The importance of school culture in supporting student mental health in secondary schools. Insights from a qualitative study

Schools have the potential to provide a place of education and sanctuary for children and young people of all backgrounds. The rise in mental health problems in children and young people in the wake of the COVID-19 pandemic, particularly in relation to growing ineq-uities, means that identifying ways in which schools can help respond to this growing mental health crisis demands urgent attention. This paper reports on case studies carried out in two London comprehensive schools, exploring how aspects of school culture impact (both positively and negatively) on student mental health. Methods comprised in-depth inter-views with school staff and parents, focus groups with students and documentary analysis of relevant materials. Fieldwork was conducted during spring 2021 as schools were returning to face-to-face learning following national periods of lockdown. Our study shows how schools might attempt to drive positive mental health outcomes through aspects of school culture and uses a system framework to explore complexities around cause and effect in this area. Key findings include the considerable differences in school mental health provision, challenges in the identification of student mental health needs and the importance of recognising how the mental health of teachers must be considered alongside that of students. Overall, we highlight particular dilemmas of the post-lockdown era that our findings indicate for the education sector, and suggest there may be value in reframing the


BACKGROUND
There has been a staggering rise, during the pandemic, of referrals for children and young people (CYP) to mental health (MH) services.Recent analysis from the Royal College of Psychiatrists shows that between April and June 2021, referrals increased by 134%compared to the same period in 2020-from 81,170 to 190,271 (Royal College of Psychiatrists, 2021).Similarly, referrals to urgent emergency crisis care showed a rise of 80% between 2020 and 2021.There have also been significant increases in the rates of probable mental disorders in CYP.In 2020, 16% of children aged 6 to 16 years were identified as having a probable mental disorder, compared with 11% in 2017 (Royal College of Psychiatrists, 2021).Such figures support concerns of a rising MH crisis in CYP (Ford et al., 2021;Viner et al., 2021).Yet the literature outlining effective in-school strategies for tackling student MH remains inconclusive (Barry et al., 2017;Caldwell et al., 2019;Durlak et al., 2011).This paper adds to existing knowledge by focusing on the importance of school culture in creating an environment in which student MH is privileged.Through the use of a systems-based approach (Rudasill et al., 2018), it reflects the complex factors which influence both the ways school culture is experienced and how this ultimately impacts on student MH.apparent conflict between 'attainment gaps' and personal development, moving towards an educational approach with greater complementarity of these aims.

Mental health provision and the 'whole school' approach
Schools provide a place of education and potentially sanctuary for CYP of all backgrounds, socio-economic groups, ethnicities and genders.The psychosocial and physical environment of a school, where a child spends a considerable proportion of their formative years, has the capacity to impact on wellbeing and MH, positively or negatively (Reiss, 2013), including through the support it provides to students around health-related behaviours.In England, schools have responsibility to decide on the nature of MH support provided for their students, although there is currently no requirement for them to report centrally on the form this provision takes (Long et al., 2018).A 2018 survey looking at school MH policies reflected different levels of provision across the country, reporting that, of 90 mainstream schools, only two primaries and two secondaries had standalone policies on MH, although 44% of secondary schools were providing some form of MH support to their students (Brown, 2018).The Green Paper 'Transforming Children's and Young People's Mental Health Provision' (Department of Health & Department for Education, 2017) sets out the ambition that MH support should be available to CYP when they need it.It lays out a range of plans, including the placement of a MH lead in every school and college, as well as multi-disciplinary MH support teams working with schools and colleges.
More attention is being paid by educationalists to the broader aspects of educational settings which are thought to impact on MH.This approach, including both the taught curriculum and work across all aspects of school life, aims to strengthen relational, social and emotional factors and is referred to as a 'whole school' approach (Weare, 2015).Evidence suggests that interventions which focus on creating positive relationships among students, and between students and teachers, and which involve students actively in these processes, have the potential to improve MH (Bonell et al., 2018b).Social and emotional capability is characterised by a range of key areas of competency, including: self-awareness and self-esteem; self-regulation; social skills, including relationship skills and communication skills; and resilience and coping (Feinstein, 2015).
In a meta-analysis of SEL programmes in 213 schools, Durlak et al. (2011) found a significant positive impact on measures relating to the building of social and emotional skills, particularly if implemented early.Research, however, suggests that SEL provision is currently not only highly variable but there are no accepted indicators of success and no clear framework for assessment (Feinstein, 2015).However, alongside evidence of positive associations linking 'whole school' initiatives to positive MH outcomes, there are apparent anomalies; analysis of data in a large UK-based cohort study concluded that, whilst associations were found between school climate and student MH, these were complex and not necessarily causal (Leurent et al., 2021).
Despite noted inconsistencies in the evidence base, socio-cultural elements of school life are increasingly understood to be important for student health and wellbeing.Such findings support work demonstrating how fundamental school, and the social/emotional environment it contains, is to healthy human functioning (Markham & Aveyard, 2003).Indeed, recent government guidance in England advocates the development of whole school approaches to supporting the MH needs of CYP-particularly those aspects which have been shown to be linked to student behaviour (Department for Education 2021).It is recommended nationally that support should focus on building resilience, confidence and wellbeing at the whole school level, as well as targeting those students with greater need.Links are drawn between the culture, ethos and environment of a school and the profound influence this can have on both pupil and staff mental wellbeing.Yet, whilst there is a considerable body of literature exploring links between school leadership and attainment (Day et al., 2008;Sammons et al., 2011), there is far less looking at links between school leadership and wellbeing (including among staff), particularly in the wake of the COVID-19 crisis.
A related, much-debated area is the relationship between attainment and wellbeing.Heller-Sahlgren (2018) proposes that high achievement may compromise wellbeing yet other commentators, drawing on both national and international data, have shown thatwhilst the relationship is complex-positive correlations between these two factors are evident (Bradley & Greene, 2013;Clarke, 2020;Suhrcke & de Paz Nieves, 2011).Clarke contends that a broader, multi-dimensional conceptualisation of wellbeing would help us move away from an unhelpful and dichotomous view which segregates academic and wellbeing outcomes into different silos (Clarke, 2020).

Defining school culture
Within these discussions, school climate and culture are considered to be beneficial constructs pertaining to positive school outcomes (Rudasill et al., 2018), both in relation to academic outputs (Bektaş et al., 2015) and student wellbeing (Bonell et al., 2018a;O'Reilly et al., 2018).Indeed, significant improvements in standardised tests have been linked to school programmes which focus on developing social and emotional learning (Durlak et al., 2011).Integral to the success of such outcomes is the adoption of aforementioned whole school approaches and the importance of interventions not being considered peripheral 'add-ons' but being genuinely shared across the whole staff body (Greenberg, 2010).
Yet, definitions of the terms 'school culture' and 'school climate' and research relating to them are inconsistent, with their composition and parameters often construed in a variety of ways, using contrasting theoretical models and informed from different academic fields.Culture and climate are often used interchangeably and tend to describe the character, values, norms, beliefs, rituals, ceremonies, symbols, stories, myths, traditions and atmosphere of the school (Karadag et al., 2014).As such, these concepts are influenced by the behaviours, actions and composition of people involved in the organisation.When the terms are differentiated, school climate is generally understood to relate to the overall learning, social and physical environment of a given organisation (Wang et al., 2020).'Culture' meanwhile relates more narrowly to a set of shared beliefs, values, meanings and assumptions (Van Houtte, 2005).Culture, in this sense, is subsumed within the broader definition of climate (Figure 1).Wang and Degol (2016) present school climate as specifically comprising four elements: academic, community, safety and institutional environment.Whilst this provides a useful basis for identifying key variables, there is a danger of such a framework masking the complexity and ever-changing social, environmental and economic backdrop of schools.Individual schools are, for instance, influenced by national and local government guidance, the demographics of their students, the socio-economic climate, and family and community networks, as well as a myriad of contextual factors such as pandemics.We suggest that greater clarity is added by Rudasill et al.'s (2018) 'Systems View of School Climate' (SVSC) perspective, which acknowledges that factors influencing climate are both multi-layered and temporal.Specifically, their SVSC attempts to unpick what they describe as a 'chaotic conceptual landscape ' (p. 41), to lay bare a number of core constructs which appear to impact school climate and thus may help predict student outcomes.In particular, they argue that environmental contexts (positioned at a range of different system levels; individual, familial, school, classroom, wider community, cultural, life events) are nested and interactive (Rudasill et al., 2018).The way in which an individual manoeuvres through and interacts with the different levels of the system creates a set of unique experiences, and it is the multiple perspectives gleaned from these which constitute school climate.As such, climate cannot be measured objectively, it is rather an aggregated set of perceptions relating to a set of core concepts.In order to get a clear view of climate, therefore, it is essential to gain the perspective of a wide range of stakeholders.

Research aims and overview
In this paper, we report on research undertaken at two case study sites in London secondary schools in the period following a national lockdown in England in 2021.Our overall research question, developed pre-pandemic, sought to understand how school culture impacts on student MH, identifying potential gaps in guidance and provision in order to better support student MH in secondary schools.However, as the implications of the pandemic in relation to student MH became more evident, we incorporated the significance of this context into our research, also interrogating the particular changes COVID-19 imposed on school culture and MH support structures.Given the significant challenges in conducting fieldwork at this time, with constant changes to COVID-19-related policies (Dunn et al., 2020), an emergent methodology was used, with researchers adopting a reflexive approach to the scope of the project.Our intention throughout was to ensure that any practical applications of our findings for policy and practice were captured; with this in mind, we included practitioners and experts from the civil service, academia and voluntary organisations, both in the scoping phase of the work to help frame the study and in an exploratory workshop where early findings were presented.Specific contextual factors inevitably mean that elements of Rudasill et al.'s (2018) SVSC framework contribute differently in each school environment and, for this reason, our findings do not attempt to artificially reflect every single component of the framework.Rather, our paper aims to identify specific school factors across the SVSC model which appeared to influence student MH and which in the current context might therefore have potential to be built on to support improved student wellbeing.Notably, whilst the study focus was on student MH, the inter-relationship between staff and student MH became increasingly evident after being raised repeatedly by participants, and these findings are therefore incorporated into the discussion.Through focusing on the links between school culture, climate and student MH, we conclude by exploring how best to support the wellbeing of whole school communities, particularly at a time of rising resource pressure and concerns over prioritising 'curriculum catch up' following extended periods of lost learning.

METHOD
Data collection followed a case study methodology as proposed by Yin (2017), which allows for an in-depth study of a complex set of processes within a real-life situation.The focus is on discerning relationships, activities and mechanisms, with a view to better understanding the issues from the perspectives of participants.Exploration of two very different London-based secondary schools within our study allowed for comparison of different processes and helped hypothesise how different features within the respective contexts might influence outcomes (Goodrick, 2014).Ethics permission for the study was granted by the London School of Hygiene and Tropical Medicine (REC 22806).
An initial scoping phase of work comprised informal interviews with stakeholders (academics, civil servants and professionals from the third sector) and an overview of current literature.The latter involved a rapid search (limited to the last 10 years) using Cochrane Database, Medline and PsychExtra, with search terms selected to explore links between school culture, MH and the COVID-19 pandemic.Supplementary Google searching was used to identify relevant grey literature and UK Government guidance to schools.The quality of the literature was not assessed.The focus of the scoping was to gather evidence and expert views relating to the ability of secondary schools to support the MH of students through their school cultures as the sector emerged from pandemic lockdowns, and to highlight facilitators and barriers relating to good practice.The scoping work was used both as the catalyst for a collaborative piece of research agenda setting (Barker et al., 2021) and to inform themes interrogated in the case studies.
Data for the two case studies were collected through in-depth interviews and focus groups, used to interrogate the perspective of a range of stakeholders: students, parents, teachers, welfare staff and school leadership.Participants were provided in advance with Project Information Sheets and signed consents were received; in the case of participants under 16 years, parental consent was sought.Topic guides explored links between school culture and MH, examining the formal and informal mechanisms which were seen to both promote and hinder good MH.Documentary analysis was also conducted of school policies, Ofsted inspection reports and other relevant documents in the public domain.
Following analysis of the school case study data (reported here), an online workshop was held on 16 November 2021, bringing together stakeholders across academia, the third sector and the civil service-many of whom were consulted during the scoping phase of work.The workshop aimed to explore and contextualise emerging themes and findings, and create a channel for ongoing dialogue between academia, policy and practice.

Recruitment
Recruitment of schools occurred in the late spring and early summer terms of 2021.This was a period when schools across England were grappling with returning to universal face-to-face teaching following winter 2021 closures when only key worker children were eligible to attend.A number of recruitment methods were used, including disseminating information about the study through local voluntary organisations and charities, contacting schools directly and accessing local informal networks.The study was also adopted by the local NIHR Clinical Research Network, which disseminated information through their own channels.As a thank you for participation, schools were offered a confidential report providing findings specific to them, as well as £1000 to cover administration time and expenses.Given the challenging context of COVID-19 and the significant upheaval the sector was facing (including nationwide lockdowns for most of the period of recruitment), whilst a large number of schools were contacted, only two responded positively to the invitation to participate.To preserve anonymity, no detailed demographic data are contained in this paper, but Table 1 provides high-level details.
Case study A was oversubscribed, with a reputation as being a strongly academic school and, among some of the parents, seen as a good alternative to private education.The school catchment was extremely diverse, covering wards in the highest and lowest income quartiles in England.Case study B was a faith school, located in a more socio-economically homogenous, deprived catchment with a significant intake of refugee and migrant children.The turnover of some of these students was rapid and the school prided themselves on the pastoral and practical support offered to young people from a variety of traumatised backgrounds.
Our objective as researchers, given the significant contextual pressures for schools relating to COVID-19, was to minimise any burden on staff.For this reason, we were pragmatic about constraints faced recruiting individuals within the case study schools-the final achieved sample is shown in Table 2.  Recruitment in each case study school was facilitated by a member of staff involved in pastoral support.Efforts were made to interview staff from a range of roles and levels of seniority, including those with a specific brief for pastoral care and safeguarding.The student focus groups reflected the gender, socio-economic and ethnic make-up of the schools, though are likely to have included a greater proportion of students with recognised MH needs than found in the overall school population.School B's student population had a greater percentage of boys than girls.

Data collection
In-depth interviews lasted between 30 min and 1 h and focus groups between 1 and 1.5 h.A total of 22 students were included across four focus groups, while interviews involved 11 members of staff and 6 parents (see Table 2).Focus groups were conducted in person on school premises, with social distancing and other COVID-19 precautionary measures in place.The majority of in-depth interviews with staff and parents were carried out virtually using Zoom, as this proved more convenient for participants.All interviews were recorded, anonymised and transcribed verbatim.

Topic guides
In-depth interviews and focus groups followed draft topic guides covering broad areas, including: perceptions of school culture; views about and experiences of MH provision; and identification and behavioural manifestations of poor MH.Topic guides were adapted for parents, staff and students, though in each case the format allowed scope to cover areas of T A B L E 2 Overview of in-depth interviews and focus groups.

Numbers Format Interviewer Gender Ethnicity
In

Analysis
Interviews were analysed following a method of reflexive thematic analysis (Braun & Clarke, 2020).Reflexive thematic analysis is a method that reflects our own belief that researchers' standpoints are central and valid components of the analytical process (our collective life experiences, particularly as parents for instance, are acknowledged as influences on our interpretation of the data).Furthermore, the method has previously been used effectively in our specific area of MH within educational contexts (Byrne, 2022).Transcribed interviews were initially coded using NVivo software management tools, and then arranged into themes using a process of both inductive and deductive interpretation (Miles et al., 2014).Analysis followed the key stages Braun and Clarke propose of familiarisation, coding, theme generating/developing/reviewing and then theme refining/defining/naming.As well as the inductive interpretation deriving from initial immersion in the data, deductive interpretation involved elements of the coding book being influenced by codes from the literature and those emerging from stakeholder discussions held during the scoping phase of the work.This code book, which was then used as a framework, was iteratively interrogated as the analysis developed and certain codes and themes grew in prominence-notably issues impacted by the pandemic such as staff welfare and curriculum catch up.Analysis was conducted primarily by the lead author and then shared and discussed iteratively with the wider team to cross-check codes and improve reliability.Quotes used are illustrative of themes rather than broadly representative.

FINDINGS
Findings are categorised by elements of the SVSC structure presented earlier and summarised in Table 3.

Relationships/fitting in
Both case study schools sought to support MH in the wake of the pandemic by promoting an ethos of respect, diversity and inclusivity-espoused through values and vision statements (found on respective websites) as well as through teaching, assemblies and other school events, some involving the wider community.
I think the school ethos is all about helping people to grow-to become a functioning individual in society.(CSA.Staff4) Students in the focus groups experienced varying levels of perceived security in their friendships, ranging from those who appeared assured and confident to others who were more insecure and marginalised.Both schools had active policies to reduce bullying and promote respectful relationships.In addition, both schools had pastoral care systems where students with anxieties about relationship issues (or anything else) could drop in for relaxed discussions.Students in both schools welcomed this informal support.However, despite attempts to foster healthy school-based relationships, underlying tensions emerged.Here a teacher reflects on how inner-city language could be tinged with an underlying aggression which became normalised: The kind of language that some of the inner-city kids have is suffused with aggression-it can be a form of bullying and intimidation.We're now adopting a whole school clampdown.(CSB.Staff2) And for some, particularly the younger students who had not yet learnt to manoeuvre their way through the 'edgier' sections of the school community, there was a sense that not everyone was welcoming: You can walk up to a person and say 'hi' and they will find a way to threaten you and bully you.(CSB.FGyr7) When discussing relationships, students often referred to the concept of trust and fairness.A student's views on a teacher's character appeared to be determined by the authenticity of their response when confided in.The type of teacher a student would consult depended both on the teacher's role and the specific nature of their relationship with them.Respondents suggested that student/teacher relationships benefitted from continuity, with bonds strengthening over time.In school A, where the turnover of staff was high, this interfered with such continuity.

Tolerance of diversity
In both ethnically diverse schools, race was not raised as a divisive issue in any focus group.Whilst this of course does not suggest an absence of any racism, there was a sense from students that, within the immediate school micro-system, racial diversity was embraced and accepted: If people are racist they would get in a lot, lot of trouble… people just accept we're all the same-doesn't matter what colour you are.(CSB.FGyr9) A focus on inclusion emerged strongly, with clear pride taken in enabling students to remain supported at school, despite a range of behavioural challenges and special needs.

Shared beliefs and values
Two distinctly identifiable cultures emerged from the case study sites.School A particularly emphasised its academic excellence.School B, whilst acknowledging the importance of academic performance, did not highlight attainment in the same way, putting more focus on emotional development and the support it offered to its hugely diverse intake.School A clearly articulated an expectation of high standards, requiring both students and staff to perform to their best.Indeed, a strong driver, supported and encouraged by many parents, was the idea that everyone, despite their background, could do well: Parents have selected this school probably because of this [the academic excellence].The school is very mixed.There are lots of immigrant parents who are very ambitious for their kids.They've come to this country and they want their kids to succeed.The school sort of fosters this pressure to do well.(CSA.Staff3) Whilst for some, particularly the high achievers, this strategy was clearly successful, other students and some staff felt that it was time for the balance to be readdressed.In school A, whilst most participants described the school as 'high-achieving', 'academic' or 'world-class', others-particularly those parents whose children had identified needs that the school struggled to meet-used the words 'over-controlling' and 'authoritarian'.It was suggested that those students who tended to be recognised and awarded were those who were excelling academically and that more effort should be made to support achievements at all levels, covering both academic and non-academic areas.Students mentioned feelings of being overwhelmed by work pressures, although they also suggested that during lockdown pressures had eased.Periods of transition, particularly from Year 6 to Year 7, were seen to be particularly difficult, with the fun and colourful aesthetics of primary school being overtaken by a more severe attention to grades and homework in secondary school.Some students just want the sense that not all interactions are transactional or with a complete academic purpose.For example, one Year 7 girl wanted butterflies on her worksheets.Seems like a little thing but she considered it was important.(CSA.Staff4) School B appeared to take a balanced approach to the tension between academic goals and personal development, with the majority of respondents mentioning the care and attention paid to holistic wellbeing.Drawing out the voice of students and fostering engagement was seen to be an integral part of the process of valuing and respecting their opinions, with a mixed year group student council meeting weekly: They really do hold the school accountable.We listen and know when they're not happy.It improves trust in processes.They understand how to make proper complaints and to explain what they mean.It's their space.We can't fix everything, but they have a voice that we listen to.(CSB.Staff2) The most recent Ofsted report from school B supported these impressions and commented on an impressive understanding and consideration of the cultural contexts of the students.Considerable effort was taken to meet the diverse needs of students, often involving helping them to access multi-agency support.The school building was used as a community hub out of school hours, with a series of community initiatives run in the holidays and a soup kitchen running weekly throughout the year.Whilst the school itself wasn't responsible for these services, there was a strong sense of integration between school and community activities which impacted on the school ethos.A standalone department in the school served the needs of around 150 young refugees who were given support to raise their level of English and maths in order to access mainstream classes.Alongside student wellbeing, academic performance was talked about as an equal priority, but it was weighed against broader wellbeing issues.

Safety and discipline
Safety and discipline are integral to most conceptual models of school climate, and the associated idea that fair, consistent rules engender trust emerged from our fieldwork: If you behave good, they will give a phone call to your parents-and if you behave bad, they punish you for that-so it's clear.They deal with it well.(CSB.FGyr9) In school B, a metal detector sat in a corner of the room where the focus groups were taking place.One student explained what it was and how in the past there had been an incident with knives.For those in the group who had not known the school had such devices, there was agreement that this was simply an important aspect of being kept safe and, as long as the use of such devices did not 'happen every week' it was accepted with equanimity.

Personally, I don't see the issue cos we don't carry knives. So if everyone has to walk through them then that's fine with me. (CSB.FGyr9)
To support safety and discipline, school B had two part-time community police officers whose role was to encourage and foster good relations between the community, school and police.Yet despite the significant effort made by school management to ensure stringent safety measures were in place, there was nonetheless a residual sense, particularly from the younger group, that 'threats' were never far away and that even the internal school environment had to be navigated with caution.
Despite evident challenges schools face in providing a consistently secure environment, some students, notably those with chaotic or disrupted home lives, still felt that school offered greater sanctuary and safety than home.For these children, trusted teachers were a source of important support:

I don't misbehave in school because I trust the school-I misbehave at home because I don't trust my parents… I owe respect to the school. I misbehave in a place where I don't feel listened to… I like school… I feel comfortable. (CSA. FGyr11&12)
Students expected teachers to be strict and follow due process if a student was misbehaving or disrespectful-yet they lost respect in instances where they felt misunderstood or not listened to.School B, which was intent that students with extreme needs and often difficult behaviour should not, if avoidable, be excluded to Pupil Referral Units (PRUs)-sometimes struggled with the fallout from such a position.At times the school found themselves trapped in a catch 22; the process of having children moved to units which were better equipped to deal with very challenging behaviours required a lot of paperwork, with the evidence needed to support the move taking time to gather and present.Yet the school was loathe to have the students expelled and sent to PRUs.For this reason, it was reported that difficult pupils remained for longer than ideal and created significant stress for other students and teachers.Students, lacking insight into the details of each case, began to question the 'fairness' of poor behaviours being tolerated.

School leadership structures
The governance structure of each school, including the way the senior team communicated and supported school staff (teaching and non-teaching) and parents, appeared to have a tangible impact on school culture.School A's leadership team were considered powerful purveyors of the school ethos and culture.Yet whilst a number of staff were identified as supporters of a 'whole school culture', the leadership was seen to be reluctant to embrace and embed ideas that were not centrally generated.Leaders in school A were portrayed as reluctant to open their doors to external scrutiny, creating-according to some-an atmosphere where individuals became guarded and wary of sharing problems.The leadership team appeared to have a particularly strong and controlling presence.
School B, in contrast, was described as being generally transparent about the challenges faced, creating a more open and trusting environment where more individuals felt able to share vulnerabilities and concerns.The background of students was put at the front and centre of school policies: Our leadership team engender this compassionate approach.Our head is clear that our kids come from such a deprived background… they are worth the best education and they deserve the best from us.If all we do is reprimand themthey won't learn from us.(CSB.Staff2)

Physical and environmental context
The two case study schools represented extreme ends of the spectrum in terms of appearance and location.In case study A huge levels of care and attention were paid to maintaining the condition of the immediate environment.Most respondents were extremely proud of their surroundings, and it was clear that the building and grounds engendered a sense of both valuing the immediate environment and feeling valued oneself.Case study B was in a modest, older building where both indoor and outdoor space was more confined and many of the facilities appeared in need of updating.Whilst students suggested that additional facilities-such as access to sports pitches-would be enjoyed, there was no strong sense that the environment impacted negatively on MH.A number of respondents did, however, comment on the position of the school in relation to the surrounding area (mentioning issues of drug dealers, gangs, alcoholics, etc. that CYP would often encounter on journeys to and from school) and the danger of the social environment becoming normalised, lowering aspirations and reducing expectations for the future.
They [the students] go down the road into XXXX and they see drug abusers and alcoholics.This is a really deprived area.There are people selling and using.They're in a culture where there are students doing 'county lines'….We can't shy away from it… so we have to give them the tools to withstand this.(CSB.Staff2) Yet the school, rather than burying their head in the sand, appeared attuned to the reality of the local environment and worked closely with community and local services to build resilience: We have a summer camp run and organised by the police.The target population are kids who are at risk of grooming or who would be on the streets during the holidays.(CSB.Staff2)

School processes for offering MH support
Both case study schools were currently deploying a broad range of support interventions for students deemed to be in need of MH or wellbeing support, including informal sessions with teaching assistants, formal counselling and resilience support.One of the case study schools (school B) offered a particularly wide range of tailored MH support, using the THRIVE Framework (Wolpert et al., 2019) to guide the delivery of their MH response-a model which facilitates a multi-agency approach to support.School staff were aware of the significant additional MH challenges emerging from the pandemic; during lockdown, specific teachers had been assigned particular students who they would call on a weekly basis to check in with.However, at the time of interviewing, due to the mounting pressures from many directions, the formal response to growing MH need was largely reactive.
For the most severe need, clear processes were followed, often built on statutory guidance in terms of safeguarding and referral to Child and Adolescent Mental Health Services (CAMHS).Whilst neither case study school had a specific MH policy, there appeared to be significant overlap between MH and safeguarding.Current levels of underfunding and system pressures meant these processes were often reported by staff (and parents) to be slow, clunky and lacking flexibility.
There were frequent concerns raised that student MH could not be optimally supported since staff MH was itself not given equal status.This was despite growing pressures on staff from pandemic-related factors (e.g., impacts from lockdowns, changes in examination/ marking systems, pressure about attainment gaps) and financial challenges from cuts in external resources.The majority of participants interviewed suggested that staff support, in both schools, fell far short of the efforts made for students: We've been absolutely hardly supported at all… We need to recognise that we can't just keep pushing ourselves through-no matter where you work-be it in education or elsewhere.(CSB.Staff2) In school A, a high turnover of teachers was alluded to by several staff and parents, who suggested various factors they thought could be responsible for this, including pressures teachers were under to sustain strong academic performance, high London costs and the young age profile of staff.
A number of teachers also raised concerns that certain manifestations of MH might be easier to identify than others.A gendered difference was noted, with girls being directed to formal MH support systems whilst boys, whose MH issues were more likely to present as poor behaviour, appeared at greater risk of slipping through the net: Boys seem much less likely to do things like self-harm.In secondary schoolthere's so much posturing-my worry would be that they just don't talk about it.Linked to the challenge of identifying MH issues, there was a reported value (mentioned by all stakeholders) in adopting universal screening which could identify 'lower level' MH problems, with the potential to offer support at an earlier stage.

Pandemic lockdowns
Participants across both schools reported increased pressure post-lockdown to catch up with missed periods of learning, though most were clear that curriculum catch up would be a 'long-player' rather than something that could be instantly achieved.The leadership teams in both schools were reportedly supportive of an approach which did not place too much additional pressure or stress on staff and students: … they [the students] don't need this added pressure.It's not their fault.We were banned from saying they were behind.Instead, we talk positively about working together.(CSB.Staff2) Despite its focus on MH and wellbeing, it was in fact personal, social, health and economic education (PSHE) that had been particularly badly hit by the disruption of the pandemic.The teaching of PSHE was usually carried out in form time (before subject-based lessons) or on scheduled 'dropdown days' when specialists were invited in to talk.However, the tendency to see PSHE as an 'add-on' meant that it was more readily put on hold than subjects which were examined.
For staff, the pandemic had created further stresses and challenges in relation to reviewing the needs and teaching requirements of their students.Cancellations of exams had, in the short-term, created more work in relation to teacher assessment.During lockdown, staff had adapted to teaching on Google Classroom, with many form tutors taking specific responsibility for following up the wellbeing of their individual students.Yet staff recognised that teaching at a distance had often been to the detriment of knowing about and supporting student wellbeing: One of the biggest impacts of the pandemic… is that we definitely haven't had as much time to explicitly look out for pastoral needs.Of course, there were things we did online but it was quite different… We used to telephone all the students in our form group. It's just not the same as face to face….(CSA.Staff5) A number of staff also noted that student discipline and attention had suffered from the disruption of routine: A lot of students have spent more time on the streets-they don't have great family circumstances, so when they come back they find it harder to switch out of roles.Most are happy to be back.But for some it's been hard to return.(CSB.

Staff2)
In students' own eyes, experiences of COVID-19 lockdowns were highly differentiated; the majority of respondents experienced them as largely positive, benefitting from less social Well I'm not naturally very social so I didn't mind lockdown… Now I feel like really awkward when I speak to people and I want to be on my own.But lockdown wasn't like that-I was ok.(CSA.FGyr7&8) However, a minority, largely those experiencing problems prior to lockdown, reported significantly heightened trauma and MH issues: Being home-for several months-with strict parents who don't let me go outwell it honestly was the worst thing that you could have done to me.It's just been downhill.(CSA.FGyr11&12) Once back at school following the various periods of lockdown, CYP complained of new procedures that interfered with normal freedoms, including one-way systems and bubbles.In addition, processes for managing students had become more regimented, particularly around the monitoring of latecomers: Yeah, they actually bought a machine-to actually let the teachers know that you're late.There's an entire department in the school that just worry about if you're late or not! (CSB.FGyr7) Meanwhile, parents suffered not only from the general uncertainty of the new lockdown structures but, for those whose children had started in Year 7 during the course of the pandemic, there was also the sense that-without any prior knowledge of the school-it was hard to discern what was normal.In school A, parents reported how hard it had been during the pandemic to access anyone in the school if they had concerns about their child, and whilst they understood the huge pressures the school was under, they nonetheless found the lack of access personally frustrating.

Social media
Social media emerged as a recurrent factor related to MH, which had developed new resonance in the context of the pandemic.It was sometimes linked by respondents to episodes of feeling excluded-potentially exacerbating the impact of lockdowns-and perpetuating fantasies of unobtainable and elusive friendship groups.There were noticeable gender differences too in discussions of social media.Girls recounted incidents of blatantly sexually explicit material which made them feel uncomfortable and devalued.However, there was also some concern that boys have to navigate a highly complex and sexually nuanced world in which they may sometimes unwittingly be seen as the 'villains': Boys too [face difficulties] in building a positive and healthy masculine identity when social media bombards them with porn and images of women which may be atypical.Our young people lack the experience to know-it's up to us to guide and provide role models.(CSA.Staff6) Yet there was also acknowledgement that not having social media, particularly during the lockdowns, made access to peers harder.Young people, notably those higher up the school, articulated both harms and benefits of social media, often demonstrating a highly thoughtful approach to this area: I don't have any social media at the moment because I've deleted all mine.It just wasn't making me happy… I weighed up the pros and cons and realised that the cons outweighed the pros.Now I don't have it I feel good.(CSA.FGyr11&12) Social media was furthermore described as being pervasive throughout the home, community and school.Parents and teachers agreed that the school's approach and policy around the use of telephones in school was important and generally the policy of zero tolerance, whilst not necessarily supported by children, was strongly advocated.In school A, an incident was reported where inappropriate images of a student had been circulated and students approved of the swift action that had been taken to tackle the resulting fallout: I think that people, particularly those in the lower school, didn't realise that sending photos like that is actually a crime… it was dealt with quickly-I think on that occasion they probably got the police involved.(CSA.FGyr11&12) Figure 2 summarises the research findings presented above, by system level.

DISCUSSION
This paper has identified specific school factors across the SVSC model which appear to influence student MH and which, in the current context, might therefore have potential to be built on to support improved student MH.Our findings endorse previous research which has shown how a complex mix of factors relating to school culture and climate, together with wider contextual issues, all appear to play a role in influencing how MH and wellbeing are responded to and supported by a school.Importantly, they suggest that, if trust in the school culture is to be maintained across the whole school community, there needs to be consistency between what the school publicly proclaims and everyday practice-and that the ability to achieve this appears largely influenced by leadership style.Other key findings include the insight provided into the disparate range of MH provision made available within schools, as well as the clear challenges schools face both in identifying and responding to MH need.The tension between academic achievement and student wellbeing appears to have been heightened during COVID-19 and is an area which undoubtedly demands further research.Finally, amidst these post-pandemic challenges of lost learning and student MH concerns, the importance of attending to the wellbeing of staff, and links between student and staff MH, must not be overlooked.
Across our fieldwork, an open and trusting culture, where there was alignment between what schools purport to do and what happens in practice, was widely acknowledged as important.Though our study also indicated that, in order to genuinely achieve a 'whole school approach', mental wellbeing needs to be threaded through the fibre of school life and more focus on the teaching of social and emotional skills (such as through the THRIVE Framework; Wolpert et al., 2019) may improve students' abilities to tackle academic challenges.In particular, a school's climate is likely to be strongly influenced by the style and strength of its leadership, which differed greatly between our case study sites.We suggest that this may be an area deserving of further larger-scale research.
Similarly, MH provision clearly varies significantly between schools, particularly in relation to 'lower' levels of need which are not covered by statutory requirements.Our results suggest that the type of wellbeing provision within a school may, in part, be dependent on the individual motivation of committed teachers.Case study B, for instance, was an example of a school where a very wide range of provision was in place, much of it apparently enabled thanks to the head of safeguarding's personal motivation, strong partnership working and ability to call in 'favours' from external parties.A challenge for schools thus appears to be to find a way to provide consistent, evidence-based provision across the board, from within a constrained resource base.Yet the fact that so many different forms of intervention are used across the sector nationally means that data offering clear evidence of efficacy can be hard to find.
A 2017 Green Paper (Department of Health & Department for Education, 2017) set out an ambition, now being enacted, to strengthen MH provision in schools, with plans to have a designated MH lead in every school by 2025.The education and health sectors will no doubt be keenly interested to see how this, and the subsequent pledge of £8 million in response to concerns about the impact of lockdowns on students, will affect MH outcomes in CYP.A valid concern may be that, in the huge raft of possible options schools have to support CYP wellbeing, too much is left to chance.Care is therefore needed to ensure that uncertainties around the availability of motivated and skilled teachers do not risk further exacerbating existing inequalities in this area.Also pertinent is the fact that a large number of staff and parents in our study mentioned how financial constraints and pressures on the wider health and social care system impacted on the ability of schools to respond to individuals in need.
Also of note was the clear emphasis that one of the schools in our study put on academic achievement and the impact this appeared to have in determining school culture.In case study A, a strong focus on individual attainment, compounded by pressures to maintain a long-standing 'outstanding' Ofsted rating and top grades in league tables, appeared sometimes to be to the detriment of maintaining an open supportive school culture where personal development (for both staff and students) could be valued.Case study B, in contrast, supported an extremely diverse student intake-with considerable levels of social, educational and psychological need-yet achieved a balance whereby care for CYP's development was not diminished by the urgency of addressing the COVID-19 'attainment gap'.The extraordinary pressures that schools are under are clear.Yet in the light of data suggesting that the MH of the most vulnerable CYP is likely to be worst affected by the pandemic (Ford et al., 2021), it seems crucial that policy and regulation provide schools with greater scope to attend to the personal and social development of their students.Whilst academic excellence appears an essential part of the value system that shapes climate for many secondary school staff (Hoy & Hannum, 1997), this research suggests that an over-emphasis on academic achievement per se can be to the detriment of other parts of a school's system.
This study therefore adds to previous work exploring correlations between academic achievement and wellbeing, which has often found contradictory results.We align with Brooks in concluding that promoting both physical and MH in schools could create a virtuous circle, reinforcing both attainment and achievement whilst improving wellbeing and allowing children to flourish (Brooks, 2014).Notably, it has previously been shown how acquiring effective social and emotional competencies, as well as a sense of engagement and belonging to a school, are associated not only with improved health and wellbeing but better achievement (Brooks, 2014;Cemalcilar, 2010).More research, focused on exploring this apparent complementarity of academic output and pastoral care, would help guide national organisations in this area, and lend support to the already cautiously shifting direction of policy.In 2019, for instance, some of the core standards inspected by Ofsted (2019) were revised to place more emphasis on the way a school supports social and personal development and wellbeing.We suggest that there is potential to explore the use of such regulatory levers still further.For instance, how to share and promote good practice, whilst allowing for flexibility in response to different local contexts, remains an important question for national debate.
Linked to this, our staff participants frequently raised the scope for greater MH-related data.Whilst schools hold multiple datasets relating to student academic attainment, information relating to the MH and wellbeing of students is rarely routinely collected.Respondents in our study repeatedly raised concerns that this may result in high levels of need, including those exacerbated by the pandemic, remaining overlooked, with MH issues not being picked up early enough when proactive and timely help could still be offered.Our results furthermore suggest that certain manifestations of MH challenges may be easier to identify than others.There appeared to be a gendered differentiation in our schools, for instance, with girls-who may be better able to articulate their anxieties-more often being directed to formal MH support systems, whilst boys-whose MH issues may be more likely to be interpreted as poor behaviour-are potentially more likely to 'slip through the net'.Calls for universal mental wellbeing screening for both students and staff are growing (Anna Freud Centre, 2021a) and it may be that implementing such a system would go some way towards tackling this apparent inequity in access.Identifying and promoting appropriate tools and techniques to facilitate regular measurement of MH in schools could certainly be a key aid in both acknowledging the scale of the problem and successfully monitoring the effectiveness of the response.Evidence in this area is in fact already emerging from a collaborative project led by the Anna Freud Centre (2021b), which is providing insight into effective ways of measuring student wellbeing, while a range of resources are available to support schools in collecting more robust data.Yet, if meaningful, consistent and robust universal data are to be gathered, thus allowing for the extent of the problem to be understood and progress to be properly monitored, continued resources would be needed to provide schools with the necessary means to undertake this.
Finally, a number of participants in our study cited instances where poor MH in staff resulted both in reported episodes of absence and increased turnover of teachers.The health services literature certainly suggests that, as pressure on staff increases, they are in turn less able to provide empathy and support to those they care for (Berwick, 2013).It is therefore plausible that this finding is likely to be mirrored in education, where a stressed and unsupported workforce are less likely to be in a position to attend to the MH of the CYP they  (CooperGibson Research, 2019) examined evidence around staff wellbeing in schools, highlighting the stigma staff experience in coming forward to ask for help (which was also witnessed in our case studies), as well as challenges in identifying effective ways of recognising and supporting MH issues in staff.The report stresses how behavioural issues and poor school culture can particularly impact on staff, a dynamic which will no doubt have been further exacerbated by the contextual pressures caused by the pandemic.Recent research has also begun to explore links between teacher and pupil MH; whilst still exploratory, this suggests that stress in teachers has a knock-on detrimental effect on students (Glazzard & Rose, 2019;Harding et al., 2019).
Currently, much of the literature on wellbeing in education focuses on CYP rather than staff, and where there is a focus on staff this is usually simply to highlight means to help them support students (CooperGibson Research, 2019).Attempting to remedy this, the Anna Freud Centre's Mentally Healthy Schools Campaign (Anna Freud Centre, 2021b), based on a Five-Step Framework, incorporates 'supporting staff' as one of the key planks in whole school support.Included in the framework are a number of specific recommendations: to conduct a confidential annual staff wellbeing survey, to provide appropriate MH training and to promote open conversations and clear signposting to support.We would recommend further policy focus is given nationally to supporting schools in adopting important, evidence-based campaigns such as this.

STRENGTHS AND LIMITATIONS
The case study methodology employed in this research, and the particular context of school pressures following lockdown (as well as social distancing restrictions), meant that sample sizes were kept small to reduce the burden of the study on school staff.This inevitably limits to some extent the transferability of our findings (Etz & Arroyo, 2015).However, this type of research is suited to a critical realist perspective such as ours, which acknowledges the importance of context and accepts the multiple complexities of the real world (Yin, 2017).Such methods also allow for in-depth examinations of complex areas in real-life settings.Given the highly temporal and contextual nature of school culture, climate and young people's MH, particularly during a pandemic, we therefore believe that there is value in smaller-scale research such as this which can illuminate key parts of a broader picture.A further limitation is the likelihood, given the MH and pastoral care responsibilities of the teachers responsible for recruiting at our case study sites, that our study had an over-representation of students who had been in contact with support and MH services.Similarly, the parents interviewed were those whose children tended to have had contact with school MH services.Going forward studies should seek to incorporate a wider range of participants with more varied MH experiences and levels of service uptake.

A C K N O W L E D G E M E N T S
We would like to express our grateful thanks to all participants in the case study schools who took part in this study.

F
U N D I N G I N F O R M AT I O N This paper was compiled as part of a study undertaken within the National Institute for Health Research (NIHR) School for Public Health Research (SPHR)-funded Public Mental Health Programme (Grant Ref. SPHR-PROG-PMH-WP6.1&6.2).The NIHR SPHR is a partnership between the universities of Sheffield, Bristol, Cambridge, Imperial and University College London, the London School for Hygiene and Tropical Medicine (LSHTM), LiLaC-a 14693518, 2023, 3, Downloaded from https://bera-journals.onlinelibrary.wiley.com/doi/10.1002/berj.3853 by Test, Wiley Online Library on [28/06/2023].See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions)on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License Comparative demographic data for case study sites.a T A B L E 1a Data taken for 2020/2021 from www.compare-school-performance.service.gov.uk.b Figures rounded to preserve anonymity.
Summary of themes and sub-themes.