Understanding and enhancing mental health competence - a promising new approach to improving lives for young people

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BackgroundThe Chief Medical Officer for England's Annual Reports 2012 and 2013 acknowledged the importance of promotion of mental health in young people, rather than focusing on mental health problems. One conceptualisation of positive mental health is mental health competence (MHC). MHC includes skills for getting along with and caring for others, as well as the capacity to manage emotions and behaviour. Improving MHC through school-based programmes may lead to benefits, ranging from reductions in risky behaviours such as substance use to higher school achievements. As young people move into adulthood, MHC skills are also assets in a rapidly changing labour market and participating as active citizens in society. There is good evidence that key elements of MHC are open to change in childhood and adolescence. We know that social and emotional learning (SEL) programmes in schools can achieve lasting effects on aspects of MHC, including social skills and prosociality. Our long-term aim is to accelerate the development of MHC interventions to improve young people's lives. However, there are a number of knowledge gaps before MHC programmes are ready to implement and evaluate.Our proposal will establish a collaboration to begin to fill these gaps through 3 related workpackages (WP). WP1. Working with young people, practitioners (health and education) and policy stakeholders to further develop MHC concepts We will work with young people and stakeholders from health, school and policy settings to define and develop MHC concepts and plan WP2&3. Over many years, our work has included consultations with Young Research Advisors (YRAs) from the National Children's Bureau. We will engage with YRAs to ground the work within lived experiences, transforming MHC into a concept with meaning for young people and schools and real potential for interventions. Second, we will convene a stakeholder network to further develop MHC concepts and interventions. We will also discuss issues with translating interventions into practice. WP2. Scoping school-based intervention typologies to identify candidate interventions with potential to modify MHC One way to accelerate development of MHC-related interventions is to identify which existing effective school programmes around learning, mental health and wellbeing can or might influence MHC. We will examine recent evidence reviews to identify those interventions which theory or evidence suggests are likely to influence MHC and where changes in MHC may form part of the intervention's effects.In this WP we will re-analyse data from one type of intervention (SEL). The INCLUSIVE trial included SEL elements and significantly reduced bullying and substance use and improved mental health, wellbeing and quality of life in young people. We will examine whether these benefits related to improvements in MHC. WP3. Investigate the potential for MHC to improve outcomes at a population levelWe will scope the potential for interventions around MHC to improve adolescent wellbeing by simulating the likely effect of improvements in MHC on key outcomes in young people. Our method evaluates potential national interventions where randomised trials are unfeasible or have not taken place. We will undertake one pilot simulation using the UK Millennium Cohort Study, assessing the impact of improving MHC at age 11 years (the transition to secondary school) on bullying, mental health, smoking and drinking and academic attainments at age 14-16 years. Findings from the three WPs will be integrated by YRAs and members of the network and used to plan future work, including evaluations of trial data, modelling MHC interventions, development of future intervention pilots, and disseminating insights about implementation of interventions in practice, with the overall aim to improve health and wellbeing in young people.