Active Ingredients: Universal Schools Project

Schools are increasingly recognised as a key setting for mental health support, but the evidence on which features of the school environment actually make a difference for LGBTQ+ students, and why, remains limited. The Active Ingredients project investigates what modifiable aspects of school environments universal mental health interventions should target, and how and why LGBTQ+ mental health varies between schools. It is built on a prior phase of research that engaged LGBTQ+ young people to understand what kinds of support they valued and why.

What should universal approaches actually target?

Background

Earlier advisory work with LGBTQ+ young people through McPin Foundation produced three headline findings that shaped the Active Ingredients project's design. First, LGBTQ+ young people are more likely to experience negative mental health outcomes than their cisgender and heterosexual peers, and interventions to address this should begin in early adolescence. Second, inclusive school environments, those that accept and actively promote diverse sexual and gender identities, would reduce depression and anxiety. Third, young people expressed a strong preference for universal interventions, precisely because these do not single students out or require young people to disclose identities they may not be ready to share.

Active Ingredients designs a mixed-methods programme to investigate the mechanisms to understand the school-level factors that matter most, then tests whether they explain the variation in LGBTQ+ mental health outcomes between schools.

Publications

The preparatory phase of the research produced two published outputs. A rapid realist review published in Nature Human Behaviour (2023) examined universal interventions to promote inclusivity and acceptance of diverse sexual and gender identities in schools, identifying five intervention themes, student pride clubs, inclusive antibullying policies, inclusive curricula, workshops, and staff training, and explaining how each can work to reduce discrimination, marginalisation, and poor mental health. A companion paper in the International Journal of Environmental Research and Public Health Understanding How School-Based Interventions Can Tackle LGBTQ+ Youth Mental Health Inequality: A Realist Approach, developed the programme theory explaining when and for whom these interventions are effective. Both papers draw directly on the qualitative evidence review and young people's input that formed the foundation for the Active Ingredients study.

My Involvement

My involvement spans approximately two meetings over the course of a year, with additional tasks between meetings. Within sessions, this includes discussing approaches to recruitment and interview design for the qualitative study, considering the ethics of how data is collected and used, and reviewing preliminary findings as they emerge. Between sessions, it includes co-producing recruitment materials, contributing to qualitative research papers as a co-author (including sensitivity and accessibility reviews of language), and helping create dissemination materials for schools; infographics, press releases, and blog posts.