Understanding if mental health and wellbeing coordinators in primary schools can help improve student mental health support: an expanded study

The intervention consists of the Mental Health and Wellbeing Coordinator (MHWC) role and related training program. The MHWC role: Intervention schools will receive funding from the Victorian Department of Education and Training to employ a mental health and wellbeing coordinator (MHWC) at a full-time equivalency. Each school will recruit or appoint a teacher to the MHWC position. Once recruited the MHWC will: 1. Receive evidence-based training around supporting the mental health needs of primary school students; 2. Embed evidence-based training (Tier 1 practices & frameworks) across the school and build the capability of teaching and education support staff to better identify and support students with mental health concerns; 3. Be a significant contributor to the school’s wellbeing team; 4. Support the referral pathway for students identified as requiring further assessment and intervention within the school or to external community-based services (the MHWC role will not involve providing 1:1 counselling support to students); 5. Work proactively with regional staff (i.e., psychologists, speech and language therapists, social workers), school wellbeing and leadership teams, and other health professionals (community-based psychologists, paediatricians, GPs, other allied health) to engage appropriate mental health support such as assessment, counselling, classroom based adjustments; 6. Connect wellbeing initiatives across the school and be responsible for implementing whole school approaches to mental health and wellbeing, including the social and emotional learning curriculum. MHWC full time equivalency (FTE) allocation will be determined based on number of student enrolments at each school using the following scale: 0-149 students = 0.4 FTE, 150-299 students=0.6 FTE, 300-449 students=0.8 FTE, >449 students=1.0 FTE. An additional loading will be applied to regional and rural schools. The MHWC Training Program: The MHWC will participate in a purpose designed training program, delivered by the research team at the Melbourne Graduate School of Education (University of Melbourne), to build knowledge, skills, and attitudes to effectively focus on building the capacity of the whole school, working with individual teachers and the whole staff cohort. The training comprises an induction session followed by three core modules: (1) Mental Health Literacy, (2) Supporting Need and (3) Building Capacity. MHWCs will receive all core modules, and up to three nominated school trainees from each participating school will receive components of the training. MHWCs will also attend monthly Community of Practice sessions (2 hours) throughout the intervention period which will include a selected expert for each session. For the 2022 expanded study, MHWCs will also be assigned to a 'Learning Leader' who will facilitate the Community of Practice sessions for a particular cluster of schools and be available for learning and development support and coaching throughout the intervention period. The learning leader is a member of the research and training team, delivering the intervention. The learning leader is assigned to a subset (or ‘cluster’) of schools based on geographic location. Up to two x 30 minute support/coaching ‘drop-in’ sessions are offered per week and are delivered via video-conference. Mental Health and Wellbeing Coordinators can link in to as many or as few sessions as they wish and discuss any issues related to their role. Content of the core modules will focus on the following broad areas: • Mental health and wellbeing as a continuum, including behavioural, social emotional and learning indicators. • Risk and protective factors for mental health concerns and promoting wellbeing. • Engaging parents and carers and supporting school staff in conversations with parents and carers about student mental health and wellbeing. • Building and maintaining effective relationships with service providers. • Understanding the referral pathways within the school system and into the community. • Evidence-based prevention and promotion activities and programs and evaluating their effectiveness and fit for purpose in the school context. The instruction will use a problem/task centred approach informed by Merrill’s first principles of instruction (Merrill, 2002). These principles work on the basis that learning is promoted when: learners acquire knowledge in the context of real-world problems; existing knowledge is activated as a foundation for new knowledge; new knowledge is demonstrated to the learner, applied by the learner, and integrated into the learner’s world. MHWCs and other school participants will practice applying their knowledge through case studies, role-plays, and case studies and examples from their school context. Outputs of the training include a mental health and wellbeing profile and plan; and care pathway mapping based on each participant’s individual school context and circumstances. The majority of content will be delivered over an intensive 3-day training program via a synchronous online environment, using teleconference technology to facilitate the building of professional networks and communities of practice. In addition, asynchronous learning including, videos, content-based activities, pre-reading, skills and knowledge checks, completion of online modules from other providers (as pre-requisites to cover basic concepts and engage with potential resources for staff professional development) and reviewing previously covered material to consolidate learning. Communities of practice and skills practice ‘on-the-job’ will also form an integral part of the learning approach and will continue as part of the model once the training is complete. Adherence to the intervention is monitored via the following: • Job Analysis Tool: To evaluate the tasks, responsibilities, time and resources required to achieve all aspects of the MHWC role and successful implementation of the MHWC model, MHWC activity will be recorded in two study developed databases (“Job Analysis Tool” [JAT] & “Care Pathway Tool” [CPT]). Information collected from both these tools will include the number of students referred for additional support, number of interactions with classroom teachers, time spent on tasks, type of mental health and wellbeing activities the MHWC is assisting with, number of referrals made, uptake/outcome of referral, waitlist times and number and type of interactions with regional staff. • Survey data: survey data includes study-devised questions about implementation including how much time the MHWC is committing to the various aspects of the role and how much time, if any, they are spending on activities unrelated to their role. The intervention period commences at the start of the school year when the MHWC commences in the role, and continues for 24 months; after which the MHWC will continue in their role without direct support from the research and training team. The 74 primary schools delivering the MHWC model were identified by the Victorian Department of Education and Training (DET) from the NWVR (North-East Melbourne, Mallee, Hume Moreland and Loddon Campaspe areas), and SWVR (Barwon, Wimmera South West, Central Highlands, Brimbank Melton and Western Melbourne areas). Schools were recruited by DET based on mental health need (through consultation with regional stakeholders and Incident Reporting Information System [IRIS] data), readiness (ensuring schools have the capacity and willingness to participate) and context diversity (including metropolitan, regional and rural contexts, and those impacted to different degrees by COVID-19). In addition, 2 Specialist Schools and 1 English as an Additional Language (EAL) school were included amongst the schools recruited in 2022. The 35 BAU schools were recruited by invitation from MCRI sent to selected primary schools in the NWVR and SWVR. BAU schools were selected based on matching characteristics with intervention schools, including socio-demographic characteristics (ie. ICSEA), school size (ie. number of enrolments) and location (ie. metropolitan/regional/rural). Between 2023 – 2026 the MHWC model is rolling out to all Victorian government and low-fee non-government primary schools. This includes schools that were previously recruited as BAU (‘control') schools. Therefore, over the next four years, the number of BAU schools will decrease from 35 in 2022, to 26 in 2023, 19 in 2024, 9 in 2025 and 0 in 2026.