Feasibility of a secondary school-based mental health intervention: Reprezents’ On The Level

Natalie Louise Bisal, Jilly Gibson Miller, Christine Cox, Shane Carey, Liat Levita

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Aims: There is a need for innovative school-based mental health interventions to promote good mental health, healthy coping strategies, and engagement with support services. Consequently, Reprezent, a youth development organization, with mental health professionals and young people co-developed an online mental health intervention show, On The Level (OTL). This study assessed the acceptability and feasibility of delivering OTL to young people (aged 11–18 years) in 36 secondary schools across London and Essex, UK.
Methods: OTL was delivered online as part of the school curriculum, in classrooms at timepoint 1 (T1, 50 min). Follow-up data was collected at timepoint 2 (T2) 4–6 weeks later, during a 20-min OTL review show. For interactive OTL elements and data collection participants logged into an online survey. Measures of acceptability and engagement, mental health and well-being outcomes and intervention evaluation were taken at T1 and T2. We also assessed
the feasibility of implementing the OTL intervention in secondary schools.
Results: 10,315 participants received the intervention (T1) and 3369 attended the follow-up session (T2), this high attrition, and potential selection bias, was due to only 30% of schools being able to take part in T2. Rates of acceptability were high among young people and school staff. At T1, 88% found OTL engaging, and 84% felt more confident they had the tools to help them better manage stress and anxiety. At T2, 66% viewed mental health in a more positive
way, and 71% had better understanding of how to maintain good mental health. Rates of engagement with mental health tools and services were good, and significant reduction in levels of stress were found 4–6 weeks after the OTL
show (T2). The low mental health and well-being indices reported by the school children at baseline strongly support the need and use for a mental health intervention such as OTL in secondary schools.
Conclusion: These findings indicated good feasibility and acceptability of OTL intervention and support the delivery of the OTL mental health intervention at UK-based secondary schools to educate young people about mental health
and well-being and give them the necessary tools to support their mental health.
Original languageEnglish
Article number98
Number of pages17
JournalChild and Adolescent Psychiatry and Mental Health
Publication statusPublished - 9 Dec 2022
Externally publishedYes

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This work was supported by the TRIUMPH Network (http://triumph.sphsu.gla.ac.uk) which is funded by the Cross-Disciplinary Mental Health Network Plus initiative supported by UKRI under grant ES/S004351/1; Essex Clinical Commissioning Groups for schools; North East Essex Clinical Commissioning Group for colleges grant pilot (Colchester); The Charities Aid Foundation.


  • Adolescents
  • Secondary schools
  • Interactive digital mental health intervention
  • Cognitive behavioural framework
  • Feasibility


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