Researched and tested by the London School of Economics, funded by the Education Endowment Foundation, and implemented by Bounce Forward, Healthy Minds is only all encompassing, and evidence based, health and relationships curriculum for years 7-10. It covers resilience, mental health, relationships, decision making, mindfulness, social media and more.
More and more we worry about the mental health of our teenagers. As surveys show, their emotional health is worsening. And their behavioural problems are increasing.
These are problems that schools can influence. For schools make almost as much difference to the emotional health and behaviour of their pupils as to their academic achievement. So how can schools do better for their wellbeing?
While young people’s life skills are strongly influenced by the ethos of the school, there also needs to be at least one hour a week of dedicated and specific teaching of life skills. But at present schools lack the means to teach life skills in a fully professional way.
To remedy this, researchers from the London School of Economics scoured the world for the best well-tested materials for teaching secondary school pupils in:
From this research Bounce Forward constructed a four-year course from ages 11-15, consisting of weekly lessons of one hour each. For each lesson there are dedicated teaching materials, written advice to teachers on how to use them, and dedicated teacher training. The whole course reflects the teachings of “positive psychology”: it focuses on building strengths rather than attacking weaknesses, and on what is worth doing rather than on what to avoid.
The structure of the course is shown in the diagram below. No such programme on this scale has ever been tested in the world. These are difficult and delicate subjects to teach. Many earlier programmes have failed due to lack of teacher training. So one key feature of the course is that the teachers have to be trained for five days before teaching each year of the course.
In devising the curriculum, we had high ambitions – of supplying what teachers all over the world have been looking for. But this could only be verified by a ‘randomised controlled trial’.
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The final curriculum and the trial were organised by Bounce Forward. Our first task was to find 34 state schools, largely in deprived areas, that wanted to teach the programme – several schools large enough to give reliable estimates of the effects of the course. The schools were then randomly divided into two groups. The schools were drawn from a wide range of local authorities from Wolverhampton to Kent, and the trial ran from 2013 to 2017 or 2014 to 2018, depending on when the school joined the experiment.
Each group taught the course over the full four years to one whole cohort of entrants to the school and measured the wellbeing of the pupils before and after the course. But one group of schools started one year later than the other, and that group of schools also measured the wellbeing of the pupils in the previous year’s entry – thus providing a control group that could be compared with all the pupils who were taught Healthy Minds.
To help assess the impact of the course, pupils completed a detailed questionnaire on their wellbeing before the course began and the same questionnaire again at the end of the course four years later. So the effects could be tracked by comparing the results of the pupils who took the programme with those who did not – assuming that both groups would have followed the same wellbeing trajectory if neither group had taken the programme.
In reporting the effects of the course, we focus on five outcomes. The first is ‘global health’, which was the primary outcome named before the trial began. This is captured by asking pupils ‘In general, how would you say your health is? Next, we look at the most commonly used measure of wellbeing worldwide, which is life satisfaction: ‘Overall, how satisfied are you with your life nowadays?’ The other three outcomes are created from twelve questions at capture various dimensions of physical health, emotional health and behaviour.
The schools reported enormous enthusiasm from staff and pupils alike, and all the schools have gone on teaching Healthy Minds to each subsequent year’s entry to school – a real vote of confidence.
These results include the effects on every group of pupils that a school signed up to teach, whether they were well or badly taught, or occasionally not taught consistently throughout. These are the effects after four years of teaching, and incorporate results measured on average two years after the material was taught.
The trial showed that the course works. The results are shown in the figure above. This shows how far an average pupil has increased her percentage ranking as a result of the course when compared with other pupils nationwide. On our primary outcome (global health) pupils who took the course improved their ranking by 10 percentiles (out of 100) – a substantial increase. The results for the more detailed set of questions on physical health were similar. Life satisfaction increased by 6 percentiles, which is like the effect on life satisfaction when an adult finds a partner. All effects were positive and significantly different from zero, except in the case of emotional health where the sample was too small for the effect to be significant.
The main cost of the course (compared with teaching PSHE as usual) is the training of the teachers. This involves 19 days of training and each day costs £190 for the teacher training and £160 for the teacher replacement cost. So, the total cost per teacher trained is £6,650. If we assume each teacher teaches 90 pupils (in three classes) and we add in the cost of materials, the cost per pupil over the four years is £100.
This is a remarkably low cost, when compared with the difference in results obtained from teaching PSHE this way. For example, suppose we focus on the effect on life satisfaction. The increase of 6 percentile points corresponds to an increased score on life satisfaction (measured 0-10) of 0.37 points. This is at the end of the fourth year of the course. There was already some effect in earlier years and there will be some in subsequent years. So conservatively we could assume an overall gain of 1 point-year. But 1-point year of life satisfaction (measured 0-10) corresponds to roughly 0.1 QALY (measured on a scale of 0-1).
Thus, the cost per QALY of the Healthy Minds course is only £1,000. By contrast the NHS is expected to provide all healthcare treatments for which the cost is less than around £25,000. So Healthy Minds costs only 1/25 of what NICE requires. It is real value for money. We should do more to promote mental health (as well as treat it) and Healthy Minds is one way to do that.
“Young people need Healthy Minds and schools should make it a top priority. It’s the most outstanding wellbeing curriculum in the world!”
Lord Richard Layard
London School of Economics
Funded by the Education Endowment Foundation
“Maths, English and Science help me succeed in school. Healthy Minds helps me thrive in life.”
All 34 schools involved in the Healthy Mind’s trial have continued with the curriculum
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