightened risk of psychological distress, which can lead to poor work performance, poor quality teacher-student relationships and mental illness. A pilot cluster randomised controlled trial (RCT) - the WISE study - evaluated the feasibility of a full-scale RCT of an intervention to support school staff's own mental health, and train them in supporting student mental health.
  
  
  
  Six schools were randomised to an intervention or control group. In the intervention schools i) 8-9 staff received Mental Health First Aid (MHFA) training and became staff peer supporters, and ii) youth MHFA training was offered to the wider staff body. Control schools continued with usual practice. We used thematic qualitative data analysis and regression modelling to ascertain the feasibility, acceptability and potential usefulness of the intervention.
  
  
  
  Thirteen training observations, 14 staff focus groups and 6 staff interviews were completed, and 438 staff (43.5 %) and 1,862 (56.3 %) students (years 8 and 9) completed questionnaires at baseline and one year later. MHFA training was considered relevant for schools, and trainees gained in knowledge, confidence in helping others, and awareness regarding their own mental health. Suggestions for reducing the length of the training and focusing on helping strategies were made. A peer support service was established in all intervention schools and was perceived to be helpful in supporting individuals in difficulty - for example through listening, and signposting to other services - and raising the profile of mental health at a whole school level. Barriers to use included lack of knowledge about the service, concerns about confidentiality and a preference for accessing support from pre-existing networks.
  
  
  
  The WISE intervention is feasible and acceptable to schools. Results support the development of a full-scale cluster RCT, if steps are taken to improve response rates and implement the suggested improvements to the intervention.
  
  
  
  International Standard Randomised Controlled Trial Number: ISRCTN13255300 retrospectively registered 28/09/16.
authors.affiliation: School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS, UK. judi.kidger@bristol.ac.uk.
authors.forename: Judi
authors.identifier: 0000-0002-1054-6758
authors.initials: J
authors.lastname: Kidger
authors.affiliation: School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS, UK.|National Institute for Health Research Collaborations for Leadership in Applied Health Research and Care in the West (NIHR CLAHRC West), 9th Floor, Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK.
authors.forename: Tracey
authors.initials: T
authors.lastname: Stone
authors.affiliation: School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Tilling
authors.affiliation: School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS, UK.
authors.forename: Rowan
authors.initials: R
authors.lastname: Brockman
authors.affiliation: School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS, UK.
authors.forename: Rona
authors.initials: R
authors.lastname: Campbell
authors.affiliation: University of Exeter Medical School, South Cloisters, St Luke's Campus, Exeter, EX1 2LU, UK.
authors.forename: Tamsin
authors.initials: T
authors.lastname: Ford
authors.affiliation: School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS, UK.
authors.forename: William
authors.initials: W
authors.lastname: Hollingworth
authors.affiliation: Division of Psychiatry (Faculty of Brain Sciences), University College London, 6th Floor, Maple House, 149, Tottenham Court Road, London, W1T 7NF, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: King
authors.affiliation: Ricardo Araya, Professor of Global Mental Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Araya
authors.affiliation: School of Social and Community Medicine, University of Bristol, Canynge Hall, 39, Whatley Road, Bristol, BS8 2PS, UK.
authors.forename: David
authors.initials: D
authors.lastname: Gunnell
mesh_terms: D000293:Adolescent; D000328:Adult; D005240:Feasibility Studies; D005260:Female; D005392:First Aid; D017144:Focus Groups; D006293:Health Promotion / Q000379:methods*; D006379:Helping Behavior; D006801:Humans; D007318:Inservice Training; D008297:Male; D001523:Mental Disorders / Q000209:etiology / Q000517:prevention & control; D008603:Mental Health; D009786:Occupational Health Services; D010379:Peer Group; D012572:School Health Services; D000070777:School Teachers / Q000523:psychology*; D012574:Schools; D012944:Social Support; D013315:Stress, Psychological / Q000628:therapy*; D013334:Students / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Adolescence; Mental health in schools; Pilot randomised controlled trial; Teacher mental health; Wellbeing