Demand currently greatly outweighs supply in teenage mental health, with statutory services and the third sector struggling to cope with the number of referrals. There is increasing interest in the possibility of using schools to provide mental health interventions. This pilot study looked at the feasibility of developing a version of an existing evidence-based transdiagnostic large-class didactic approach widely used in NHS adult services – ‘Stress Control’ – for use with teenagers as a universal early intervention/prevention approach taught by teachers within the Personal and Social Education (PSE) curriculum in a high school in a highly deprived area. PSE teachers were trained, over five hours, to deliver each of the eight sessions in single weekly periods. Measures of anxiety and depression (RCADS) and wellbeing (WEMBWS) were administered at pre- and post-intervention and at 9-month follow-up. Results suggest that teachers reported few problems in delivering the approach, seen as relevant by pupils and showed significant reduction in anxiety and depression and significant gains in wellbeing at post-intervention. These gains were maintained at 9-month follow-up. There appears to be potential in this model. One of its strengths appears to be the positive collaboration between the psychologist, teachers and pupils, which resulted in changes being made to the original model. Limitations of the study and suggestions for future research are given.

Depression is a highly common condition (World Health Organisation, 2022). Although many people demonstrate recovery there are marked levels of relapse. Mindfulness-based cognitive therapy (MBCT) is effective in preventing relapse. To date, the majority of studies do not primarily focus on the cost-effectiveness of MBCT within health care utilisation and workplace absenteeism. This study aims to explore the effectiveness of MBCT for prevention of depression relapse in patients attending a UK NHS primary care service. An observational (pre–post and follow-up) study of patients (n=23) who experienced at least three depressive episodes were provided with MBCT. Cost-effectiveness was assessed using self-report measures of service utilisation and employment absence. These were assessed before MBCT, following, and 6 months post. Secondary outcomes assessing clinical effectiveness included measures of depression (PHQ-9), anxiety (GAD-7), and functional impairment (WSAS). There was a significant reduction in absenteeism at work and in health care usage and expenditure at the end of treatment. These improvements were continued during the follow-up period. Secondary outcomes indicated clinical improvements on depression, anxiety and functioning were maintained to follow-up.

Key learning aims

1. (1) MBCT is a potentially cost-effective intervention in reducing absenteeism and health care usage for clients with recurrent depression.

2. (2) In line with previous observations, MBCT is a clinically effective intervention for relapse prevention in recurrent depression as recommended by the National Institute for Health and Care Excellence (NICE).

3. (3) Clinicians can consider the use of MBCT for clients with mild depression and recurrent depression within their services as recommended by NICE.