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The implementation of whole-school approaches to transform mental health in UK schools: A realist evaluation protocol

Lookup NU author(s): Liam SpencerORCiD, Dr Darren Flynn, Dr Gregory Maniatopoulos, Dr James Newham



This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


Background: Evidence suggests that mental health interventions are more effective when they consider the whole context of schools; addressing the needs of all students, their families, and staff; otherwise known as a whole-school approach (WSA). The UK Government is piloting WSAs to transform mental health and wellbeing by locating Educational Mental Health Practitioners in educational settings across England. This study aims to develop a ‘bottom-up’ understanding of the contextual factors and mechanisms that underlie WSAs in Trailblazer schools in the North East and North Cumbria; to gain insight into the facilitators and barriers of delivering a WSA; and optimal evaluation methods. Methods: To undertake a Realist Evaluation, including: The generation of initial programme theories from existing academic literature and policy documents; ‘theory gleaning’ interviews with NHS/local authority stakeholders, Trailblazer staff, and school senior leaders; refining and development of theories; and individual interviews and focus groups with pupils, parent/carers, and school staff. Results: The findings will enable Trailblazer partners to better understand how their WSAs to mental health contain the essential components for transformation in schools in the region. This will contribute to the embedding of continuous evaluation into regional Trailblazers’ practice for participating schools; for subsequent annual waves; and producing relevant findings for non-Trailblazer schools. Conclusion: Complementing the national evaluation of all 25 Wave 1 Trailblazer pilot sites, this study will generate an explanatory theoretical account of how to optimally design, implement, and evaluate WSAs by exploring the contextual factors associated with implementation of WSAs.

Publication metadata

Author(s): Spencer L, Flynn D, Johnson A, Maniatopoulos G, Newham J, Perkins N, Wood M, Woodley H, Henderson E

Publication type: Article

Publication status: Published

Journal: International Journal of Qualitative Methods

Year: 2022

Volume: 21

Online publication date: 10/04/2022

Acceptance date: 15/02/2022

Date deposited: 21/04/2022

ISSN (electronic): 1609-4069

Publisher: Sage Publications, Inc.


DOI: 10.1177/16094069221082360


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Funder referenceFunder name
National Institute for Health Research (NIHR) North East and North Cumbria Applied Research Collaboration (NENC ARC), Ref: OFC20_05