‘Measuring Mental Health and Wellbeing in Schools: Challenges and opportunities’ Prof Miranda Wolpert

Matt Kempen
Marketing Manager for ACAMH

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Professor Miranda Wolpert, Director of the Evidence Based Practice Unit at UCL
Measuring Mental Health and Wellbeing in Schools: Challenges and opportunities

Recorded on 16 June 2017 at ‘The Jack Tizard Memorial Lecture and Conference; Public mental health for children and young people: addressing mental health needs in schools and communities’.

Transcript

Thanks very much. I think my microphone should be on, yes. So I know I saw on the mentimeter that there’s a large preponderance of psychiatrists and psychologists here today and some teachers. Can I just get a show of hands? Because it’s obvious not everyone filled in the mentimeter. How many people here are from schools? Great, so, probably about an eighth. How many are child mental health professionals who work into schools? Great, probably again about an eighth.

Fantastic. Thank you very much. So, I’ve got various hats as some of you will know. But as Stephen kindly said, I’m a Professor at UCL. But I’m also a Director of the Child Outcomes Research Consortium, which is a collaboration, a learning collaboration, that sets out to think about how we can measure outcomes achieved by children, and young people, in order to more effectively provide services for them. And when we formed ten years ago, we were very much a collaboration of health service providers.

And over the last decade we’ve expanded to include voluntary sector providers, but, also, crucially, schools. And, I guess, a lot of what I’m sharing with you today comes from learning from that collaboration around some of the many challenges of trying to measure child mental health, and wellbeing, outcomes and use those to really improve the effectiveness of services. And a lot of what I’m talking about, you can find on the Cork website. What you’ve got in your packs are key resources. So they won’t be the slides in order, but they’ll be the key resources, the key links, so that you don’t need to scribble those down.

But they won’t be the exact ordering of slides I’m going to talk about today. And, I guess, I just wanted…I was very aware that in Richard’s, I thought, very interesting talk he mentioned about the rollout of children and young people to improving access to psychological therapies. I just want to mention, on the Cork website is our analysis of the first four years of that programme of the outcomes achieved by children seen within that programme.

And that report is freely available on the Cork website if you want to look at it, and something I can answer questions about, although it’s not the topic of my talk today. So what I am talking about today are the challenges, and opportunities, about measuring mental health, and wellbeing, in schools. And, I guess, I’ve got a lot more to say about the challenges, but I’ve also got lots to offer in terms of opportunity. So I’ve asked him to say if I start perseverating on the challenges too long to remind me to move on to the opportunities.

And, in terms of the challenges, I’m going to talk about the challenges of what to measure, what tools to use, and for what purpose. But in terms of the opportunities, I’m going to offer some ideas about how we clarify purpose, some suggested tools and sources very much aligned to some of the things that Richard was talking about, and, in particular, a suggested measurement framework that’s freely available for people to think about and to use. And I’m going to end with a couple of free offers, since we’re in marketing mode.

So I’m going to start with challenges. So already from the questions this morning, we’ve got this issue of nomenclature in terms of what do we mean by mental health, what do we mean by wellbeing, what do we mean by happiness and what’s the intersection between them? And as was alluded to this morning, there are many different definitions. And there’s no simple answer to what do we mean by mental health, what do we mean by wellbeing? This is one definition that has been provided, but there are many.

And, I guess, one of the things that I want to be upfront about, from the start, and I think that came out from the questions, this morning, is that mental health and wellbeing are not synonymous, they’re not the same thing. And, exactly as Richard said earlier, you could be deeply unhappy, and have no mental health problems, you can have mental health problems and be managing in your life. And I think one of the things for, us as a community, is to think what is most important to us when we’re trying to help children and young people and make sure that we’re not conflating those two concepts as if they were the same thing.

And what I’ve got up here is a slide from a colleague who’s a lecturer at Liverpool, which is a very interesting paper that I would really suggest people look at, which really looks at longitudinal data and looked at what were the coronets, both of wellbeing, as measured by things and mental health as measured by things like the SDQ. And what she, and colleagues, interestingly found out was that there were different things that predicted wellbeing, or correlated with wellbeing, than correlated with mental health.

So, just for example here, not feeling safe in your local neighbourhood has a high negative correlation with feelings of wellbeing, or what might be thought of as happiness, but doesn’t, in any way, correlate with whether you have a mental health difficulty. On the other hand, having a chronic illness correlates highly with mental health difficulties, but doesn’t, in any way, impact, or correlate with, general wellbeing. So there’s some very interesting questions in there for us to unpick and think about.

And I think one of the themes from my talk today is going to be very much about wanting for us, as a community, to think about clarity of what we’re measuring and why we’re measuring. So measuring all these things is of interest. But don’t think you’re measuring one thing when you’re doing another is going to be one of the themes I’m going to talk about. So one way of sort of thinking about the different things we might want to measure in terms of both mental health and wellbeing is whether we’re interested at the individual level, at the family level, at the community, or in terms of the learning environment, in terms of the school characteristics.

And each of those present measurement challenges, each of those require different tools, each of those tell us interesting things, but they tell us different things. So it’s about thinking about what do we want to measure and why? And in your pack are just a couple of examples of some measurement tools that are commonly used. This is one, for example, which is for primary school children around trying to access their mental health broadly in terms of emotional and behavioural difficulties.

But here’s another one which is named the Student Resilience Scale, which is much more about what sources of support are available to that young person. And this is particularly looking at the source support away from school, in terms of parents, and in the community, and also at school in terms of people that are interested in that young person. So I think these sort of skills are interesting because they move away from just being how you’re feeling to what sources of support available.

And they also offer opportunities for the school to think what could we do to enhance that, what could we do to change that if those sources of support are not available? So, I guess, as a psychologist, that was trained very much in indicators that were very individually based, I am becoming more, and more, interested in some of the indicators that are more based on things, in a social environment, which allow you opportunities for intervention, that are not just at the individual level.

And what I would add to that is we’re still at the early stages of thinking about the whole range of outcomes. So I thought the question about social injustice and how that links with wellbeing and happiness was an interesting one for me also, in terms of what do we mean by a good outcome in child mental health, what would a good outcome look like for a young person? So it might be happiness, it might be not having mental ill health, it might be being in a job, it might be having good relationships.

But it might also be being politically activated. It might be being empowered to fight for what you believe. It might be a whole range of other dimensions that currently we’re not measuring because no-one’s telling us that those are the things that are important in our society. So, I guess, one of the pleas here is to think about what do we think…so, what measures is what gets talked…what gets measured is what gets talked about.

So we need to think, very carefully, that what we’re measuring, are the things that we are genuinely interested in. And I just…this is just to let people know that we’ve got an event coming up on 3 July at the Royal Society of Medicine, not far from here, which is bringing together philosophers, young people, parents, psychometricians, psychologists, and social historians, to all think about what does a good outcome look like for child mental health and try and take that forward and what should we be measuring thinking about that as a more broad agenda?

Ah this one isn’t working. So this should be moving. This hand is meant to be moving out at you and shaking like this. Aha, there it comes, there it comes. So this is the slide that summarises my learning over the last ten years of measurement, which is basically it’s jolly hard, and it’s very flawed. And the metaphor I use for measurement in mental health is it’s equivalent to measuring someone’s height with a very shaky hand.

So you’re basically saying you’re about this happy, or you’re about this mentally ill, or you’re about this mentally stable at this point. And at this point, you’re about this mentally ill, or mentally stable, or happy. And is that better? Is that worse? Is it any difference just to do with measurement error or is it to do with real underlying differences? So there are many challenges in terms of measurement. One of the challenges that I’ve just been introduced to the other week and I’m absolutely delighted with as a new term, is the jingle jangle fallacy.

How many people have heard of the jingle jangle fallacy? Great, virgin territory. So jingle jangle is the fallacy that two things…so, the jingle is that two things are the same just because they’re called the same, and the jangle is that two things are different just because they’re called different names. And in mental health and wellbeing measurement, we have jingle jangle in spades. So we have two measures, one of which calls itself the resilience scale, one of which calls itself the happiness scale.

But when you look at the questions, they’re asking more or less the same thing. And then we have other things, all of which call themselves, for example, happiness scales, which may be asking completely different things. So we’ve got real issues here that we have to really dig into, the actual questions that are being asked, which is why I flashed up the actual measures. Because never be fobbed off by the title of the measure. Someone has thought that up to get a grant, or to get the funding, or wants it…or from vanity or from this is what they thought they generally believed was the right thing.

But, actually, that may, or may not, be what the thing is measuring. So, actually, some of the sophisticated psychometric analysis that needs to be done, you need to, as users of measures, always look at the actual questions. Never forget that most of our measurement of mental health is questions, and all it is, is a set of questions, you need to look at what the actual questions are. So moving on then to measurement specifically in schools, why measure in schools?

So we’ve got increasing interest in schools as a site of support for child mental health. But increasing challenges around what sort of things schools can do and how they know whether they’re helping. And I’m going to refer in the opportunity section and it’s in your pack to work funded by Public Health England, led by my colleague Jess Dayton, which looked at different ways of measuring schools. And I’m going to talk about how we can take that forward. And, from that work, we came up with three different reasons why you might want to use measurement in schools.

And, I guess, just to declare, at this point, that when I’m talking about measurement here, I’m talking largely in terms of self report measures. I’m talking largely in terms of measures completed by pupils or students in schools, which are subjective measures about how they’re feeling. I’m very aware that we may also want to measure all sorts of other things. So we may want to measure teacher report, we may want to measure cognition views. We may want to measure parent views.

We may want to measure things like attendance or attainment. So we can talk about those as well. But, for the purpose of this talk, I’m focusing primarily on self report measures from pupils. So, in terms of different reasons to measure, there are three primary legitimate reasons that schools may be particularly interested in measuring mental health and/or wellbeing. One is in order to identify children in need so to try and work out who should get help, who are the ones that really need help to make sure that the right people get the help they need?

The second is to evaluate a particular intervention. So, for example, the healthy minds intervention that is something that needs evaluation to see does this work, does this not work? And you need tools and measurements around that. And the third is more around getting a snapshot of wellbeing, or mental health, in the school so that you can evaluate things over time or get a general sense of comparison over time across schools. And I know Richard was said that you would never compare happiness in one school with another, I can see the logic for that.

But I can also see that if you can control for other factors, then that comparison may or may not be relevant. And I think that’s something for us to think about. What I would say, what I haven’t listed here and I thought about listing it was a fourth reason for doing a measurement, which is basically marketing. And I suppose the reason I haven’t added it, but I wanted to sort of speak about it is I think that probably, in my experience, can be the primary reason that anyone wants to measure anything is to prove to someone else that what they’re doing is worth funding.

And I think if you go in with that mindset then it’s very difficult to find anything that you didn’t already believe before you went in. And I would say that isn’t a measurement that what you’re doing is going in searching for information to reinforce your beliefs. And I think there’s a real danger that anyone who goes into measuring something they passionately believe in and where they feel they are fighting for the needs of children goes in unneutrally. And that makes it very difficult then to actually analyse the measures in useful ways.

So I suppose I want to flag up an invalid reason for me to measure is for marketing. And we need to think about how we manage that so that that doesn’t happen. So if I can then move from the challenges, to the opportunities, of which I think there are many, at this moment in time. And I think, in many ways, England is at the forefront in some of the things we’re doing, as indeed are the other countries in the UK. So there are a wide range of things happening across schools.

And I suppose I wanted to pay tribute here to the number of things that schools are doing that I think psychologists and psychiatrists are often slow to finding out are actually already happening. And I think schools have an enormous amount to teach child mental health professionals. I was discussing in the break with Eric a research project that I and colleagues were involved in, Crispin Day and Panos Vestanas who led it, some years ago, which was a funded project from the Department of Health, which was teaching child mental health professionals about schools so they could work more effectively in schools.

And what we found, from that project, was that child mental health professionals were, on the whole, not very keen to be taught. They were very keen to teach and not so keen to be taught. So I suppose I want to sort of throw that out there, because I think there is much that we can learn from schools. And I think teachers, good teachers, know huge amounts about how they manage and work with children with a range of difficulties. And part of I think one of the paradoxical things we need to really avoid is in the emphasis on mental health in schools we end up disempowering teachers and making teachers think they can do less and they need to refer more.

And I think that’s a major danger at the moment for what we’re…of where we are. So, in my experience, there’s lots going on in schools. And it isn’t part of my talk to necessarily talk about what’s evidence based and what’s not. But I suppose I’ve come, over the years, as a professor of evidence based practice to be increasingly interested in practice based evidence, and increasingly to think about interventions as things that happen in complex systems, and which complex systems make complex adaptations to, rather than things that can be very easily taken from one context and put in another.

So I’ve become increasingly less concerned with the idea that we’ll have a list of good things and then you just pick from that list. I’m rather thinking about how do you evaluate whatever you’re doing in situ? So, for example, you know, I’ve been very impressed with the work of the Northeast Schools Commission, which is the first commission of schools that have come together specifically to look at mental health and support across their schools. Sue Bailey is essentially involved with the schools up there.

And I went to a meeting with them to talk to them about the sort of things they were doing. And, across the region, there were a variety of different things. So one school, for example, had taken the ideas of Stephen Peter, you know…do people know about the inner chimp? There’s a there’s a sort of pop psychology idea of of people having a sort of inner chimp that is less accessible to reasoning. And they’d had a very enthusiastic teacher in the school who developed an intervention around this that allowed them to have a language with pupils to talk about their inner chimp and manage their behaviour.

And their experience with that was making massive differences to the behaviour of pupils in their school. There was another person in the room who’d had a psychodynamic psychotherapist to work with primary school children, and they felt that had made a massive difference in their school. There was another person who was doing training for all the people in their schools and they felt that had made a massive difference to their school. And I suppose what that’s increasingly leads me to think about, it’s a bit like the common factors argument in mental health interventions.

There are some common factors here about the charisma, the dedication, the interest, the focus that goes on in schools, that actually can make a huge difference. And I suppose what it has left me thinking is that we should put more energy into evaluating what people feel fits for their particular school, rather than trying to persuade them we’ve got the perfect intervention and now they’ve got to fit it somehow into their school context. So I suppose that’s why…and I’d be interested to debate that with people, because I know that will be not an uncontentious idea.

So, in terms of measurement, and what we need to measure, at the outset, I think one of the things we need to measure at the outset is what schools are doing. There are many ways that you can think about what schools are doing in terms of mental health and wellbeing. And this is just one. It’s one I quite like. It was developed by colleagues in Islington Healthy Schools. And one of the reasons I like it was it was developed with schools and for schools.

And what it is is it’s just…it posits there are seven domains that you can work on in relation to supporting children in your school which includes what Richard was talking about, the whole school approaches, but also the targeted approaches. And what it has, and this is a free resource that you can get, through the link in your handouts, this allows you then…schools to audit what they’re doing in relation to these different domains of activity. So what are you doing to support parents, to work with parents?

What are you doing to support specific help with vulnerable pupils? And it gives you an audit tool to evaluate that and see what you’re doing and then think about a plan of activity. Because, as people have noted, the Ofsted framework mentions mental health, but it’s not prioritised. So how do we make sure that that mental health is a priority for senior leadership teams, for governors? How do we get that onto the agenda? So audit tools such as this can help make sure that this is something that’s looked at, that’s evaluated and considered.

So then thinking about the different issues of measurement in relation to the different reasons for measuring. And I’m going to take each of these in turn. So if you, as a school, or your school is interested, particularly, in identification, and I should mention, sorry, that all of these are available in the Public Health England toolkit that we developed, which is freely available from the Cork website and elsewhere. So if your school is interested in identifying pupils, I guess, the one thing, the one caveat, I would add to this, and, I think, the worst of all possible worlds, would be if we, as a mental health community, encouraged schools to identify pupils, simply to refer them to a specialist.

And if we get the model that you mustn’t touch those pupils, you know, this is dangerous stuff, only real specialists can tread in here, i think that would be the worst of all possible worlds, partly because we don’t have enough resources to meet the need, but partly, also, because from my research, and from my understanding of the literature, and, again, this is not non contentious, even if we did have enough resources, even if we had as many psychiatrists, and psychologists, as we wanted to, and we could have as many as we wanted, we can’t cure everyone.

With the current evidence base that we’ve got at least half of people who will be seen by a really good specialist, who really knows their stuff, will not be better at the end of treatment. They will still have ongoing difficulties. They’re still going to be in schools, they’re still going to be in their community. People are going to need to be working with them and supporting them. We’re going to need to find ways of supporting people to live with ongoing difficulties.

And we also know that there are high remission rates for many of these difficult…so many of these things will, in fact, get better over time. So we’ve got a complicated picture here. And if our one answer is always, “Refer to a specialist”, I think that’s not a helpful answer. So I want to put that out there as a start. So, for me, identification needs to be only in the context of if you know what you’re going to offer to those people when you’ve identified them, and you have thoughts as a school, and as a community, linked to your child mental health providers, of how you’re going to support them, within their context, what you’re going to offer.

So, for example, in terms of the check in conversations with young people, which are highly recommended, there’s an approach that I’ve become very interested in from the States led by Anne Vander Stoep, and colleagues, called ‘the emotional health check’. And what they do is quite a simple identification process using…they actually use the questionnaire, but you could use another questionnaire, with quite a simple cut-off. Then they bring people in for an hour long interview. But the point of that interview is to look both at the school issues, and the mental health issues, and to identify sources of support within the school, and the community, not to try and refer out.

And what they find is about in 75% of cases they manage to support that young person with existing resources without having to refer to a specialist. I’d like to refer to the work here of Neil Humphrey and colleagues, who was mentioned earlier today. And they’ve got some interesting work thinking about different forms of identification in schools. So the measure that I was talking about earlier was really about a threshold approach of saying you’d use a self report measure and pick people over a certain threshold. But you could also look at individual risks or you could look at cumulative risks.

So we know that people with cumulative risks, it gets more, and more, likely that this is going to be an issue for you in terms of mental health difficulties. And this is something that’s being explored by a number of sites currently. So one of the examples given in the PHE toolkit is of Cheltenham College in Gloucester who used the Warwick Edinburgh Emotional Wellbeing Scale alongside their own assessment of problems, and contexts, to identify students who needed help, and then used that to try and monitor progress over time as well.

But there’s a whole range of approaches being tried. So there are schools using peer nomination, there are schools using sociograms where pupils rate…they just simply say who their friends are, and then the school tracks who are the people who no-one has rated as a friend? And then tries to find out ways to support them. There are a number of different approaches to think about that. Again, you may want to ask some questions about some of the ethics, different approaches, happy to talk about that.

I think one of the interesting approaches that we’re starting to look at is a whole range of network analysis. You’re going to hear, I’m sure, more about that, as the years go on, thinking about how people are in groups, and thinking about school interventions in terms of those networks rather than simply in terms of the individuals. There’s also some interesting work going on amongst the Head Start sites. How many people have heard of Head Start?

Great, so a majority of you, but not all. So, Head Start, in the UK, is a project funded by the Big Lottery, which is a seven year project which has funded six sites across the country, all to do different sorts of early intervention with young people between the ages of ten and 16 in schools and in their wider community. And Jess Dayton, and colleagues, are leading the learning team that is working alongside Head Start to evaluate the impact of those interventions.

And the sites at the moment are looking at their different models of identifying who is at risk, who should be considered for intervention. So, for example, in Blackpool, they’re using the student resilience scale, that scale I put up earlier that showed about family support to identify children that don’t have the sort of family support they’re using, a model of cumulative risk factors, in order to identify which children might get interventions or not. We’re early days, we don’t know what’s the best model of identification yet, but these are things that are being experimented with.

Moving then to evaluation, and perhaps this is the most common approach that mental health professionals will be called upon to think about in terms of targeted interventions of the sort that Richard was mentioning earlier. And here, what you’re trying to do is evaluate a particular intervention, whether it’s the mind chimp, or whether it’s the CBT in schools, or whether it’s a whole school approach, you’re trying to see has it really helped the young people, has it really made a difference?

And what you need to understand for that is what’s the counterfactual? What would have happened if I hadn’t done this? Because one of the difficulties here is that children are developing over time, people are getting better over time. So simply saying, “Oh, well, the children I saw got better”, but they may have got even better if they hadn’t seen you. So that is a real challenge for our community, as many of you will well know.

And, yes. And I would say from my looking at the literature, I’m afraid our answer to that is not as clear cut as I would comfortably like it to be. So, what I’ve become…and I and colleagues have become very interested in is how can we clarify from the outset for anyone who is trying to evaluate any sort of intervention, what it is you are trying to evaluate and therefore what you should measure and how you should measure it? And this is the tool that I would like, if you take one tool away from here, this is the tool I’d like you to take away.

This is the tool that’s going to change your life. This is the…if I do say so myself. This is the evidence based practice unit logic model. There are millions of these. And this is…you know, there’s nothing inherently special about this other than it’s very simple. It’s simple in theory, it’s really, really, hard in practice. So what the challenge to oneself to do is when you want to set out a new intervention, this is whether you’re a psychologist, or psychiatrist, someone in school, or elsewhere, you need to hold yourself to the task of saying, “What is the intervention I’m going to do? Who am I doing it for, who is my target audience?”

So, just as Richard said earlier, is it that I’m expecting this to have an impact on everyone in the school? Is it that I’m targeting a particular at this group? Is it I’m targeting girls who have eating disorder, who are from a particular ethnic population? And really be clear. Don’t let yourself say, “Well, I think it’s everyone.” If actually you think really I’m actually really interested in this particular group, be as clear as you can.

This should always be done at a group, always be discussed and be signed off by the group that’s agreeing on this. Then, in terms of the intervention, what is it I’m actually doing? I’m being really concrete using a tidier framework. How many of you have heard of a tidier framework? Great, so the tidier for…oh, fantastic, one. The tidier framework is a sort of complicated name for a simple concept, it just says you need to hold yourself to account for what you’re doing in terms of who does it, what materials are used, when is it done, how much is it done?

If it’s a manualised intervention, how much are you personalising, or changing, the intervention? I can’t at this moment remember the name of the person that wrote the tidier framework but it was it was published in the BMJ. I don’t remember the name of the author.

I just want to give due credit. But I think it’s a really useful framework. So, whether you’re in a school, or in a clinic, when you are saying what it is you are doing, you should be able to answer the tidier framework questions for that and then what you should be able to do is write down very clearly here what this means.

So is it two psychologists in a school twice a week for one hour? Is it relaxation training one hour a week with these pupils? Being very, very specific? Then I’m going to skip over the really hard one to the next one, which is outcomes. So then thinking and what outcomes would I expect to achieve? Now, as I’ve said earlier, that’s not a simple question, you know?

Is it, I expect them to be more politically active? I expect the young people to get better exam grades? Or is it that I expect them to score higher on a happiness scale? What is it I expect to see? And then is that realistic? And is that realistic that doing this exactly one hour a week is going to mean that they no longer ever feel unhappy or whatever it is that I think? So trying to be really clear, what is it that I expect to achieve?

And, of course, you can make this more complicated by making proximal, and distal, outcomes, or by making things that are measurable or non measurable. But there is a real advantage in keeping this to one page, and keeping to the number of slots here. You can make more slots here or you can make fewer. But I would encourage you to keep it as simple as possible because it helps you keep clear and also helps go against the bias that you don’t quite find the outcome you thought you would.

So then you create another outcome that, oh, yes, but it did something else different. Because, I think, again, we’re all seeking…I think everyone in this room is here because we want children and young people to be happy, to be mentally healthy, and we want to be part of that journey. But that doesn’t mean that everything we do necessarily actually does help. How do we help ourselves learn from what we’re doing? How do we help ourselves challenge? And things like this logic diagram help.

So then moving to the change mechanism is then trying to then hypothesise, why do you think doing this is going to lead to this? Why do you believe that giving someone relaxation training once a week is going to mean they have better exam results at the end of the year? Is it because they’re going to feel better about themselves, is it because they’re going to learn new skills to work in the exam? Is it because they feel you care about them and they’re going to feel more cared for?

This is your chance to really think about what are the underlying principles here, rather than just accepting that there’s some sort of branded thing that I’m employing because someone has told me I have to do it. So this is your thought piece. And then here are what are the factors that are going to make this work or not work? So is it the engagement of the pupils, is it the skills of the professionals doing it? Is it how much the senior leadership team is going to allow you to do this and is going to support this? Is it how much you give?

So, you know, if you say you’re going to give once a week, but it keeps on getting cancelled. So these are the things that you can then write down, are the moderators, the things that you need to keep an eye on, because if they’re not in place, it’s not going to work. So their logic diagram is available on the website, freely available, with some tools about how to use it. And I would encourage you to think about that as a way of thinking about when you’re starting out any evaluation, making sure that’s filled in and agreed with other people.

So these are just some examples of where it has been used in schools and these are all available in the PHE toolkit. So I’m going to end with just sharing with you the final approach, which is the snapshot approach, which is really thinking about doing an annual check, exactly as Richard was saying, an annual or biannual, but we’re thinking about it being annual check in schools. It could be with the same year group, or it could be with with one year group followed over time, if you want to look longitudinally, to try and see how are people feeling at a given time?

And the approach that we’ve used and that has developed, has grown out of the Head Start programme. But it has also been developed with other projects, such as that being led by the Mercers group of schools, so that we now have three wellbeing measurement frameworks which are freely available for people to use and think about for primary schools, for secondary schools and for colleges. And what they do is they distil down the core measures that we, and the participating people who developed them, think might cover some of the dimensions that may be of interest.

So they include wellbeing, they include mental health. So, they include the things that Richard talked about. They include the Huebner for the younger children and the [inaudible 00:33:41] for the older children. They include the SDQ. They include coping measures of coping. They include the Student Resilience Scale, which measures those things about your family and your community. And I think they also include questions about whether you’re a young carer and some other questions. They’re not perfect. Schools may choose to use those measures or other measures.

All the measures are freely available, other than the SDQ which you have to pay for if you use it online, but the others are all freely available. And, as an update, for those schools in the audience who are interested, the Big Lottery has agreed to fund another 130 schools to use this measurement framework next year and get a report back on their snapshot in their schools. So if schools are interested in that they can contact us on the Cork email address.

And I’m going to end with just letting you know about another free resource that may be of interest to people and which my colleague Jamie Smith who’s speaking this afternoon may speak about also, which is an attempt to bring together schools to think about these issues in more detail, to share best practice in relation to mental health and wellbeing in schools. So thinking about measurement and interventions. It’s a free network. And if you’d like to join and would like to know more about it those are the contact details. Thank you.

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