Title: School-based mental health provision for children and young people (11-18 years) with experience of care: Mixed-method study of implementation, acceptability, need and priority outcomes
Funder: Health and Care Research Wales (Welsh Government)

Abstract: Background: The mental health and wellbeing of care-experienced children and young people (CYP) is a public health and social care priority. Schools are a key setting for supporting mental health and wellbeing but there are limited services specific to the needs of care-experienced CYP. To date there has been limited research to understand how schools may best support the mental heath and wellbeing of this population, and how they might work with stakeholders across educational, and social care systems as part of this process. There is also a lack of understanding about how this population are supported at key transition points, notably during the transition to post-16 education. Aims: To understand stakeholder experiences of delivering and receiving mental health and wellbeing provision for care-experienced CYP (aged 11-25) in secondary schools in Wales and in the FE sector, and to make recommendations to develop and optimise provision. Plan of investigation: The study comprises six inter-related work packages (WP), with WP0 providing overall study coordination. WP1. We will conduct secondary analysis of school datasets to map prevalence in provision. The School Health Research Network is a biennial survey of secondary schools in Wales and we will re-analyse the Student Health and Wellbeing survey and the School Environment Questionnaire (completed by senior school staff) from 2017/18; WP2. We will conduct interviews with CYP, parents and carers and staff in schools to explore experiences of delivery and receipt of provision. Four secondary schools from four Local Authorities (LA) will be purposefully sampled to include at least one Welsh medium school. CYP (n=16 to 24), parents and carers (n=16 to 24) and school staff (n=20 to 24) will be recruited; WP3. We will conduct interviews and focus groups with YP and staff in two FE colleges to explore experiences of transition from secondary school and the delivery and receipt of provision in the FE sector. Colleges will be sampled from the four LAs used to sample schools, and care- experienced YP (n=8 to 12) and staff (n=6 to 8) will be recruited; WP4. We will conduct interviews and focus groups with senior managers and social workers to explore experiences of provision delivery across educational settings. We will recruit child services and foster carer social work teams from the two LAs in WP3. In each team, the senior manager (n=4) and two to three social workers (n=8 to 12) will be recruited; A thematic analytical approach will be applied across the four WPs, focussing on contextual determinants of mental health provision within educational and social care systems. WP5. Finally, we will integrate findings and draft recommendations for stakeholder workshops with CYP, parents and carers, practitioners and policy-makers, prior to finalising recommendations for optimising provision. Potential benefits: The study will support policy-makers to ensure that the mental health and wellbeing of care-experienced CYP is optimally addressed within educational settings. It will also aid practitioners by sharing how current provision may be enhanced and what new provisions may be supportive. By informing policy and practice change the study will seek to have a longer-term impact in improving health and education outcomes for care-experienced CYP, and will support future research agendas around the development and evaluation of interventions tailored to this population.

Lay abstract: Background The mental health and wellbeing of care-experienced children and young people (CYP) is a public health and social care priority. Schools are important settings for supporting mental health and wellbeing but there is a lack of services that are tailored to the needs of care-experienced CYP. There has been limited research on how schools, colleges and social work teams, can best work together to support CYP’s mental health and wellbeing. Aims The project aims to understand how CYP, parents and carers, school and college staff, and social workers experience delivering and receiving mental health and wellbeing provision for care experienced CYP (aged 11-25) in secondary schools and FE colleges in Wales. Research methods The project will include four related studies: 1. Survey analysis: Firstly, we will return to survey responses collected in 2017/18 as part of the School Health Research Network (SHRN). SHRN undertakes surveys of secondary schools in Wales every two years and we will look at pupil responses to understand care-experienced CYP’s views on mental health in schools. SHRN also conducts a survey of school policies (completed by senior staff), and we will re-analyse this to understand school mental health provision; 2. Schools: We will undertake interviews with CYP, parents and carers and staff in four schools; 3. FE colleges: We will conduct interviews and focus groups with CYP and staff in two further education colleges; 4. Social work teams: Finally, we will conduct interviews and focus groups with senior managers and social workers in child services and foster carer social work teams. From these studies we will develop a set of recommendations on how schools may better support the mental health and wellbeing of care-experienced CYP. We will present the recommendations at workshops with CYP, parents and carers, practitioners and policy-makers to develop them further. Public involvement Public involvement helped shape the application and contributed to the research questions (The Fostering Network in Wales’s Foster Carer and Young People Forums, and staff at Cardiff & Vale College). Public involvement throughout the study will include: consultation with stakeholder groups about current mental health provision; advice on engagement with care-experienced CYP and research tools; and consultation with the Project Advisory Group on all aspects of study delivery. Dissemination Study findings will be shared with researchers and policy-makers through conferences, publications, and policy briefings, including a briefing for younger readers. What we hope to discover We are hoping to discover how best to support the mental health and wellbeing of care experienced CYP in educational settings. The study will support policy-makers to ensure mental health and wellbeing is addressed within educational settings. It will also aid practitioners by sharing how current provision may be enhanced and what new provision may be supportive. Findings will also have a longer term impact in improving the health and education outcomes for care-experienced CYP.

Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: MENTAL HEALTH