How clinical and research teams are working together to reduce stress in sixth form students

How clinical and research teams are working together to reduce stress in sixth form students

by | Sep 4, 2023 | Blog Post, News

How clinical and research teams are working together to reduce stress in sixth form students
Over the last few years, rates of mental health disorders among young people have been rising. The latest data from the NHS found that in children aged seven to 16 years, rates rose from one in nine in 2017 to one in six in 2022. Adolescents aged 17 to 19 saw an even greater increase in mental health difficulties, rising from one in 10 in 2017 to one in four in 2022 – this means a quarter of young people in this age group were experiencing a probable mental health disorder.

Dr Stephen Lisk

Trial Manager for BESST at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's College London

Adolescence is a key period for the prevention and treatment of depression and anxiety, as half of lifetime mental health problems start by age 14. We know that accessible and effective interventions are crucial to combatting these conditions, especially in the lives of adolescents where there are many barriers to help seeking, such as long waiting lists, inconvenient locations, competing time commitments, and fear of stigma. Researchers at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London and clinicians at South London and Maudsley NHS Foundation Trust have been working together to develop and test a school-based group workshop programme called DISCOVER to help reduce stress in young people aged 16-18 years.

 

The DISCOVER programme, led by Dr Irene Sclare from South London and Maudsley NHS Trust, uses psychoeducation and cognitive behavioural therapy (CBT) methods to equip sixth form students with tools to better manage their stress. Researchers in four areas of the UK, led by Dr June Brown, Reader in Clinical Psychology at King’s IoPPN, are running a large clinical trial, called the Brief Educational Workshops in Secondary Schools Trial (BESST), to investigate the effectiveness of DISCOVER.

So, what is my role in this project? I am trial manager for BESST, acting as a central coordinator to ensure all the clinical and research elements of this large research project come together as planned. You could therefore say I am a link between all the different teams – so let me explain how this collaboration works!

How did BESST and DISCOVER come together?

Based on an adult workshop model developed by Dr June Brown, Dr Irene Sclare started developing the DISCOVER stress workshops for adolescents. In 2014, they collaborated to run the first pilot study of the workshops in schools in South London. Their teams subsequently ran a slightly larger study in 2019 which showed the DISCOVER workshops were accessible and likely to be effective. However, a larger study was needed to rigorously investigate the effectiveness of the workshops – hence BESST was born.

Understanding the structure of BESST

BESST is a nationwide randomised controlled trial (RCT), funded by the National Institute of Health and Care Research (NIHR), with multiple institutions contributing to the project. There are two sides of BESST – research and clinical. The research side is led by King’s College London, with the IoPPN acting as the trial’s core research institution. However, we also collaborate with other research institutions across England to make this possible, including the Anna Freud Centre in London and Manchester, University of Bath, University of Northampton, and Middlesex University. Our research teams are responsible for all organisation of the trial, recruitment of schools, participants and workshop delivery teams, data collection and management, and data analysis and reporting findings.

On the clinical side of the trial, we continue a long-standing collaboration with the DISCOVER workshop team at South London and Maudsley NHS Foundation Trust, with the DISCOVER team leader, Dr Irene Sclare, as the clinical lead for BESST. The DISCOVER team have provided valuable input into workshop delivery within the trial and have been responsible for ensuring staff are fully trained to deliver the workshop programme. As trial manager, I have been working closely with members of the DISCOVER team to ensure the research and clinical aspects of the trial work together effectively.

What does the trial actually look like?

BESST is a cluster randomised control trial. This means that we recruit a number of students within several ‘clusters’ (in this case, school sixth forms) to participate in the trial. We then randomly allocate half of the sixth forms (and all participating students within them) to receive the DISCOVER programme delivered by a workshop delivery team (intervention arm), and half to receive their usual school care but no workshop (control arm). Our six research workers conduct assessments with all students at the start of the trial, and at three- and six-months after the workshop so we can understand what effect the workshop has on the students.

Working with clinical teams to run DISCOVER in schools

We’ve had a lot of interest and enthusiasm from students and staff to take part in BESST. We recruited 57 sixth forms across Greater London, Southwest England, Midlands, and Northwest England, with a total of 900 students taking part in the trial. With this trial being nationwide, it was far too large in scope for all workshops to be delivered by the core DISCOVER team at the Trust. We therefore recruited 16 Mental Health Support Teams (MHSTs) from 11 NHS Trusts across England to deliver DISCOVER in the sixth forms allocated to receive it. MHSTs are teams of mental health professionals that are already embedded within schools in England, making them ideal to be trained to deliver the workshop programme. The DISCOVER team ran a series of two-day training sessions with all MHSTs to ensure all staff were ready to deliver the workshops, as well as providing ongoing supervision sessions throughout BESST. It was then my role to ensure the schools were ready to receive the workshops being delivered by these MHSTs.

What happens next with BESST?

By the end of 2022, the last workshop had been delivered in the trial; in fact, every single workshop that was due to be delivered was completed according to plan, which is a fantastic achievement for everyone involved in the trial. We have now finished following up with students after the workshops, with the last students followed up in May 2023, and have been busy performing the analyses to understand how effective the workshop was. The results will be ready to publish soon – we hope they will inform our approach to early intervention and lead to wider roll-out to provide highly accessible support for as many young people as possible, giving them the resources they need to combat mental health difficulties during a highly vulnerable period.

Please do check out the BESST twitter account to follow along with our progress.

You can also read more about how DISCOVER was developed in Dr June Brown’s blog.

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A-Level Results Day: Results Day

A-Level Results Day: Results Day

by | Aug 17, 2023 | Blog Post, News

A-Level Results Day: Results Day

Results day is finally here. It’s bound to be an emotional day, whatever the outcome. Many young people will experience a mixture of excitement, anxiety, and countless other emotions. A-Levels are an important milestone in the UK education system, as they tend to determine what happens next for many students. We’re here to help you support the young people in your life.

a young girl holding a leaf

If things have gone well

Your young person may have met or even exceeded their targets – in which case, congratulations! Encourage them to enjoy the moment. It’s tempting for you or them to start worrying about what comes next and getting into planning mode. They may start comparing to others and downplaying their achievements.

Everyone has different goals and versions of success and remind them that theirs is every bit as worthy of celebrating!

Try and plan something exciting to celebrate, such as seeing family or friends, going out for their favourite meal or doing something that is special to them.

If things haven’t gone to plan

On the other hand, it’s possible that things didn’t go to plan. Your young person may be feeling disappointed, upset, or anxious, and may be trying to push these feelings away. Remind them that these emotions are completely natural.

Try talking to them about their feelings. They may not want to discuss immediately but reassure them you’re there if they want to talk, need advice or company.

If they start panicking, support them to take a mental pause. Not everything has to be decided at once. Try deeper, relaxed breathing – a proven way to relax your mind and body, allowing greater clarity of thought in the process.

Most importantly, whilst today is bound to be a significant one, these results don’t define them as person. Support them to remember that they have all sorts of interests, passions, and abilities that make them the person they are – their results won’t change that.

It may be that a new path suits them better than the one originally planned. Encourage them to be open to new opportunities and reassure them you’ll support them through this period.

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A-Level Results Day: The Day Before

A-Level Results Day: The Day Before

by | Aug 16, 2023 | Blog Post, News

A-Level Results Day: The Day Before

Tomorrow is results day, and it’s completely natural for young people to be feeling worried. This day can carry a lot of significance as it often determines the next steps in their education and career paths. However, your young person may be feeling about it, it’s important that they know they’re not alone. Whether they are feeling stressed, anxious, fearful, angry, or confused, these are all completely natural human responses, and a sign that they care about their results.

a young girl holding a leaf

We know that these feelings can also be uncomfortable, so, here are some tips to help you support and reassure the young people in your life ahead of results day.

Worries outside of their control

It may be that they have worries about things going wrong that keep going round and round in their head, causing anxiety to build. Most of these worries are likely to be about things that are outside of their control.

Here are three techniques that can help young people create some distance from these types of worries:

  1. Thought switching.

They can try switching their attention away from worries by shifting their mind to something unrelated. Both of you can try and pick a category like a sports team or a country and think of something from that category for every letter of the alphabet, A through to Z. Or you could both focus on what’s going on around you by counting how many things you can see of a certain colour or shape, or things you can hear around you.

  1. Having a plan for the day

Secondly, try and encourage them to distract themselves from worries by planning to do something enjoyable, such as:

  • Seeing or speaking to friends or family
  • Going on a walk or run
  • Eating something they like
  • Leaning into their hobbies
  1. Relaxation breathing

Thirdly, calmer slower breathing can reduce stress and calm their busy minds too.

While sitting together, both take a deep breath in for approximately 5 seconds, and then breathe out for another 5 seconds, repeating several times. Try to imagine that you’re both breathing in calmness and breathing out the stress.  

Worries inside your control

What about worries connected things that are inside their control?

It’s helpful to direct as much energy as possible towards addressing these worries. This will help young people feel less anxious and more empowered ahead of tomorrow.

Results day is undoubtedly nerve-wracking, but it’s important to recognise that there are always options and opportunities available, even if the immediate outcome isn’t what was expected. Here are a few tips for the night before:

  1. Help them prepare by ensuring all the necessary contact details are ready, such as for their chosen universities, apprenticeships, clearing or otherwise.
  2. Try to get a good night’s sleep! Suggest that they wind down least an hour before bed to switch off their busy mind and aim for a time that allows them to get 8-9 hours of sleep. This could involve reading, listening to calming music, or having a shower or bath.

Reminder: Results day is just a moment in time, and the journey continues regardless of the outcome. Let young people know that it’s okay to feel nervous but try not to let those feelings overshadow the potential for positive outcomes and new opportunities.

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    Children and Families Policy Research Unit awarded £5.5m by NIHR

    Children and Families Policy Research Unit awarded £5.5m by NIHR

    by | Aug 3, 2023 | News

    Children and Families Policy Research Unit awarded £5.5m by NIHR

    The Children and Families Policy Research Unit (CPRU) has been awarded funding worth an estimated £5.5M by the National Institute of Health and Care Research (NIHR), to continue its operations for the next five years, starting from January 2024. Dr Johnny Downs, an NIHR Clinician Scientist at the IoPPN, King’s College London, has been named a co-investigator of the CPRU.

    The CPRU is a collaboration between UCL and the universities of Bristol, Oxford, Manchester, Newcastle, King’s College London, Bradford Institute for Health Research, Anna Freud Centre, and Institute of Fiscal Studies. The aim of the CPRU is to conduct high-quality research which enables policymakers and practitioners to make informed decisions which affect the nation’s health and wellbeing. The announcement builds on the work done by the CPRU over a decade, and further strengthens its commitment to support evidence based policy-making at a local and national level.

    Under the co-directorship of Professor Ruth Gilbert, GOS Institute of Child Health, Institute of Education, and Dr Jenny Woodman, Institute of Education (IOE), Social Research Institute, and Thomas Coram Research Institute, the CPRU has worked to deliver groundbreaking research programmes into addressing health inequalities, supporting vulnerable children and families, and improving health outcomes for children with disabilities and long-term conditions. The CPRU works closely with children and families to put their experiences at the heart of research and ensure that they can inform and influence policy decisions.

    Dr Jenny Woodman said: “With this important funding, we will be able to work with analysts and policy colleagues at the Department of Health and Social Care and other government departments to generate and present high quality evidence at the right time to support their decisions. We research what makes children healthier, taking into account the environments in which they live, the places they spend time, the health of their parents and carers and siblings and the health, education and other services they and their families use.”

     

    It is a great privilege to join the NIHR Children and Families Policy Research Unit at UCL which has such a wonderful track history in creating data resources, developing research methods and delivering high quality evidence that impacts policy and practice for children and families. Between 2024-2029, the policy research programme will be examining how public, primary and specialist physical and mental health interventions can best deliver effective health and social care for vulnerable children and families and reduce health disparities. The Unit has put together a great interdisciplinary team and I am delighted that its work has such a strong emphasis on engaging young people, their families, mental health clinicians and researchers. I’m really looking forward to getting started.
    Dr Johnny Downs

    NIHR Clinician Scientist at the Department of Child & Adolescent Psychiatry at King's IoPPN and co-investigator on the NIHR Children and Families Policy Research Unit

    The funding will enable a further five years of research on priority policy areas for child and family health for the Department of Health and Social Care, such as health inequalities, early years support for children and parents, support from health, education and social care for children and young people affected by chronic physical or mental health conditions, and services to address family violence.

    The award is part of a package of funding for Policy Research Units across England & Wales announced by NIHR worth an estimated £100M.

     

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    King’s College London receives £11m Research England grant to transform research into children and young people’s mental health

    King’s College London receives £11m Research England grant to transform research into children and young people’s mental health

    by | Jul 6, 2023 | News, Pears Maudsley Centre

    King’s College London receives £11m Research England grant to transform research into children and young people’s mental health
    Over £11m of funding from UK Research Partnership Investment Fund (UKRPIF) for King’s College London from Research England will fund cutting-edge brain imaging equipment and a pioneering mental health research collaboration hub at the Pears Maudsley Centre for Children and Young People, which will open in South London in 2024.

    The new clinical research Centre will be the only facility in Europe whose primary focus is on mental disorders and neurodevelopmental conditions affecting children and young people.

    This equipment will provide a significant upgrade to the Centre’s research capabilities, transforming understanding of the interplay between young brains, behaviour and cognition, by providing cutting-edge clinical research equipment alongside a dedicated research collaboration hub, and facilitating collaboration with all sectors across the UK. Researchers will be able to work alongside the young patients and families who are being supported by clinical services in the Pears Maudsley Centre to improve their understanding of why children develop these conditions and how treatments work and deliver more effective prevention strategies.

    The Pears Maudsley Centre is home to the King’s Maudsley Partnership – comprising King’s College London, South London and Maudsley NHS Foundation Trust and the Maudsley Charity.

    Children’s brains, thinking styles and experience of the world are not the same as adults. This exciting news means that we can get the necessary equipment to undertake the cutting-edge research required to improve children and young people’s mental health. This new funding means we can better understand the specific disorder mechanisms underpinning mental health problems and identify and test opportunities for effective intervention.
    Professor Emily Simonoff

    Interim Director of the King's Maudsley Partnership

    Professor Dame Jessica Corner, Executive Chair at Research England, said: “I am delighted that we are able to support The Pears Maudsley Centre with £11m from the UKRPIF fund. The investment will enable King’s College London to develop an invaluable collaborative research environment in which to drive the creation of personalised mental health prevention and treatment strategies for children and young people.

    “We hope this funding will help enable new insights into the causes and progression of these disorders which affect one in six young people and provide a transformative leap forward in research in this area by leveraging King’s College London’s unrivalled expertise in the field.”

    The state-of-the-art equipment will give new insights and transform understanding of why some children develop mental health problems, allowing researchers to develop effective ways to prevent and treat mental illness both in the UK and around the world. To date, many studies have been carried out with equipment designed for adults or those without neurodevelopmental conditions.

    The new equipment is specifically designed for use with babies, children and young people to enable the study of their brain structure and function, cognition and emotions.

    It includes:

    • OPM-Magnetoencephalography (MEG) which is worn like a helmet and adapts to any head size, including babies, allowing participants to move freely, play or interact with family during a scan. The MEG cap tracks brain networks in real time and can be an early indicator of conditions such as autism or ADHD.
    • 3T MRI (Magnetic Resonance Imaging) a high-quality portable MRI which is well-suited to children.
    • Child friendly suites for near infra-red (NIRS) and electroencephalography (EEG) and eye-tracking which are more robust for younger children and those who find it difficult to sit still.
    • Immersive assessment facility (to understand social and cognitive function in real world settings) and VR for both experiences and therapy.

    Despite the urgency and scale of the challenge, mental health research lags far behind the focus and discoveries resulting from successful investment in physical health care research. As of 2018, only 6.1% of the UK’s health research budget was spent on mental health and funding has remained largely unchanged for a decade1. As a result, improvements in prevention and care are progressing too slowly to meet the increasing need.
    This investment from Research England will support a step-change in mental health research for young people.

    The ambitions of the Pears Maudsley Centre are to ensure that all young people enter adult life with their best mental health by generating new scientific insights, reducing the time taken to translate new discoveries into effective prevention and treatment effective programmes.

    The Pears Maudsley Centre is set to be a game-changer in children and young people’s mental health. This UKRPIF and philanthropic funding will enable us to deliver a major upgrade in research capabilities, by providing cutting-edge clinical research equipment alongside a dedicated research collaboration hub, facilitating collaboration between our world leading academics and clinicians. It will give us a crucial understanding of brain mechanisms and more accurate, personalised measures of treatment in a specialist clinical research facility designed specifically for children and young people.

    Professor Shitij Kapur

    President & Principal of King’s College London

    The funding from Research England is double match-funded (£22m) by private and philanthropic sources, including Maudsley Charity, Pears Foundation, The Rayne Foundation, The Charles Wolfson Charitable Trust, The Wolfson Foundation, Garfield Weston Foundation, and The Prudence Trust.

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    Meet our volunteers: Madihah’s Story

    Meet our volunteers: Madihah’s Story

    by | May 26, 2023 | Blog Post, News

    Meet our volunteers: Madihah’s Story

    Each year at the South London and Maudsley NHS Foundation Trust, around 400 volunteers support services across the Trust. The CAMHS Mentoring Project matches young volunteers on a one-to-one basis with young person currently using one of our services. The pair meet regularly to access community activities together and build a relationship. Volunteer mentors are someone the service user can have fun with, try new things with, and talk to for informal support. 

    Madihah, currently a volunteer, shares her experience of the project and how she believes the programme can support young people with their mental health.

    Madihah

    Madihah

    CAMHS Mentoring Volunteer

    Volunteering in the CAMHS Mentoring Programme has been an amazing learning experience, where I could build on and practise important skills like self-reflection, setting boundaries, and being a supportive role model to a young person. I came across the programme while completing my Psychology degree and was eager to join as I was looking to gain experience in supporting young people with their mental health. As I am aiming to complete a doctorate in Clinical Psychology in the future, this programme has been invaluable in building my knowledge of the mental health sector.

    Working with young people has been something I’m passionate about, especially as I am currently working in a secondary school as a teaching assistant and learning mentor, supporting Special Educational Needs (SEN) students and providing pastoral care to all students. I’ve been able to transfer my skills from my professional life and provide my mentee with the best resources to improve her confidence and gain access to further education. Not only that, but this programme has also allowed us to create a friendship where my mentee could feel comfortable to talk and be open about her struggles. We were able to build our connection through shared interests like visiting museums and talking about our favourite tv shows. This opened up the door to conversations involving deeper topics and any worries my mentee had, which we discussed.

    Over the past eight months, mentoring has allowed professional growth for me and self-growth for the both of us. It is something that I feel anyone can benefit and learn from, while also being able to witness the rewards of providing essential care and support to a vulnerable young person. I could not recommend it enough!

    You can find out more information on how to join the CAMHS Mentoring Project and other volunteering schemes the South London and Maudsley Trust has to offer: https://slam.nhs.uk/camhs-mentoring-project.

     

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