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Stakeholder Perspectives on Factors Influencing the Successful Implementation of Whole-School Approaches to Mental Health

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Title: Stakeholder Perspectives on Factors Influencing the Successful Implementation of Whole-School Approaches to Mental Health
Language: English
Authors: Liam P. Spencer (ORCID 0000-0002-6223-6081), Neil Perkins, Darren Flynn, Emily J. Henderson, Gregory Maniatopoulos, Markku Wood, Helen Woodley, James J. Newham
Source: Health Education Journal. 2026 85(4):404-417.
Availability: SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com
Peer Reviewed: Y
Page Count: 14
Publication Date: 2026
Document Type: Journal Articles
Reports - Research
Descriptors: Mental Health, Consciousness Raising, Knowledge Level, Allied Health Personnel, School Personnel, Parents, Students, Attitudes, Program Effectiveness, Holistic Approach, Foreign Countries, Skill Development, Social Influences, Participation, Emotional Response, Goal Orientation, Intention, Positive Reinforcement, Behavior
Geographic Terms: United Kingdom (England)
DOI: 10.1177/00178969261427923
ISSN: 0017-8969
1748-8176
Abstract: 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.
Abstractor: As Provided
Entry Date: 2026
Accession Number: EJ1507467
Database: ERIC
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  Data: Stakeholder Perspectives on Factors Influencing the Successful Implementation of Whole-School Approaches to Mental Health
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  Data: <searchLink fieldCode="AR" term="%22Liam+P%2E+Spencer%22">Liam P. Spencer</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-6223-6081">0000-0002-6223-6081</externalLink>)<br /><searchLink fieldCode="AR" term="%22Neil+Perkins%22">Neil Perkins</searchLink><br /><searchLink fieldCode="AR" term="%22Darren+Flynn%22">Darren Flynn</searchLink><br /><searchLink fieldCode="AR" term="%22Emily+J%2E+Henderson%22">Emily J. Henderson</searchLink><br /><searchLink fieldCode="AR" term="%22Gregory+Maniatopoulos%22">Gregory Maniatopoulos</searchLink><br /><searchLink fieldCode="AR" term="%22Markku+Wood%22">Markku Wood</searchLink><br /><searchLink fieldCode="AR" term="%22Helen+Woodley%22">Helen Woodley</searchLink><br /><searchLink fieldCode="AR" term="%22James+J%2E+Newham%22">James J. Newham</searchLink>
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  Data: <searchLink fieldCode="SO" term="%22Health+Education+Journal%22"><i>Health Education Journal</i></searchLink>. 2026 85(4):404-417.
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  Data: SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com
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  Data: 14
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  Data: <searchLink fieldCode="DE" term="%22Mental+Health%22">Mental Health</searchLink><br /><searchLink fieldCode="DE" term="%22Consciousness+Raising%22">Consciousness Raising</searchLink><br /><searchLink fieldCode="DE" term="%22Knowledge+Level%22">Knowledge Level</searchLink><br /><searchLink fieldCode="DE" term="%22Allied+Health+Personnel%22">Allied Health Personnel</searchLink><br /><searchLink fieldCode="DE" term="%22School+Personnel%22">School Personnel</searchLink><br /><searchLink fieldCode="DE" term="%22Parents%22">Parents</searchLink><br /><searchLink fieldCode="DE" term="%22Students%22">Students</searchLink><br /><searchLink fieldCode="DE" term="%22Attitudes%22">Attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22Program+Effectiveness%22">Program Effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Holistic+Approach%22">Holistic Approach</searchLink><br /><searchLink fieldCode="DE" term="%22Foreign+Countries%22">Foreign Countries</searchLink><br /><searchLink fieldCode="DE" term="%22Skill+Development%22">Skill Development</searchLink><br /><searchLink fieldCode="DE" term="%22Social+Influences%22">Social Influences</searchLink><br /><searchLink fieldCode="DE" term="%22Participation%22">Participation</searchLink><br /><searchLink fieldCode="DE" term="%22Emotional+Response%22">Emotional Response</searchLink><br /><searchLink fieldCode="DE" term="%22Goal+Orientation%22">Goal Orientation</searchLink><br /><searchLink fieldCode="DE" term="%22Intention%22">Intention</searchLink><br /><searchLink fieldCode="DE" term="%22Positive+Reinforcement%22">Positive Reinforcement</searchLink><br /><searchLink fieldCode="DE" term="%22Behavior%22">Behavior</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22United+Kingdom+%28England%29%22">United Kingdom (England)</searchLink>
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  Data: 10.1177/00178969261427923
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  Data: 0017-8969<br />1748-8176
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  Data: 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.
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