Since working on a study of negotiated implementation in the 1980’s, Helen has evaluated initiatives in settings across health and social care, using a broad range of techniques. She joined the Health Innovation Network in 2018, working on a large mixed methods process and impact evaluation of the national roll out of ESCAPE-pain in the community and leisure sectors. Since then, she has led large scale, complex evaluations, including regional scale-up of remote monitoring in Rheumatoid Arthritis, national evaluation of micro-volunteering in health and care, and a regional programme to increase emotional wellbeing in children and young people. She has also supported companies on the Digital Health.London Accelerator and Launchpad Programmes develop their evidence base and been part of a multi-agency collaboration to extend the work of the DH.L Evidence Generator to create a national digital evidence hub. Helen is particularly passionate about involving patients/service users and the public to co-produce and deliver evaluations.
In 2017, the UK Government provided a vision and funding for the transformation of mental health (MH) for children and young people (CYP). South West London (SWL) secured funding to develop and implement a programme of transformation. The creation of school clusters with a Mental Health Support Team (MHST), is a key feature of the programme. The MHSTs deliver targeted evidence-based interventions in schools/colleges to CYP, their parents, and staff. The programme aims to support schools/colleges to develop a Whole School Approach (WSA) to improving emotional wellbeing. The aim was to understand the implementation and impacts of the programme. Here we report the case study element only.
A case study approach was used with four school clusters (n=51 schools/colleges) comprising interviews/focus groups (n=196), surveys (n=226), school cluster meetings (n=8). Perspectives were captured from school/college staff, MH service providers, CYP and parents/carers. Staff from schools not involved in the programme were interviewed (n=8) to provide a counterfactual. The eight WSA principles were used as an analytical framework.
There is evidence of positive change associated with the development and implementation of interventions across the eight WSA domains. There has been increased activity around emotional wellbeing for CYP in schools/colleges, especially interventions delivered by the MHSTs, access to self-help resources, and direct support via an online platform. Factors influencing successful implementation functioned at two levels: (1) Schools clusters – additional resources, leadership and workforce development, relational connections; and (2) System – effective governance, leadership, partnerships, national funding. Tensions between the different programme levels linked to priorities and autonomy and differences between education and health sectors (e.g. culture, priorities) impeded implementation.
Implementation of a complex system-wide programme has improved emotional wellbeing provision for the whole school community across SWL. Factors operating at multiple levels – school, school clusters and the system – interacted to influence implementation.