As the start of term approaches, many school leaders will be thinking about how to help students overcome the wellbeing challenges of the pandemic. But how much do we know about what works in this area? Wellbeing expert Willem Kuyken, Ritblat professor of mindfulness and psychological sciences at the University of Oxford, tells Simon Lock that although more research is needed, the evidence does give some clues about the best bets.

Simon Lock: After two very disrupted years, looking after the mental health and wellbeing of students will be high on the agenda for many school leaders in September. What sort of challenges do they face?

Willem Kuyken: The big challenge is that it’s a really mixed picture. One of the things the pandemic has exposed is that we actually had something of a pandemic of wellbeing problems even before Covid-19. Before the pandemic, some 18 to 20 per cent of young people had significant mental health problems.

What we’re seeing now is that, for some groups of people, wellbeing and mental health has gotten worse and, for other groups of people, they’ve actually done just fine through the pandemic - and that’s for a whole range of complex reasons.

For children who have been in families that are struggling with unemployment and deprivation, it’s been a really hard time, whereas for young people who maybe were exposed to bullying at school, being back at home has actually been a respite.

So, I think it’s a really mixed picture, with some things clearly getting worse - such as depression and anxiety for the population as a whole - whereas there is evidence that other things have improved; for instance, there’s some evidence that rates of self-injury have gone down during the pandemic.

The picture for individual pupils might be mixed but do you think the pandemic has changed how schools think about wellbeing?

I feel strongly that there’s something very interesting happening in the world just now. As we come out of this pandemic, there is an opportunity to reappraise what’s really important and what makes a difference.

My grandfather died in his early 50s of a heart attack. This was a long time ago and he ate a lot of red meat, he never exercised, he smoked regularly. That was absolutely the norm. If he had been born 50 years later, he might not have done any of those things; his high blood pressure might have been spotted and he would more than likely have lived longer.

So, there has recently been a massive cultural shift in terms of things like smoking, exercise and diet. I think we now have an extraordinary opportunity to think about a similar kind of shift in ethos around wellbeing. Wellbeing is about foundational psychological skills like attention, focus, and self-regulation; it’s about the ability to build positive relationships and to feel good about what we do with our lives; it’s about realising our potential to flourish. That sits alongside academic learning in schools - and I think more people are realising that now.

That’s true but, practically, academic learning and wellbeing are still often seen as separate rather than being intertwined.

I think the separation of wellbeing and academic outcomes is really unhelpful. It’s a zero-sum game to think of these as being separate pursuits and that, if you spend time on wellbeing, then you don’t have the time for core subjects. I think they really go hand in hand.

For a child to learn, she or he needs to feel safe. They need to be fed, they need to feel that they are seen and heard. My sense, from science but also from what I hear from teachers, is that wellbeing needs to be thought of as something that is in the fabric of every moment of the school day. It’s not something that’s done in the PSHE (personal, social, health and economic) lessons but it’s woven into every interaction, every meeting, every classroom.

I think we’ve seen that with programmes that address bullying or programmes that address behaviour problems in classrooms - we know they have to be part of the whole culture of the school. All the teachers need to be working together towards those same objectives. We know that an anti-bullying lecture once a term is not enough; it has to be in the fabric of the whole school. When you have that, I think you see evidence that these programmes can be effective.

Saying that, I know how hard this is to do, particularly in areas where children are coming in not having had breakfast, and levels of deprivation or rates of turnover in the staff group are very high. So, I really do understand that this is a very big challenge for many heads and senior leadership teams in schools.

Could research help here? We’ve seen a real push towards evidence-informed practice in recent years when it comes to classroom pedagogy. Is the same happening with schools and wellbeing?

It’s interesting because, up until about 10 years ago, most of my professional work had been in the health service. And in the health service, we have NICE (the National Institute for Health and Care Excellence), which is a body that looks at the evidence base.

When new things are introduced in the health service, it happens through systematic reviews and meta analyses of what works and is cost effective. So, anything that is delivered in the NHS - in hospitals and primary care - will have met NICE thresholds for, say, the treatment of depression, or anxiety, or cancer or anything else.

Schools don’t operate that same system - at least not formally. Apart from the statutory requirements, they tend to introduce things that are perhaps “of the moment”, that there is an enthusiasm for. I know that teachers are being led by evidence with academic outcomes but, if the same approach that happens in the health service were to happen more around wellbeing, I think schools could make a lot of inroads to improving the wellbeing of young people, but, crucially, of teachers and headteachers too.

Wellbeing in schools is a relatively new area of research. Is part of the problem for teachers that there isn’t actually a lot of evidence out there to inform best practice yet?

That’s a really good point. And I think we absolutely need more really high-quality research that answers the questions of which wellbeing programmes are effective, for whom they are effective, how they are effective and how they can be implemented in a sustainable long-term way.

Over the past seven years, we’ve done this with a universal schools-based mindfulness intervention, looking at the mental health and wellbeing of 28,000 children and 85 schools across the country. We’ve tried to answer those questions.

The reason we’re doing the research around mindfulness is because I think the enthusiasm ran ahead of the evidence. That is probably true for a lot of wellbeing programmes. It probably isn’t helpful for me to name them because the evidence may still develop in interesting ways - but I think the business of stopping and pausing, and really looking at the evidence, is a good investment of time.

If a headteacher or a senior leadership team don’t have the skills to do that, find someone to help you who does. It takes a lot of energy and a lot of cultural change to bring a programme in effectively.

You’ve mentioned mindfulness, which is one of your areas of expertise. What is this?

In its simplest form, mindfulness is a natural capacity that we all have to pay attention to our experience in a particular way, with a sort of curiosity, and with kindness and with care.

That’s the simplest definition. But I think it’s a bit like the word “wisdom”; it’s got lots of different facets.

One way of describing mindfulness that resonates with a lot of people is that between stimulus and response there is a space. If we can access that space, then we’ve got a choice and we’ve got the potential for freedom.

So, for example, imagine a teacher in a classroom working with a child with behavioural problems. Now, imagine the child does something extremely challenging: that’s the stimulus. How does that teacher respond? If they are really tired and they are feeling quite stressed, it is very understandable for that teacher to respond in a reactive way, in maybe a way that they regret afterwards.

But, if the teacher can be supported to be more “present”, more in their body, more aware of that reactivity, then they’ve created enough space to say: what would be a helpful response in this moment? How can I draw on my previous teaching experience and what I know about classroom management to respond to this young person in a different way? I think that’s where mindfulness starts.

It starts with learning about our reactive tendencies: how we can be prone to jump to conclusions, catastrophise, take things too personally. But it’s also about how we use that in our relationships, in our day-to-day work, our teaching. So, it can become a much larger thing.

Mindfulness approaches are being used more and more in schools. Is there strong evidence to suggest that these approaches can be helpful for pupils?

I think there is no doubt that mindfulness skills are associated with wellbeing. When you look at formal mindfulness-based programmes, there is a really compelling evidence base now that it helps to prevent depression in adults. The NICE guidelines recommend mindfulness-based cognitive therapy and this is widely available through the NHS. There’s also really good evidence that mindfulness-based programmes can help with chronic pain.

And there is emerging evidence in other areas coming into the educational sphere. One of the places where the evidence is strongest is actually with teachers. Our own and other people’s work has consistently demonstrated that when teachers learn mindfulness, their levels of stress go down, their levels of wellbeing go up, and their ability to meet their work and to meet their children with a greater sense of kindness and compassion goes up as well.

Can creating mindful staff have a knock-on impact on pupils?

If we have a mindful headteacher, we’re more likely to have mindful teachers, and if we have mindful teachers, we’re more likely to have mindful children. I think there’s no doubt about that.

By the word “mindful”, I mean the ability to regulate ourselves, the ability to meet stressful moments with a sense of spaciousness, interest and kindness. These are foundational skills, I think, that will spiral out to improve the outcomes for children.

So, mindfulness could be effective, then. Does the existing evidence give us any clues about what else might work in schools?

I would say there’s a huge amount of work still to be done in this area but there are a few things that are really good for schools to know.

One is around school climate and school ethos. There is a fairly good, robust evidence base to suggest that the climate or the ethos of a school - a sense of safety; a sense of positive relationships, between staff and the senior leadership team, between the teachers and the students; a sense of a well-organised school - this kind of school climate is associated with positive wellbeing and mental health outcomes for young people.

So, creating a positive school ethos and a positive school climate around wellbeing is one thing schools can do. There are some programmes that we know are effective here. For example, Incredible Years [a series of programmes that aim to prevent and treat behaviour problems and promote social, emotional, and academic competence], has got a really robust evidence base, primarily focused on classroom management.

Even for those programmes or ideas that are well-evidenced, do we need to be cautious about implementation?

There is a quite large body of work suggesting that how things are implemented in a school makes a massive difference. There is a whole range of different factors here but one thing we know is that implementation takes time: you can’t just decide one academic year to do something and then do it the next year. It probably requires a five- to 10-year window to systematically introduce something really high quality into a school.

Another point is that implementation involves top-down and bottom-up influences. So, the school leadership team, the governors and the head need to buy into whatever you’re doing. But you also need champions on the ground, among the pupil body and among the teacher body - and those champions are the ones who will be the influencers, if you like, who will shift the student body and shift the teacher body as a whole.

You also need to balance the integrity of the initial programme with flexibility. The way research works is that you research a programme and then you find that it works. If you then dilute that programme as you bring it into a school, it may no longer work.

On the other hand, if you don’t consider within the school, for example, the proportion of free school meals or the children for whom English is not their first language, that lack of flexibility could also impair the programme. So the whole business of implementing something, making it a sustainable part of the school, is complex. Good senior leadership teams and good heads understand that already.

The other thing, certainly in the mindfulness field, that really needs to be thought about very carefully, is the extent to which the children and the teachers, and the wider community around the school, buy into whatever you’re doing. If the children don’t value it or see it as being something credible, then you’re swimming against the tide. That needs to be a place to start: to really see what you’re doing from the children’s perspective and to meet them where they’re at. And I think, again, really good programmes know how to do that.

For school leaders looking towards the next academic year, thinking that the wellbeing challenges seem insurmountable, what advice would you give?

One of the papers that we published earlier this year was looking at the mental health and wellbeing of all of the children in our trials. We learned a few things from it that might help.

The first thing that we learned was that rates of mental health problems are in excess of 20 per cent. So we have a really significant problem that needs addressing. The second thing that we learned is that school climate is associated with mental health and wellbeing; so as I already said creating a positive school climate really can make a difference. But the thing that I found quite sobering, and I think might be very reassuring for schools, is that the amount of variance in children’s mental health and wellbeing that was carried by schools was only between 1.5 and 2.5 per cent.

That means that much of the variance in mental health and wellbeing of children is coming from forces outside of the school; the community that young people are living in, rates of deprivation, for example, the adversity they’re facing at home, their backgrounds, their upbringing.

That’s not to say that schools can’t make a difference to wellbeing - they can and they do. But actually it’s okay for headteachers and school staff to give themselves a break. There are many wider social issues driving wellbeing that policymakers should be looking at that are outside of schools’ control.

Simon Lock is senior digital editor at Tes. Willem Kuyken is Ritblat professor of mindfulness and psychological sciences at the University of Oxford. He will be speaking at the E-ACT Ideas Conference on 7 October 2021. For more details, visit e-act.org.uk/conference

This article originally appeared in the 13 August 2021 issue under the headline “What works for wellbeing?”