Aim: To explore how 6 female students would engage with a group-based mental health intervention in an alternative education setting, and whether such an intervention would be effective at alleviating trauma and depressive symptoms, and improve psychosocial functioning. Participants: 6 female students aged 15 years old took part in the intervention. Four staff members participated in qualitative interviews and 29 members of staff completed feedback surveys. Method: A mental health programme was delivered to two groups, each with 3 students. The programme involved ten sessions delivered over a 5-weelc period. Participants' trauma symptoms, depressive symptoms, and psychosocial functioning were measured pre- and post-intervention. Participants also took part in semi-structured interviews to gain insight into their experience of the programme. Two staff members were interviewed prior to the intervention to determine whether the intervention would be appropriate while two other staff members were interviewed on completion of the programme to determine whether staff had noticed any changes in the girls during the course of the intervention. Results: All participants showed positive changes in a number of symptoms on completion of the programme. However, changes were variable and some negative changes were also observed. All participants reported to enjoy the programme and find it helpful. Staff reports towards the programme were very positive. Conclusions: As a first step towards working with disengaged students excluded from mainstream education, this study illustrates the usefulness of group-based, school-based mental health programmes for students with social and emotional difficulties.

This work focuses on the provision and improvement of food in secondary schools. The study evaluates the effect of a whole school intervention based upon the implementation of school nutrition action groups in two secondary schools in South Wales. The study explores the impact of the intervention on food sales, pupil food choices, knowledge and attitude. Foods provided during the school day can make significant contribution to meeting the dietary requirements of children and adolescents (Crawley, 2005c) and it is estimated that the midday school meal may account for at least 33% of daily energy intake (Crawley, 2005b). This chapter sets the backdrop and context to this work and describes the provision of school meals in UK and westernised countries. As well as considering a contemporary perspective, the chapter describes the historical development of school meals service in UK in order to understand the barriers and motivators to the movement for change in school meal provision. The chapter explores the role of government priority and investment and describes the development of national food strategies, particularly Appetite for Life in Wales. These strategies, implemented via food and nutrient based standards, aim to positively impact on school meals and adolescent health.

Peer support approaches, where pupils offer formal support to others, are used in schools as an additional source of pastoral care. Previous research shows benefits for whole school environments, pupils who receive support, and pupil peer supporters, but is largely limited to Western case studies, which are often short-term and/or limited to qualitative data. This thesis addresses these issues through cross-national work on peer support use, and longitudinal case studies. Peer support use in Japan was investigated through a qualitative study. A range of approaches was seen and major themes identified, including the evolution of Japanese peer support, conflicts in approaches, and an emphasis upon community. A qualitative study in South Korea explored peer support and other anti-bullying initiatives, both proactive and reactive. Thematic analysis showed the importance of collectivist values, and a gap between policy and practice. Peer support was little used and, despite positive attitudes, barriers were perceived. A comparison of the UK, Japan and South Korea considered the impact of cultural values, education systems and the nature of bullying upon peer support use. Two mixed methodology case studies of peer listening schemes in UK secondary schools were conducted, one over 18 months and another over six months. Both schemes had the general aim of providing additional pupil support, without focus on particular outcomes. Impact upon the domains typically benefited by peer support was evaluated; findings were broadly similar. Pupil awareness of the service was high, but in-depth knowledge was weaker and use was low. Attitudes were mixed, impact upon bullying and school climate was limited, but users and peer supporters perceived benefits. Both schemes evolved to include multiple approaches, and practical factors affecting development and effectiveness were identified. Finally, implications for peer support practice are drawn from the findings as a whole, and future research directions suggested.

The current research used a grounded theory approach (Charmaz, 2006) to explore the ways in which a small group of teachers working in mainstream schools constructed the term ‘mental health’ and how they responded to young people who may be experiencing ‘mental health’ problems. The findings indicated that four conceptual categories emerged from the data. One of the conceptual categories indicated that the teachers had two constructs of mental health, with one construct suggesting teachers felt mental health language was limiting for young people. Conversely, it was also found that mental health language could have a motivating effect on the teachers in being able to know how to respond to young people with mental health problems. In addition, it was found that the teachers lacked confidence in sharing ownership of the term ‘mental health’. The research findings also highlighted two further conceptual categories with regards to the teachers’ responses to young people with mental health problems. The teachers were active in engaging in a collective responsibility with their teaching colleagues when responding to mental health problems. The teachers also used their interpersonal and intrapersonal skills to develop relationships with young people in the hope that this will help them to regulate and contain their emotions.

The role definition of school counsellors has always presented a variety of difficulties. This is especially true when changes occur because of local counselling movements or educational reforms which are closely linked to the contextualized socio-economic or political agenda. This is well documented in the literature. This study is an attempt to make a critical enquiry into the ways in which school counsellors describe and experience their role working in the Singapore secondary school system. It is essentially exploratory and qualitative in nature. The aim of this study is to explore the internal landscape, their feelings and thoughts; their perceptions about their roles and work, and to examine the factors that contribute to their role descriptions and experience. The unique environmental factors that shaped and define their role and experience will be explored. In-depth face to face interviews were carried out with the eleven participants involved in this study, two sessions for each participant. An adapted grounded theory methodology was used to guide the data collection and data analysis process. The findings show that the role experienced by the 11 counsellors was less restricted to role-base and operates on a flexible role description regime. Most counsellors described their role as being defined by pupils' profiles, and by the counselling approach they used. These interviews revealed that role and job scope were ill defined, there was a mis-match of expectations held by the counsellors and within the overall educational climate, and some uncontrollable factors from the wider environment were found. The emergent over-arching theme of dilemmas was identified and factors that enable and inhibit the role of the counsellors as described by the participants were also highlighted. As a result of this study, an ecosystemic approach is proposed.

Physical contact is an inevitable aspect of physical education, yet the discomfort which this engenders in a risk averse climate makes tactile interaction between adult and child distinctly problematic. This thesis will analyse the contemporary challenges and practical tensions that surround the act of touch between physical education (PE) teachers and their pupils, attempting to understand the influence of a culture of accusation on professional identity. Utilising semi-structured interviewing with a range of PE staff, the findings have been analytically reinterpreted to form a fictional narrative, representing empirical discussion in a way that cultivates an evocative interrogation of adult/child discomfort. The use of two differing methodological approaches deliberately exploits parallels which may not be immediately apparent. The combination of ‘conventional’ empirical method with ‘alternative’ techniques allows us to redefine the traditional alongside a procedurally sound investigation, taking advantage of the interplay between what is both said and unsaid. Benefitting from the theory of Michel Foucault, Ulrich Beck, Zygmunt Bauman and Anthony Giddens, the project engenders a collaborative conceptual outlook alongside a formative rationalisation of the contemporary educational landscape. Using this work has enabled an analysis of disciplined conditioning amongst PE teachers, the risk practice and fear which has contemporarily emerged, and the role of reflexivity within this. Given that current trends have prioritised suspicion, thereby undermining notions of practical freedom, it is important to explore the ways in which staff have alternatively reacted to this, since ‘traditional’ modes of interaction are gradually eradicated. Through the combination of appropriate social theory with an expressive methodological approach, it has become possible to attend to the current climate with an exploitation of discursive social formation. The study has ultimately recognised the potential for a disruption of fear based discourse thorough an alternative treatment of marginalisation, in ways both productively suggestive and previously underexplored.

This thesis explores the links between gender relations and violence against girls in and around schools in Mozambique. A participatory approach to research was used to explore young girls’ and boys’ experiences of gender violence in homes, schools and streets. This involved interviews, focus group discussions and observation with a range of institutional actors: parents, family members, teachers, ‘sugar daddies’ and young people. The study is framed as an ethnographic case study and investigates how gender and power relations are constructed through experience, interaction with others and through what girls and boys observe and acquire in different sites of learning including school, church, family and community, and the media. Drawing on the theoretical concepts of agency, power relations and subjectivities within gender and social analysis (Butler, 1990; Foucault, 1978; 1982; McNay, 2000; 2003), I explore how gender as a cultural construct is acquired by participants in structured and unstructured learning contexts. The concept of ‘situated learning’ (Lave and Wenger, 1991) is drawn upon to examine the validity of formal, non-formal and informal processes of learning through which young people learn about gender relations and sexuality in this community in Mozambique. Conceptualisation of learning as a continuum from informal to formal suggests that learning is a lifelong activity shaped by people, context and culture, and that knowledge which involves local knowledge and contextual practice experience, is acquired through ‘communities of practice’ (Lave and Wenger, 1991). In terms of the role of the school, the thesis shows how school shapes gender relations through unequal teacher-student power relations, everyday practices and structures that can result in violent acts. The thesis also explores how initiation rites involving young people in groups and individually not only contribute to conveying gender stereotypes but also provide insights into the ways in which such traditions are being mediated and transformed. Drawing young people’s voices into the debate, the thesis describes how girls and boys rely on unstructured, informal means of learning through the media and everyday life experience. It suggests that young people absorb knowledge and construct gender identities through different learning processes that might implicitly and/or explicitly lead to gender violence.

Children who are mentally healthy have the ability to develop empathy and self-awareness. They can manage their feelings, are motivated, and have good social skills. Research suggests that the school is an important location for the promotion of mental health in children. However, very little is known about how teachers in Ireland feel about taking on the role of mental health promotion. Methodology: A mixed methods approach was adopted to examine this issue within one county in the west of Ireland. Questionnaires were distributed to all of the primary schools in the county. These were then analysed using SPSS. Based on these findings, four teachers were interviewed to gain a fuller understanding of some of the issues raised. The interviews were analysed using thematic analysis. Findings: The findings suggest that, for the most part, teachers agree that mental health promotion is a part of their role. They are more likely to feel this way if they also feel that they are capable of promoting mental health, if their school has a supportive ethos, and if they believe that mental health promotion is important. In general, teachers felt that they had not received enough training in mental health promotion. As such, this was a source of some stress and can have an impact on the teachers' own well-being. These results are discussed in relation to previous research and government policy, in addition to the possible implications at a local and national level and to EP practice.

This thesis describes research designed to quantify and describe the impact of improved access to school water, sanitation, and hygiene (WASH) access on pupils' helminth infection and diarrhoeal disease and absence from school. The research was undertaken as part of a five-year cluster-randomized trial in 185 public primary schools in Nyanza Province, Kenya that addressed school WASH impacts, knowledge diffusion, sustainability, and advocacy. One hundred eighty-five schools were randomly selected and assigned to five study arms to receive various water treatment, hygiene promotion, sanitation, and water supply improvements. All pupils at enrolled schools were dewormed at baseline and at two follow-up time pOints. A total of 11,458 pupils were interviewed over two years to compare rates of school absence, rates and intensity of reinfection with soil transmitted helminths, and risk of diarrhoeal disease. We found no overall impact of our school-based WASH intervention on pupil absence. However, a domain analysis revealed a substantial and significant reduction in absence for girls attending schools that received WASH improvements. Schools that received a hygiene promotion and water treatment (HP&WT) intervention showed statistically similar reductions to those that received HP&WT in addition to sanitation improvements. Gender-specific effects were also found for reduced reinfection of soiltransmitted helminth infection. Girls showed a significant decline in prevalence and intensity of infection with Ascaris lumbricoides, while boys showed reduced reinfection for Hookworm. Household WASH characteristics significantly modified the effect of the school-based intervention, revealing potential questions about exposure to fecal pathogens at home and at school. Schools that received HP&WT and those that received HP&WT plus sanitation improvements showed no reduction in diarrhoeal disease prevalence. However, schools allocated to the water "scarce" research group, which received water supply improvements in addition to HP&WT and sanitation, did show significant and substantial reductions in both prevalence and duration of diarrhoeal illness. While household-level WASH has been investigated extensively, this is the first comprehensive study to investigate the impact of improved WASH at schools. Overall, our results reveal the important role that school WASH can play in mitigating disease burden and lowering pupil absence. Additional research is necessary to fully explore these issues.

It has recently been suggested that as many as one in five adolescents have a mental health problem that will persist into adulthood, with the most common being anxiety (Lee, Heimer, Giedd, Lein, Sestan, Weinberger, Casey, 2014). Young people suffering poor mental health problems face a number of risks such as suicide, chronic illness, school failure and relationship difficulties (Thompson, Hooper, Laver-Bradbury, Gale, 2012). Research estimates that up to seventy five percent of all mental illness has already developed by the age of eighteen (Murphy and Fonagy, 2012), yet only a portion of these individuals actually seek help during the phase of adolescence, reducing the opportunity for early intervention. Recent research has aimed to explore what may be preventing help-seeking during difficult times (e.g. Kendal, Callery, Keeley, 2011a). Studies have shown that women seem to be particularly at risk of developing mental health issues with rates of anxiety and depression amongst teenage girls having risen over recent years, whilst remaining relatively stable for adolescent boys (DfE, 2016). In this qualitative study, I employed visual methods to provide three 15 year old female participants with the opportunity to creatively explore their journeys of having had a mental health issue. After creating collages, time-lines and storyboards to map significant periods and events, I employed a narrative approach for conducting semi-structured individual interviews to reflect on their story-boards and talk about their experiences. These interviews were then analysed to look for individual and common themes. I was particularly interested in barriers or supportive factors to seeking and receiving help. It was hoped that information from this study may elicit the voice of young people to add to professional understanding of how adolescent girls experience having a mental health issue and ultimately what may or may not help, both in preventing and directly addressing difficulties.