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Mindfulness – a mental training that develops sustained attention that can change the ways people think, act and feel – could reduce symptoms of stress and depression and promote wellbeing among school children, according to a new study published online by the British Journal of Psychiatry.

With the summer exam season in full swing, school children are currently experiencing higher levels of stress than at any other time of year. The research showed that interventions to reduce stress in children have the biggest impact at this time of year.
There is growing evidence that mindfulness-based approaches for adults are effective at enhancing mental health and wellbeing. However, very few controlled trials have evaluated their effectiveness among young people.

A team of researchers led by Professor Willem Kuyken from the University of Exeter (and supported by PenCLAHRC), in association with the University of Oxford, the University of Cambridge and the Mindfulness in Schools Project, recruited 522 pupils, aged between 12 and 16 years, from 12 secondary schools to take part in the study. 256 pupils at six of the schools were taught the Mindfulness in Schools Project’s curriculum, a 9-week introduction to mindfulness designed for the classroom. Richard Burnett who co-created the curriculum describes it this way “our mindfulness curriculum aims to engage even the most cynical of adolescent audience with the basics of mindfulness. We use striking visuals, film clips and activities to bring it to life without losing the expertise and integrity of classic mindfulness teaching”.
The other 266 pupils at the other six schools did not receive the mindfulness lessons, and acted as a control group.

All the pupils were followed up after a three month period. The follow-up was timed to coincide with the summer exam period – which is a potential time of high stress for young people. The researchers found that those children who participated in the mindfulness programme reported fewer depressive symptoms, lower stress and greater wellbeing than the young people in the control group.

Encouragingly, around 80% of the young people said they continued using practices taught in MiSP’s mindfulness curriculum after completing the 9-week programme. Teachers and schools also rated the curriculum as worthwhile and very enjoyable to learn and teach.

Lead researcher Professor Kuyken said: “Our findings provide promising evidence of the effectiveness of MiSP’s curriculum. We found that those young people who took part in the programme had fewer low-grade depressive symptoms, both immediately after completing the programme and at three-month follow-up. This is potentially a very important finding, given that low-grade depressive symptoms can impair a child’s performance at school, and are also a risk factor for developing adolescent and adult depression.”

Professor Katherine Weare, who has been instrumental in promoting the teaching of resilience in schools, adds: “these findings are likely to be of great interest to our overstretched schools who are trying to find simple, cost effective and engaging ways to promote the resilience of their students – and of their staff too - at times when adolescence is becoming increasingly challenging, staff under considerable stress, and schools under a good deal of pressure to deliver on all fronts. This study demonstrates that mindfulness shows great promise in promoting wellbeing and reducing problems - which is in line with our knowledge of how helpful well designed and implemented social and emotional learning can be. The next step is to carry out a randomised controlled trial into the MiSP curriculum, involving more schools, pupils and longer follow-ups.” 

Professor Felicia Huppert of the University of Cambridge said, “The findings also support the argument that mindfulness training can enhance the psychological well-being of all pupils, not just those who have symptoms associated with common mental health problems. Psychological well-being has been linked to better learning, social relationships and academic performance, so the enhancement of well-being is likely to improve a range of outcomes in the school context.”

Professor Kuyken is currently working with PenCLAHRC on a project looking at mindfulness-based cognitive behavioural therapy to help with depression and chronic physical health problems.

Health organisations need to give careful consideration to schemes which encourage people with chronic diseases to seek support from peers, to avoid the potential negative effects, new research shows.

The study, which was led by the University of Exeter Medical School, will be published in the July edition of the journal Patient and Education Counseling, and is now available online. The research, supported by PenCLAHRC, has highlighted both the positive and negative effects of such peer support schemes. The findings emphasise that such networks are broadly beneficial – but the study’s authors warn that the potential drawbacks must be considered if they are to be avoided.

Increasingly, care providers are encouraging people who have chronic diseases to engage with other patients who have shared experiences as part of their treatment programme. They act as “mentors” and provide social and emotional support, as well as practical information.

The model takes a range of different forms, but is widely seen as an effective and low-cost care tool. Its popularity has grown against a backdrop of an increasing burden on healthcare systems caused by rising levels of chronic disease, due to aging populations, lifestyle factors and improved treatment, which means people live longer with disease.

Professor Nicky Britten, of the University of Exeter Medical School, said: “Peer support schemes can be extremely beneficial, but it is imperative that they are handled with sensitivity and understanding. There’s a lot of talk about how the recipients of this support benefit, but we have to remember that the ‘mentors’ themselves may have a serious illness, and they may encounter negative feelings such as rejection in some instances. We need to ensure support is available to help them through that.”

Prof Britten was part of the international research team, which also incorporated Sunnybrook Health Sciences Centre in Toronto, Canada, Toronto General Hospital and St Michael’s Hospital, Toronto.

The work was funded by the Canadian Institute for Health Research and the Ontario Rehabilitation Research Advisory Network. Professor Britten is partially supported through PenCLAHRC. .

The team’s findings were based on a synthesis of 25 papers about the perceived impact and experience of people across a range chronic diseases who have taken part in peer support schemes in several different countries including the UK, the US, Canada and Australia. The concepts they identified were brought together in a model which highlighted both positive and negative perceptions, and whether they were experienced by the mentor, the recipient or both.

Although peer support was largely found to foster a sense of connection and help participants find a value in life, they could both alleviate and reproduce feelings of isolation arising from the diagnosis. The schemes reduced feelings of being alone, but this could backfire if the two parties involved shared little in common, other than their illness. Mentors were found to be at particular risk of emotional entanglement, with the relationship sometimes placing their wellbeing at risk, particularly when the recipient’s condition deteriorated. They were also found to need support after the relationship was severed, to cope with a sense of loss.

Prof Britten concluded: “These schemes are billed as peer-to-peer, but there is an intrinsic imbalance in the fact that one person is receiving the service, and the other is delivering, and may have varying degrees of training to prepare them for that role. That can reproduce some of the hierarchical relationship between a patient and a healthcare professional, and any tension arising form that needs to be managed carefully. This type of support is extremely valuable, and clearly has an important role to play in healthcare. But in order for it to be a positive experience for all involved, it is crucial that the impact on both the “mentor” and the recipient is considered, and that health care providers avoid a ‘one size fits all’ approach.”