IMPACT Case Study: Bridging Data and Action – the OxWell Initiative's Journey into England's Youth Mental Health

NOTE: this is currently a living case study, being updated frequently as we learn more.

In a world where the mental well-being of our young people is increasingly under the spotlight, the OxWell Student Survey stands as a groundbreaking initiative with far-reaching implications.

Spearheaded by the University of Oxford's Department of Psychiatry and supported by the NIHR ARC OxTV, this large-scale repeated school survey is more than just a collection of data points of interest only to academics. It's become a dynamic tool for change, offering a comprehensive look into the lives, experiences, and needs of young people aged 9–18 across England.

The NHS and COVID-19: A Growing Focus on Youth Mental Health and a Snapshot of it During a Global Crisis

The NHS Long Term Plan set ambitious goals for expanding Child and adolescent Mental Health Services (CAMHS) the decade since its inception. While the NHS has long-term goals, the COVID-19 pandemic demanded immediate action and only heightened the urgency for such services, making the OxWell Student Survey's contributions even more timely and relevant.

The 2020 OxWell Survey revealed concerning trends[1], including that 14% of students met thresholds for clinical depression, 10% for anxiety, and 38% reported worse mental wellbeing during lockdown. It found females, those with food poverty, past mental health support, and upcoming exams were most at risk. These findings underscore the critical need for immediate and long-term mental health support for young people, especially in the context of the pandemic's ongoing impact. Subsequent surveys in 2021 and 2023 have been able to ask additional questions to respond to current concerns, such as the cost-of-living crisis and the extent of abnormal body shape and weight concerns.

Bridging Research and Real-world Impact

The OxWell Student Survey goes beyond the academic realm to touch lives directly. From influencing school policies to shaping national mental health strategies, its impact is both immediate and enduring. But what makes this project truly exceptional is its commitment to turning research into actionable insights – insights that schools, local authorities, and policymakers can use to make informed decisions that genuinely improve young lives.

This case study aims to delve into the multifaceted impact of the OxWell Student Survey, exploring how a ‘simple survey’ has bridged the gap between research and real-world change. It will examine OxWell’s role in research uptake, its effective dissemination strategies, its potential to improve practice, its influence on policy, and its additional impacts extending beyond the immediate scope of the project.

As you read on, you'll discover that the OxWell Student Survey is not just an academic exercise but a transformative force for good. However, it's crucial to note that while the project has achieved much, there is still a long road ahead. Continued support and funding are essential to fully realise the short- medium and long-term benefits that this pioneering initiative promises.

In Educational Settings

The OxWell Student Survey doesn't just collect data; it gives it back in a way that schools can use. Customised reports are provided to each participating educational setting, offering a mirror to schools about the well-being of their pupils. For example, in 2023, 180 schools participated in the survey gathering data on over 40,000 students. The schools were each sent an extended report of their results a couple of months later with data on their pupils and comparisons to the whole dataset. They were also given access to an online data portal where even more specific data from their school can be accessed. A national webinar was conducted for schools to bring the findings to their attention and these outputs were prioritised above any others- they were the first to know their data. 

These reports have led to tangible changes, such as shifts in bullying policies and enhanced support for maltreatment (serious abuses in the home environment). In 2021 alone, there were at least 10 instances where students sought help for maltreatment based on the survey's findings. There is now a plan to build a practice-based resource for schools where, based on student reports, interviews on best practice can be shared- for example the schools where results show that schools deal well with bullying will be interviewed as to their practice which can then be shared. The survey therefore provides a portal to prioritise the student voice in assessing impact.

Moreover, the data has been so impactful that it's been included in participating school OFSTED reports and discussed in school assemblies, serving as a catalyst for school-wide conversations about student well-being.

At the Local Level

The survey's reach extends beyond the school gates. Local authorities also have access to the data, which they are using for targeted interventions. For example:

• Liverpool Education Authority arranged a stakeholder meeting with over 100 students from OxWell participating schools  where the 2023 data was shared and the students were asked as to how they wanted the council to respond. This is part of a strategic engagement across multiple stakeholders in the city to promote a data-driven approach to interventions
• OxWell's data on substance misuse and mental health has directly influenced planned substance misuse interventions in Buckinghamshire .
• In Liverpool, the survey findings were compelling enough to prompt the authority to provide financial provisions for new school-based mental health innovations.
• Key regional partners in Public Health, Mental Health, and Education have been actively involved, using OxWell data to inform local health and education plans, including child mental health transformation plans in areas like Oxfordshire, Berkshire West and Liverpool.

On the National Landscape

The OxWell Student Survey has also made its mark on the national stage. Its data has been presented at high-profile forums such as the Times Education Commission and the Prime Minister’s Round Table on Child and Adolescent Mental Health.

The survey's findings have even served as evidence to the Youth Mental Health Coalition, contributing to broader conversations about the mental health of young people across the country.

Dissemination: Spreading the Word Far and Wide

The impact of any research is significantly amplified by how well its findings are disseminated. The OxWell Student Survey has excelled in this, ensuring that its insights reach the right audiences through multiple channels.

The OxWell Student Survey's dissemination strategy is a multi-pronged approach designed to reach a diverse audience. Whether it's the academic community, the media, or the general public, the project has successfully communicated its findings, thereby extending its impact far beyond the initial research setting.

Academic Publications

The intellectual rigour of the OxWell Student Survey is evidenced by its strong academic footprint. The research has been published in nine peer-reviewed papers and has already garnered over 200 citations. Five of these papers were published in 2022, indicating the project's ongoing relevance and contribution to the academic community. The data is also being used alongside important analyses of current need- for example the eating disorder data is being analysed alongside the latest National Child and Young People Mental Health Survey (2023).

Media Outreach

The OxWell Student Survey understands the power of media in informing and shaping public opinion and influencing policy. All told, OxWell has been featured on over 20 media appearances, including features in both local and national newspapers, radio, and television.

This media coverage has not only raised awareness but also sparked public conversations around the mental well-being of young people.

Digital Engagement

In today's digital age, online presence is crucial for any project aiming for broad impact. At the time of writing, the OxWell website has received 7,461 visits, serving as a comprehensive resource for anyone interested in the project. Additionally, its Twitter account has amassed 448 followers, creating a community of engaged stakeholders. The project has even ventured into podcasting, launching a dedicated  series with the Association of Child and Adolescent Mental Health (ACAMH) to delve deeper into the OxWell data (https://www.acamh.org/blog/insights-from-the-oxwell-student-survey/).

Planned by young people taking part and supporting this work, the results have also been shared by youth influencers on TikTok to generate discussion among this group and has been viewed more than 38,000 times[2]. Also Instagram!

Potential to Improve Practice: Data with a Purpose

The ultimate goal of any research is to make a tangible difference, and the OxWell Student Survey is no exception. Its findings have been instrumental in shaping practices and policies in various sectors, from mental health services to educational improvements and public health strategies, some of which have already been mentioned.

The OxWell Student Survey's data serves as a powerful tool for improvement, offering actionable insights, prioritising the student voice, that have the potential to bring about meaningful changes in practice and policy. Whether it's enhancing mental health services, improving educational settings, or informing public health initiatives, the survey's findings are actively being used to better the lives of young people.

Mental Health Support

One of the most striking revelations from the OxWell Student Survey was that fewer than 10% of students seek online or text-based help for self-harm. This finding has sparked important conversations among mental health providers, leading to a re-evaluation of how support services are offered to young people. It has prompted discussions on the need for more accessible and youth-friendly mental health services, thereby having the potential to reshape mental health provisioning.

Educational Improvements

The OxWell data is more than just numbers; it's a guide for schools to understand their strengths and weaknesses. The findings have been presented in school assemblies and have even been included in OFSTED reports. Schools have reported that the data is guiding them on areas that need targeted improvement, thereby making a tangible difference in the educational experience of students.

Public Health Initiatives

The survey's impact extends to the realm of public health as well. Two local authorities were so impressed by the data that they hired research assistants specifically to analyse it for their Transformation Board meetings in 2022-2023. This indicates the project's potential to inform and shape public health strategies, making it a valuable asset for local authorities. The 2023 survey has focused on commissioner and health and education decision-maker support in accessing the data. Over 20 meetings have been held with commissioners in the first 6 months after conducting the survey helping tailor learnings and strategies for each area and encouraging commissioners to work together to maximise responses to the findings across public health, mental health and education.

Informing Policy: Shaping the Future of Youth Well-being

The OxWell Student Survey is more than just a research project; it's a policy influencer. Its findings have been instrumental in shaping various policies, thereby ensuring that the insights gathered translate into actionable changes that benefit young people.

OxWell’s role in informing policy is a testament to the project's broader impact beyond academic circles. It serves as a valuable resource for policymakers, offering data-driven insights that have the potential to bring about meaningful policy changes at multiple levels.

Local Policy Impact

The survey's findings have had a direct influence on local policy decisions. For instance, the city of Liverpool allocated funds specifically for new school-based innovations based on OxWell's data. This demonstrates the project's capacity to drive local policy changes that have immediate and tangible benefits for communities.

National Policy Conversations

OxWell has also made significant strides on the national stage. Its data served as evidence to the Youth Mental Health Coalition and was presented at high-profile platforms such as the Times Education Commission and the Prime Minister's Round Table on Child and Adolescent Mental Health. By contributing to these national policy discussions, the survey is playing a role in shaping the broader landscape of youth mental health in the country.

 International Policy Outreach

The survey's influence isn't confined to the UK alone. Its findings on self-harm, backed by a substantial sample size, have been presented at international conferences. This international reach amplifies the project's impact and opens the door for potential global policy changes that could benefit young people worldwide.

Additional Impacts: The Ripple Effect of OxWell

The OxWell Student Survey's impact extends beyond the immediate realms of research uptake, dissemination, and policy influence. It has also made significant strides in areas that contribute to the long-term sustainability and inclusivity of the project.

Equity

The survey goes beyond mere data collection to ensure that the information gathered leads to more inclusive services. By analysing data based on gender, ethnicity, and health, the project has identified and worked to remove care barriers. Furthermore, the survey is extending its reach to Special Schools in 2023 and capturing data about migration patterns and status, thereby broadening its scope and inclusivity.

Scalability

OxWell was designed from its inception with scalability in mind; the survey format and transparent feedback could, with the right support, be easily scaled far beyond its current reach, as well as tailored for specific groups or international variations.

Additionally, online anxiety treatment and staff training modules developed based on the survey's findings have the potential for wider implementation.

Additionally, the OxWell data serves as a key dataset for the ATTUNE project, indicating its broader applicability and importance.

Sustainability

The project is not a one-off initiative but has plans for long-term impact. The next survey iteration is already planned for 2025, with the desired aim of expanding coverage to include primary schools and non-mainstream educational settings.

Research Capacity Building

The OxWell Student Survey is also a valuable resource for early career researchers. Over 10 PhD and Masters students across multiple universities are using the data for their research. Moreover, researchers from at least nine different universities are collaborating using the OxWell data, thereby fostering a vibrant academic community around the project.

Stakeholder Engagement

Active stakeholder participation has always been a cornerstone of the project. Stakeholder workshops have added questions for the 2023 survey, and over 30 meetings have been held with commissioners before the survey was even conducted. Innovations in Liverpool schools, for example, were directly based on OxWell data, highlighting the project's collaborative approach. It is also enabling schools to engage more with data- to develop their plans and strategies based on actual findings and then evaluating their strategies in subsequent surveys.

The Road Ahead: The Imperative for Continued Support and Funding

We hope you will agree that this demonstrates that the OxWell Student Survey is not just a research project; it's a transformative initiative with the potential to reshape the landscape of youth mental well-being. From influencing policies and practices to providing actionable insights for schools and local authorities, the project has already made significant strides. However, it's crucial to understand that the work is far from complete.

While the project has been fortunate to receive critical funding from the NIHR ARC OxTV for much of its work, the scope of its impact suggests that there is much more to be done and that could be done.

The survey's findings have immediate applications, but the true measure of its success will be in the long-term changes it can affect. To fully realise, measure, and understand these longer-term impacts, sustained funding and support are imperative.

Continued financial backing will not only allow the project to maintain its current initiatives but also to innovate, expand, and delve deeper into the issues affecting youth mental well-being. It will enable the project to build on its successes, explore new avenues of research, and, most importantly, continue to make a tangible difference in the lives of young people.

The OxWell Student Survey serves as a beacon of what's possible when research, policy, and practice come together for the collective good. With continued support and funding, there's no limit to the positive changes it can bring about in the realm of youth mental health and education.