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Lookup NU author(s): Liam SpencerORCiD, Emeritus Professor Neil Perkins, Dr Darren Flynn, Dr Emily Henderson, Dr Gregory Maniatopoulos, Markku Wood, Helen Woodley, Dr James Newham
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).
Background: Whole-school approaches (WSAs) to mental health aim to promote collaborative, system-wide action by school communities to reduce stigma, raise awareness and embed mental health as ‘everyone’s business’. Although investment in such approaches has increased in England, implementation remains challenging due to variation in interpretation and the complexity of engaging diverse stakeholders. Objectives: The NHS Trailblazer programme introduced Mental Health Support Teams in schools to enhance support for children and young people’s mental health. This exploratory qualitative study examined stakeholder perspectives on the factors influencing the successful implementation of WSAs to mental health, using the Trailblazer programme as a real-world exemplar. Methods: Interviews with senior practitioners (n = 19) and 12 focus groups with mental health practitioners, school staff, parents/carers and children and young people (n = 29) were conducted across four educational settings in three areas of the North East of England. Data were analysed thematically using the Framework Approach and mapped post hoc onto the COM-B (Capability, Opportunity, Motivation) model of behaviour and Theoretical Domains Framework (TDF) to inform policy and practice. Results: Using the COM-B model as the organising framework (with TDF domains mapped within each component): ‘Capability’ encompassed knowledge, skills and behaviour regulation; ‘Opportunity’ captured environmental context and resources and social influences and ‘Motivation’ included social/professional role and identity, beliefs about consequences, optimism/pessimism, emotions, goals, intentions and reinforcing behaviour. Conclusions: While WSAs to promote mental health in schools show promise, their success depends on sustained investment, professional development and clarity around implementation roles and expectations. This study contributes to the literature by providing real-world insights into the implementation of such approaches, extending understanding of how national policies can translate into local school practices.
Author(s): Spencer LP, Perkins N, Flynn D, Henderson EJ, Maniatopoulos G, Wood M, Woodley H, Newham JJ
Publication type: Article
Publication status: Published
Journal: Health Education Journal
Year: 2026
Pages: Epub ahead of print
Online publication date: 19/03/2026
Acceptance date: 02/04/2018
Date deposited: 20/03/2026
ISSN (print): 0017-8969
ISSN (electronic): 1748-8176
Publisher: Sage Publications Ltd
URL: https://doi.org/10.1177/00178969261427923
DOI: 10.1177/00178969261427923
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