Multilevel Barriers and Facilitators to Sustainability of a Universal Trauma-Informed School-Based Mental Health Intervention Following an Efficacy Trial: A Qualitative Study

"I would like to say how much we appreciated the work you and your team have put in to this project, a big thank you for the excellent reports that you have completed on our behalf." Assistant Director of Public Health

"Brilliant - thank you Angela. As always you and your team are so proficient at getting our requests dealt with so promptly - it is a real pleasure to work with such a great organisation."

“(The SHEU survey) was very, very useful. It gave us reassurance we weren’t missing a trick. For example not many pupils in the sample year groups were taking illegal drugs, which re-enforced our opinions. But the survey also raised issues and flagged some things up. We discovered that some of our girls weren’t eating enough – the percentage of girls in our school not eating lunch the day before the survey was higher than the county average. There were other concerns too, specifically around cigarettes, alcohol and attendance.
The school used this data and took a number of actions to address it. More female peer mentors were put in place and the school asked NEXUS (the Extended Schools service) for help, so they developed a programme for girls which addressed their eating patterns, healthy eating, sex education and self-esteem issues.
We ran an anti-bullying group for Year 9 as a preventative measure, based upon data provided by our current Year 10 students.
The travel data revealed that a high number of pupils took the car to school so we involved the BIKE-IT scheme who ran assemblies, brought in their bikes (including one with a pedal-powered smoothie maker!), and raised awareness of health and green issues.
The information about how happy the students were with their lives raised some concerns as far fewer girls were as happy as the boys, so work was done around developing aspirations, role-models and self-esteem."        
 

"The data from last time were spot-on and we have done lots of work with it. We are very keen to repeat the survey." Headteacher

"The service you provide is of national significance." Health Development Agency

"I would like to say that this survey was very useful and made me realise things about PE and health that I had never realised before......Food at school is groovy, especially if your school does Jamie Olivers School Dinners. Viva apples and thanks for the survey." Female pupil, 13 yrs old

"The system works and I find quite a lot of it useful in my work. I've also recommended it to others."

"One year (following the SHEU survey) responses from our Year 4 cohort caused us concern, so we put in place a number of team building, motivational projects. We then assessed their effectiveness by requesting the SHEU questionnaires for these pupils as Year 5's."

"We did this last year with Year 8 and 10 and was incredibly useful. It is WELL worth doing and so useful to inform PSHE planning. The safeguarding audit team were delighted that we had done it. The findings are so so interesting.
"The findings are really comprehensive and range from what percentage of year 8 have breakfast in the morning to how many have tried this particular drug, to identity, health and sleep patterns, mental health, citizenship issues....
"It's essential for the PSHE and pastoral curriculum."

"You have often stood alone against the media who were often looking for the sensational headline. I have noticed an important change: the media now look out for and report very fairly and fully on the reports from the team." 
Tributes from a Health Education Advisor to John Balding, presented at his retirement lunch, May 2005

Any comments on specific survey questions that may have caused difficulty?
All questions are clearly worded and easy to answer

"The Schools Health Education Unit has gained a reputation as one of the most reliable sources of information about young people's health." BBC

"Many thanks for a major contribution to the health of children in the UK and elsewhere over many years and putting in place the continuation of the Unit." Tribute from a Director of Public Health to John Balding, presented at his retirement lunch, May 2005

"I have never looked at myself in this way before." Pupil

"SHEU data proved the best source of the kind of information we were looking for (...) to provide research support to the National Healthy Schools Programme." 

"Thank you very much, David, for another excellent survey.  We look forward to receiving our reports."

"The data for (us) are very useful ... This is especially important when evaluating the impact of interventions regarding alcohol or other areas, as the survey data are likely to provide an earlier indication than routine data sources."

"As a result of the survey we reviewed and amended PSHE schemes of work, we are currently working on a "Green Travel Plan", a morning breakfast club was established and we further developed 6th Form mentoring."

"Within the curriculum, we are part of the Healthy Schools programme - and the local, Director of Public Health Award. We cover many facets of health from emotional intelligence to safety education and our very strong, Anti-Bullying and Child Protection programmes. You can imagine our delight when the Local Authority and our school nurse made the following comments after we took part in the regional Schools Health Education Unit Survey: " Head Teacher.
“This was an amazing set of outcomes and really good evidence that (your school) is doing a wonderful job in prioritizing the health and well-being of its pupils … Well done to staff, governors and parents for all your work on this through the Director of Public Health award and other strategies. It is very clear that pupils feel happy, safe and involved at the school and your caring ethos shines through this data.”
Healthy Schools Coorduinator.

"Many thanks for all of the fantastic information that you have sent to me over the years, it has really helped me to plan relevant courses for my students to follow and to help me to focus on the needs of the students I teach."

Any comments on specific survey questions that may have caused difficulty?
Pupils at our primary school found the questionnaire very easy to understand and most of them completed the questions in less than 45min.

"We use the data to inform whole school practice: Pastoral programmes for target groups of pupils; Items for discussion with School Council; Information to help us achieve the Healthy School gold standard; To develop and dicuss with pupils our Anti-Bullying Policy; Targeted whole class sessions with the Police Community Support Officers; To share pupil perceptions of all aspects of their school life with parents, staff and governers." 

Any comments on specific survey questions that may have caused difficulty? No problems. My children were fully briefed before the survey and they understood that they could miss questions if they did not want to answer them. We did not have any children with any concerns regarding the survey at all.

Any comments on the use of the web site? No it was easy to use.

Any general comments on the exercise? The children really enjoyed completing the survey, It has lead to many positive discussions about our health and how we all have slightly different experiences and home lives.

"Over the last twenty years you have achieved much. The surveys and subsequent reports have painted the clearest picture we have of what young people are doing and what they think." OFSTED 1998

"You and the team have the evidence to show how young people's behaviour has or hasn't changed over time." 
Tribute from a Health Education Co-ordinator to John Balding, presented at his retirement lunch, May 2005

"I really think that the HRBQ is a wonderful piece of work in terms of getting useful information for so many different organisations in one go." Healthy Children's Research and Statistics Officer

"As a Deputy Head in a large secondary school I was involved in taking part in a city wide health and wellbeing survey over a period of six years. Completing the survey every two years grew in importance year on year, with the final cycle having a major impact on our SDP, PHSE curriculum, Ofsted outcomes and governor understanding.
Over the six year period we moved from a small sample in two tutor groups filling in a paper survey to two year groups completing an online survey. The reports produced give graphical analysis of a wide range of issues. As a result of the survey we increased the number of PSHE workshop days for students to address issues such as smoking, drug and alcohol awareness, anti-bullying workshops. The surveys helped Governors make a positive informed decision to allow Brook Advisory Clinic nurses on site to support students.
As a result of taking part and using the evidence provided we were able to offer more support for students which had a direct impact on improved attendance and outcomes."

"This week I have been working on a major strategy for service design -- it is easy to get solely focussed on hospitals, performance targets, and work force planning -- all very important; but at the same the needs of young people and how we need to work across agencies to address the health needs of today and tomorrow must be recognised. SHEU is founded to do just this."

"It's good to talk with you again - we used so much of those data and did so much with it in schools - we really got the place buzzing!"

"Every school involved in the National Healthy School programme should start with an HRBQ survey." Health Education Co-ordinator

"I have valued greatly the work I have done with the team in Exeter, it has been a highlight of my years here." Health Promotion Specialist

"Please send an additional copy of our report - it is the most requested and borrowed item in the whole library." Health Promotion Unit

"We never make a move without looking at these excellent reports." Public Health Consultant

"...the most comprehensive health education survey."