King's College London

Poor mental health in young people is increasing, with clear evidence of mounting psychiatric problems. However, less than a quarter of young people with mental health problems can access services, meaning there is an urgent need for easily accessible and effective mental health resources. Common barriers include the limited provision of services, reluctance of adolescents to seek professional help as well as a fear of stigmatisation.

Young people’s mental health is a major government priority, with current policy advocating the development of effective education based mental health care to prevent the escalation of mental health problems, improve access and reduce service waiting times. However, existing school-delivered programmes for depression and anxiety only have modest effects. These programmes are also mainly focused on younger children.

BESST is an exciting clinical trial designed to understand whether a group workshop programme, called DISCOVER, can positively impact the mental health of 16-18-year-old sixth-form students.

The full study protocol can be found here.

What is DISCOVER?

The DISCOVER workshop programme is an award-winning, school-based programme for sixth-form students who experience stress, anxiety, or low mood. This workshop programme was developed with a Teenage Advisory Group of 16–18-year-olds to reach young people more easily via a self-referral route. The DISCOVER programme is aimed at equipping young people with practical skills to manage stress, worry, and other challenges they may face in their academic and personal lives.

How the trial works

BESST seeks to understand how effective the DISCOVER workshop programme is in reducing symptoms of depression (and other outcomes) in students attending the workshop compared to those who receive their usual school care but no workshop. Responses of the two groups were then compared to understand whether the workshop effectively reduced the severity of symptoms on the various questionnaires at three and six month follow-up.

Progress to date

900 students from 57 sixth-forms across England were successfully enrolled into BESST, with 70 clinicians from 15 Mental Health Support Teams (MHSTs) trained to deliver the intervention. Data collection commenced in October 2021 and the final six-month follow-up data was collected in June 2023. We have now completed analysis of the outcome data and are eagerly awaiting the publication of our findings. Be sure to check our BESST Trial Website and Twitter/X account for updates on our progress.

Trial Impact

The results of this trial will tell us whether DISCOVER is a suitable programme to take forward as a school-based mental health provision. It is very possible that DISCOVER could be a highly effective and popular component in frontline education-based mental health care as advocated by government health and education policy. We see DISCOVER fitting in very well with the current education-based mental health care aims of the government. Therefore, this trial is essential to inform the Department of Health about the effectiveness of this potentially very important intervention for 16-18-year-olds.

Study Team

Chief Investigator

• Dr June Brown: Site Lead for London, King's College London

Co-Investigators

• Professor Paul Stallard: Site Lead for Southwest England, University of Bath
• Dr Jessica Deighton: Site Lead for Northwest England, University of Manchester
• Miss Jynna Yarrum: Site Lead for Midlands, University of Northampton
• Dr Ben Carter: Lead Trial Methodologist and Statistician, King's College London
• Ms Kirsty James: Trial Statistician, King's College London
• Dr Crispin Day: Fidelity Lead, CAMHS Research Unit, South London and Maudsley NHS Foundation Trust
• Dr Irene Sclare: Clinical Lead, Michael Rutter Centre, South London and Maudsley NHS Foundation Trust
• Professor Peter Fonagy: Policy Lead, Anna Freud Centre and University College London
• Professor Sarah Byford: Senior Health Economist, King's College London
• Dr James Shearer: Health Economist, King's College London
• Dr Tim Weaver: Process Evaluation, Middlesex University
• Dr Stephen Lisk: Trial Manager, King's College London