A public health approach to improving adolescent mental health and well-being in English secondary schools

Abstract

Schools are an important setting for the promotion of mental health and well-being and early
intervention to prevent mental health difficulties. Despite this, there are still many unknowns
regarding how to optimise school practice, school environments and school policy to be supportive of
adolescent mental health and well-being.
The eight papers and one report presented in this thesis are from three mixed methods studies, all
focusing on adolescent mental health and well-being in English secondary schools. The first study
explored the impact of the Covid-19 pandemic school closures on adolescent mental health outcomes
specifically focusing on school and peer connectedness. The second reviewed the effectiveness of
school-based, peer education health interventions and evaluated a mental health literacy peer
education intervention using a realist approach. The third evaluated the implementation of a regional
School Health Research Network which provided research evidence to schools on how to more
effectively identify and target health areas for intervention.
The results presented in this thesis provide evidence of the association between school connectedness
and adolescent mental health, emphasise the importance of face-to-face contact with peers to
support mental health, highlight the benefits of directly involving young people in the delivery of peerbased mental health interventions and identify the value of a joined-up approach to school mental
health improvement, characterised by multi-sectoral partnership working alongside a whole school
approach. Key findings from all three studies are discussed using the socio-ecological model as a
theoretical framework, which highlights the importance of context and intervening at multiple levels.
Future research should examine ways to monitor and improve how well connected adolescents feel
to their school as a protective factor for mental health. The results also suggest school-based mental
health improvement should focus on system-wide change as well as supporting individuals. Future
policy should focus on creating safe, inclusive and welcoming school environments, as well as
improving teacher-student relationships to enhance student mental health. There could also be an
opportunity for school staff to receive training on the socio-ecological model’s layered approach and
how this can be applied in practice.

Date of Award	30 Sept 2025
Original language	English
Awarding Institution	University of Bristol
Supervisor	Judi L Kidger (Supervisor) & Rona M Campbell (Supervisor)