Final Report Summary - PMHS (Promoting mental health in schools: building a multi-level, cross national framework) The objectives of Promoting Mental Health in Schools (PMHS) were to build an international consortium of research partners with a joint interest in promoting mental health in schools, bringing together the diverse expertise of various international research organisations which have invested heavily in the area of mental health in schools, enabling them to exchange information and practice and engage in research tasks together. As a result of this collaboration, individual partners could enhance their expertise in researching mental health in schools and build collaboration on short and long term with other partners in the consortium. The five partners worked together to propose ideas for a multilevel framework for the promotion of mental health in schools at universal and targeted intervention levels. The framework (WP4) is based on three work packages carried out by three partner pairs, namely universal mental health promotion and mainstream interventions (WP1), interventions for children and young people with mental health problems (WP2), and interagency, collaborative interventions for children and young students with mental health problems (WP 3). Long term objectives include transfer of knowledge and dissemination of findings through individual and joint publications, and presentation in conferences and continued collaboration amongst the five partners in the consortium.The following work was carried out in relation to the work packages and project milestones: • WP1 (Universal Interventions) : about 14 months of visits took place within this WP at the University of Malta, Malta and the Flinders University, Australia, with 7 researchers participating in the visits. During these visits the researchers worked on various research initiatives related to mental health promotion in schools at universal and curricular level. This included amongst others examining the perceptions of school staff, school students, and parents on mental health promotion in school, an evaluation of mental health programmes in schools such as Kids Matter and resilience programmes on the basis of the views of various stakeholders, various school visits, and studies on initial and continuing teacher education in mental health promotion in school. Data collection included questionnaires to more than one thousand teachers, parents and pupils in Malta, observations in various schools in Australia, over 70 interviews with school and University staff in Australia, and online questionnaires with hundreds of school and university students in Australia. • WP 2 (Targeted Interventions): about 4 months of visits took place at the University of Leicester UK and the University of Sunshine Coast, Queensland, Australia, with two researchers participating in the exchange. During these visits the two researchers visited various schools, units, alternative placements, agencies and support services for students with social, emotional and behaviour difficulties and mental health problems, and carried out about 80 interviews in Australia and the UK about educational provisions and psychosocial support and interventions for students with social and emotional and behaviour difficulties and mental health difficulties. • WP 3 (Interagency Working): about three months of visits took place within this work package at the University of Hull, UK and the University of Sunshine Coast, Queensland, Australia, with two researchers participating in the exchange. During these visits, the two researchers held various meetings with academic staff, researchers, psychologists, social workers, heads of services and policy makers, and visited various agencies, support services and psychological and therapeutic services for students with social, emotional and behaviour difficulties and mental health problems. They carried out a number of face to face interviews with stakeholder organisations in Australia from departments of Psychiatry, Psychology, General Practice, Education and Third and Voluntary sectors in the UK and Australia, seeking to explore school policy for interagency working, identify a model of provision for promoting children’s mental health, and identify how partnership working between organisations and parents impacts on student experience.• WP 4 (Multilevel framework) :the research findings from the various reports in WPs 1-3 have been put together to develop a multilevel, cross cultural framework for the promotion of mental health in schools at both universal and targeted levels. Overall findings and implicationsThis project underlines the need for a whole school, multilevel and school based approach to mental health, focusing on health promotion, prevention and targeted interventions involving the whole school community in collaboration with the parents, the local community and the external support services. Such an approach will consist of the following components:• A comprehensive, universal approach at individual, classroom, and whole-school levels, including o Explicit and regular teaching of evidence based and culturally responsive social and emotional wellbeing as a core competence, with a set curriculum, available resources and trained staff to support consistency and adequacy of delivery. The structured teaching of social and emotional learning takes place throughout the school years, involving a similar process to that of other academic skills, with increasing complexity of behaviour, and social contexts requiring particular skills at each developmental level..o Infusion of the social and emotional competencies in the other academic subjects in the curriculum in a structured way, thus reinforcing the competencies across the curriculumo A positive classroom climate where pupils feel safe and cared for, experience harmonious and supportive relationships, and where they have the opportunity to practice the social and emotional skills being learned.o A whole-school approach where the school community, together with parents and the local community, promotes mental health and wellbeing in all aspects of school life, and where the skills addressed in the classroom are promoted and reinforced at the whole-school level in a structured and complementary way.o Parental involvement and collaboration in promoting and reinforcing the key skills being promoted at school• Mental health and wellbeing includes also targeted interventions for students facing difficulties in their social and emotional development: a staged, school-based approach puts the onus on the school, in partnership with professionals, parents, services and the community, to provide the necessary support for such students. This requires integrated, interagency working, with professionals and services working collaboratively together and with parents, school staff and the students themselves, where possible situated at the school, to support the social and emotional needs of children and young people experiencing difficulties. Provisions for students experiencing mental health difficulties provide a continuum of services and settings matched according to the needs of the child.• Mental health and wellbeing becomes more central in initial teacher education, with the whole faculty engaged with students at curricular and cross curricular levels, both in providing education in mental health promotion at universal and targeted interventions, as well as supporting the wellbeing of the student teachers themselves. This will be sustained in continuing professional learning in mental health promotion provided regularly by schools for their staff. • The social and emotional wellbeing of the staff and parents themselves also need to be addressed within a whole school approach. For adults to be able to teach, role model and reinforce mental health and wellbeing, they would need first to be socially and emotionally literate and healthy themselves. This requires support structures which provide information and education for staff and parents in developing and maintaining their own wellbeing and health.• Any intervention undertaken by schools to promote mental health and wellbeing will require a needs assessment of the school community to match interventions according to the needs of the school. This includes identifying existing good practice at the school and incorporating it into the initiative. The school also makes provision for organisational supports and policies to safeguard the success and sustainability of the initiative, including supportive management, active participation in planning and implementation of the whole school community, provision of adequate resources, and alignment with regional, district and school policies. • Finally any initiative is monitored, evaluated and improved regularly at individual, classroom and whole-school levels. ConclusionThis integrated framework to mental health promotion in schools is based on research carried out across different cultures and supported by the international literature. However rather than a prescriptive blueprint, this is presented as a framework which may guide schools in their efforts for self development and self improvement in the promotion of mental health and wellbeing of their students. Schools may adapt the framework according to their present needs, seeking to underline particular components of the framework at different stages in their self development process. Rather than a one-size-fits-all recipe for schools across cultures and contexts, the framework may thus be considered as a roadmap, with the schools moving along that pathway according to their own needs and realities. The findings of the project have been disseminated through a number of publications, including peer reviewed papers, in international journals, book chapters, and various international conferences. It is also envisaged that the various findings emerging from this project will be published in one book within one year from the conclusion of the project subject to availability of funding. It is hoped that that in this way the project is more likely to have an impact on policy and practice related to mental health promotion in schools, include the mental health of children and young people most vulnerable to mental health problems, social exclusion,and marginalisation. It is also hoped that further research would be generated in this area as a result of the presentation of our findings in the international literature; for instance evaluating the effectiveness of our framework in schools in promoting mental health and wellbeing, would be an important contribution to evidence based practice in this area.