歐盟學校心理健康促進

• 學校推動心理健康促進的背景

學校是提升學生情感和社交能力及培養整體心理健康的理想場所(Barry, Clarke, Jenkins et al., 2013)。兒童和青少年的生活幾乎有一半的時間是在學校渡過的，他們在學校的經歷和人際關係也會對他們的健康產生重大影響，影響行為和學業成績(Langford et al., 2014)。教職員工也很容易注意到年輕人的變化，並能針對心理健康或行為有關的問題及早介入 (Barry et al., 2013 ; Fazel et al., 2014)。全校心理健康促進介入是提高所有兒童及青少年的心理健康的機會，並預防或減少因其生活環境而處於高風險的兒童和青少年之情緒和行為困難(Barry, Clarke & Dowling, 2017; Weare & Nind, 2011)。
 

• 學校心理健康促進的好處
  • 增強學生的幸福感、目標感、聯繫感和意義(Adi, Schrader McMillan, Killoran, et al., 2007)。
  • 提高學業成績、參與度以及學習與他人相處(Durlak, Weissberg, Dymnicki et al., 2011)。
  • 改善教職員工福利，減少壓力、疾病和缺勤，提高教師效能和表現(Jennings & Greenberg, 2009)。
  • 減少憂鬱、焦慮和壓力等心理健康問題(Clarke Sorgenfrei, Mulcahyet al., 2021; Durlack, et al., 2011; Shucksmith, Summerbell, Jones, et al., 2007)。
  • 增強社交、情感技能和態度，促進在學校的學習成果、成就感、幸福感和心理健康(Durlak et al., 2011)。
  • 改善學校行為，包括減少低級別的干擾他人、事件、打架、霸凌和缺席(Adi et al., 2007)。
  • 減少危險行為，例如：衝動、無法控制的憤怒、暴力、霸凌、犯罪、酗酒和吸毒(Catalano, Berglund, Ryan et al., 2002; Zins, Weissberg, Wang et al., 2004)。
  • 減少性暴力和性騷擾(Clarke et al., 2021)。

• 成功的全校心理健康促進活動特徵
• 課程與教學法

成功的校本策略能對課程和教學法進行調整。大部分的方法強調社交和情感能力的教學，例如情緒調適、同理心、換位思考技巧和正念（mindfulness）。這些技能可以幫助兒童和青少年應對成長的挑戰，並賦予一系列社會、情緒和學術方面的益處(Durlak et al., 2011; Zins, et al., 2004)。此外，教師的社會和情緒調適能力，關係到其減輕壓力和倦怠的能力、效能的提高、以及更利他的課堂環境(Jennings & Greenberg, 2009)。

這些技能和能力通常是在社會情緒學習（Social and Emotional Learning，SEL）或社會情緒層面學習（Social and Emotional Aspects of Learning，SEAL）的框架下形成的。這些技能也可以被視為行動能力，從而使它們與HPS（Health Promotion School）框架保持一致。School for Health in Europe（SHE）將行動能力定義為計劃、發起、實施和評估，旨在使現實生活更加健康與幸福。對於學生，這包含在課堂或社區層面改善集體或個人的健康和幸福的任何行動。在美國出現的變革性社會和情感學習(Jagers, Rivas-Drake & Williams, 2019)以社會正義和公民身份為基礎，考慮到對學生賦權、集體行動和對潛在社會决定因素理解的承諾，可能會進一步與行動能力的概念保持一致。

關於學生的發言權和賦權，有證據表明，學生需要感受到他們在學校和課堂（包括教學和學習方法）的日常決策中具有影響力，只有當學生真正的被諮詢且所有學生都真正有參與，並特別確保邊緣化學生的聲音被聽到的情況下，學生才算擁有真正的發言權（Weare，2015）。證據還指出了主動和體驗式學習方法以及將學習融入學校生活的重要性（Weare，2015）。此外，社會和情感能力的學習必須符合學生當前的社會心理發展歷程。

心理健康素養 (MHL，Mental health literacy) 是指有關精神障礙的知識和信念，可以減少恥辱感並鼓勵尋求幫助的行為 (Campos, Dias, Duarte, et al., 2018)。然而，有人擔心 MHL 會過度強調基於缺陷的「精神疾患」和「適應不良」的概念。專家建議轉向「批判性MHL」，其中的考量包含文化整體性以及個人與其社會和背景環境之間的互動。批判性 MHL 的概念似乎與其他專家所支持的「批判性健康素養」互相呼應，後者以訊息評估、理解社會決定因素和集體行動賦權為中心。
 

• 學校風氣

學校風氣和價值觀是指學校和課堂的核心價值觀、態度、信念和文化。這種氛圍滲透到學校和課堂生活的方方面面(Weare, 2015)。被接納、尊重和有歸屬感的學校環境的氛圍和風氣已被證明是學校幸福感和心理健康的關鍵決定因素之一(Greenberg, Domitrovich & Bambarger, 2001; Millings, Buck, Montgomery et al, 2012)。

具體而言，培養支持性的文化和環境包括對學校生活的許多日常調整，如確保安全和溫馨的物理環境，確保從一種活動平穩過渡到另一種活動，培養一種溫暖感和反應能力，提供多種通過核心課程和課外活動獲得成功和認可的機會，以及塑造適當的情感表達、尊重的溝通和解決問題的模式(Jennings & Greenberg, 2009; O’Reilly, et al., 2018; Roeser & Eccles, 2014).

熟悉且可預測的學校和課堂常規有助於建立安全感，及讓每個人都感覺到被傾聽、被理解和被賦予權力的環境(Weare, 2015)。
 

• 關係

在學校形成的人際關係的品質是心理健康促進的基礎。成功的學校從多個層面培養正向的關係，包括能心領神會的、支持的師生關係、正向的同儕關係，以及與家長、家庭和社區的合作夥伴關係，包括當地的身心健康轉介服務及支持機構。

大量文獻強調，師生關係早在學齡前就影響社會情感和認知發展，並在整個兒童和青少年時期繼續影響學生的社會和學習能力。有證據顯示師生關係品質較好（以相互尊重、積極傾聽、溫暖與和諧為特徵）的學生更有可能有更高水平的精神投入、學業成就和課堂參與，以及更少的行為問題、停學和輟學(Barile, Donohue, Anthony, et al., 2012; Fredriksen & Rhodes, 2004; Lan & Lanthier, 2003)。

與同儕建立正向關係的孩子，與沒有這種友誼的兒童相比，往往會體驗到更高水準的幸福感，對自我有更正向的信念，並更多的從事利他行為和參與社交互動。重要的是，學校工作人員必須了解學生同儕的社交生態（即社會動態以及學生彼此互動、影響和社交的方式）並建立相互尊重和富有同情心的關係(Farmer, McAuliffe Lines & Hamm, 2011)。此外，通過適當的培訓和支持，兒童和青少年可以成為促進心理健康的積極參與者，而不是被動的接受者。學生可以成為有效的同儕教育者，教授社交和情感技能，參與結伴活動並解決衝突(Rones & Hoagwood, 2000; Weare, 2015)。學生的投入和參與，通過培養真正的自我價值感和參與感來支持倡議的可持續性(Adi et al., 2007)。

與父母家庭和社區的關係是學校心理健康促進的重要組成部分。學校在鼓勵家庭參與以促進心理健康和幸福方面發揮重要的角色。然而，與家庭合作是一個敏感的領域，尤其是在學生遇到困難的情況下。重要的是，學校採用「優勢為本介入模式」(Strengths Based Model)，承認每個家庭的不同經歷、智慧和信念，並且父母和照顧者不會因為孩子的困難而感到屈尊、污名化和指責（Weare，2015）。應該讓父母感受到他們的意見、願望和感受得到了考慮；他們應該充分被告知會影響他們孩子的決定，並在他們的角色中感受到被支持的感覺（Weare，2015）。

由於個別兒童和青少年在不同時間可能有不同的需求，最好通過提供持續的支持來實現學校的心理健康促進。除了針對同年齡的所有兒童和年輕人提供的普遍支持外，那些面臨更大風險和需求的人可能需要更具體和更有目標性的支持(Weare & Nind, 2011; Werner-Seidler, Perry, Calear, Newby & Christensen, 2017)。學校為有更高心理健康需求的兒童和青少年提供明確的轉診途徑也很重要。發展衛生和教育部門之間的夥伴關係可以對處於最困難情況下的兒童採取一致性的全面應對措施來提供他們支持 (O’Reilly et al., 2018; Weist & Murray, 2007)。這對於融合教育（Inclusive Education）系統的實施尤為重要。
 

• 政策與程序

在學校成功促進心理健康需要學校政策、系統和組織支持，包括優先支持教師幸福感和員工專業發展。對心理健康和幸福感尤為關鍵的是學校政策與實踐，將人的多樣性和行為納入考量，並對能力、殘疾、性別、種族、性取向和社經地位偏見的挑戰。反霸凌和反恐同的政策和實踐通常需要加強並與網路安全政策相互聯繫(Weare, 2015)。

學校還需要為教師提供高品質的持續專業發展(CPD，Continuing Professional Development)。這對於成功培養教師在向學生提供和維持心理健康促進方面的理解、能力和信心至關重要，也是對心理健康和幸福尤為關鍵的學校政策(O’Reilly, et al., 2018)。
 

• 全校心理健康促進的障礙和促進因素

現存文獻強調了積極變革的許多障礙和促進因素；下面將討論這些內容，並在下面的圖表中總結。
 

1. 顯然，在學校促進心理健康方面，教師是我們最大的資產。他們是學校改革的主要驅動力，重要的是將他們納入與學校改革有關的決策中（Rowling，2009）。教師的壓力和倦怠程度高，與同事、學生和家庭關係不佳，工作強度大是促進心理健康的重大障礙(Jennings & Greenberg, 2009)，更好的教師幸福感與更好的學生幸福感和較低的學生心理困難有關 (Harding, Morris Gunnell, et al., 2019)。因此，優先考慮教師的幸福感與關注學生的心理健康同樣重要（Rowling，2009）。人們擔心教師會覺得他們在自己的能力範圍之外工作，教師需要在促進和教授心理健康方面感到自在和自信。在這方面，教師培訓和持續專業發展方面的不足是文獻中提到的一個挑戰。
2. 花時間分享想法和集思廣益是必要的(O’Reilly et al, 2018)。此外，一些專家也建議向教師提供專業的、反思性的指導（類似於向其他一線專業人員提供的指導）（Lawrence，2020）。這將使教師能夠與信任的同事分享他們工作中遇到的一些痛苦經歷，以便當他們從事越來越複雜和要求越來越高的角色時，可以在情感上和實踐上得到支持(O’Toole & Simovska, in press, a )。
3. 強有力、積極主動的領導對於心理健康促進計劃的成功至關重要。校長在領導和支持改革方面非常重要，但分佈式領導（distributed leadership）對於大規模教育改革也必不可少。學校健康促進中有效領導的特徵包括明智的決策；有效的人力資源管理；道德目的；理解變化過程；關係和能力建設；團隊合作和多專業工作；促進連貫性和「聯合思考」（Fullan，2005；Reynolds & Teddlie，2001；Rowling，2009；Weare & Markham，2005；Paulus & Hundeloh，2020）提名一位積極主動、熱情的「心理健康冠軍」也被認為是必不可少的。這是一個作為學校健康促進方面訓練有素的教師可以在實施介入措施、影響其他教職員工方面發揮戰略領導作用，並且沒有太多競爭優先權 (Dix, Slee & Lawson, 2012; O’Reilly, et al., 2018)。

學校採用全面的多層次、全校性心理健康促進，需要分配大量資源，包括投資於高品質的專業發展、給予教師休假時間和開發課程資源。重要的是，政府必須為基於學校的心理健康促進計劃提供充足的資源，否則這些計劃的價值將無法實現，且將失去新興的知識、能力和實踐(Slee, Dix & Askell-Williams, 2011; Shediac-Rizkallah & Bone, 1998; Patalay, Giese, Stankovic et al, 2016; Pluye et al, 2004)。在衛生和教育部門之間建立夥伴關係也需要適當的多部門支持和資金支持(Bond et al., 2004)。
 

4. 在實施和可持續性方面，現有文獻強調實現正向的改變是一項長期承諾。以學校為基礎的多層次健康促進從根本上說是很複雜的，成功需要資助者、政府部門、社區的承諾，並了解此類介入措施不是短期的、速效的解決方案(Bond et al., 2004; Dowling & Rowling, 2020)。獲取適當的資訊或數據以及使用這些數據來指導優先事項和策略的能力，是這項工作的重要組成部分。學校需要持續的培訓和支持，以獲取和使用數據來為他們的決策提供信息，還需要注意學校文化和環境，以確保任何計劃或介入措施都適合社區的實際需求，並考慮學校環境的特殊性並將其用作槓桿。
5. 心理健康促進與學校的其他需求相競爭，尤其是學業成績的壓力。現在的教育系統通常並不平衡，過度強調考試、學歷和學術成就，而不夠關注學生的幸福感(National Children’s Bureau; 2017; O’Toole & Simovska in press, b)。政府需要做出立法承諾，以支持學校優先考慮高品質的心理健康促進活動並為其提供資源。

Background and Context
Schools are an ideal setting for promoting children’s emotional and social competencies and fostering an overall sense of psychological wellbeing (Barry, Clarke, Jenkins et al., 2013). Children and young people spend almost half their waking lives at school and the experiences and relationships they have at school can have a substantial impact on their wellbeing, influencing both behaviour and academic performance (Langford et al., 2014). School staff are also well placed to notice changes in young people and to intervene early in relation to mental health or behavioural concerns (Barry et al., 2013; Fazel et al., 2014). Whole school mental health promotion provides real opportunities to enhance a range of outcomes for all children and young people, as well as prevent or reduce emotional and behavioural difficulties in children and young people who are placed at high risk by virtue of their life circumstances (Barry, Clarke & Dowling, 2017; Weare & Nind, 2011).

The benefits of school mental health promotion
A number of well documented high-quality reviews of school-based mental health promotion initiatives have been conducted. Taken together, the evidence demonstrates that well designed and carefully implemented whole school programmes have strong positive impacts on a range of outcomes, at least in the short term; these include:
● Enhanced student wellbeing, sense of purpose, connectedness and meaning (Adi, Schrader McMillan, Killoran, et al., 2007).
● Improved academic learning, engagement, and sense of connectedness with learning and with school (Durlak, Weissberg, Dymnicki et al., 2011)
● Improved staff well-being, reduced stress, sickness and absenteeism, improved teacher efficacy and performance (Jennings & Greenberg, 2009).
● Reduced mental health issues such as depression, anxiety and stress (Clarke Sorgenfrei, Mulcahyet al., 2021; Durlack, et al., 2011; Shucksmith, Summerbell, Jones, et al., 2007).
● Enhanced social and emotional skills and attitudes that promote learning, success, wellbeing and mental health, in school and throughout life (Durlak et al., 2011)
● Improved school behaviour, including reductions in low-level disruption, incidents, fights, bullying, exclusions and absence (Adi et al., 2007)
● Reduced risky behaviours such as impulsiveness, uncontrolled anger, violence, bullying and crime, alcohol and drug use (Catalano, Berglund, Ryan et al., 2002; Zins, Weissberg, Wang et al., 2004).
● Reduced sexual violence and harassment (Clarke et al., 2021).
 

• Characteristics of successful whole-school mental health promotion initiatives

Curriculum and Pedagogy
Successful school-based initiatives make considered adjustments to curriculum and pedagogy. Most approaches emphasise explicit teaching of social and emotional competencies such as emotional regulation, empathy, perspective taking skills, and mindfulness. These skills help children and young people navigate the challenges of growing up and confer a range of social, emotional and academic benefits (Durlak et al., 2011; Zins, et al., 2004). Furthermore, teachers’ social and emotional competence is linked to reductions in stress and burnout, enhanced teacher effectiveness, and more
prosocial classroom environments (Jennings & Greenberg, 2009).
These skills and competencies are often framed under the umbrella of Social and Emotional Learning (SEL; see www.casel.org) or Social and Emotional Aspects of Learning (SEAL especially in the United Kingdom). Nielsen and colleagues (2014) point out these skills can also be considered as action competencies, thus aligning them with the HPS framework. SHE defines an action competence as the ability to plan, initiate, deliver and evaluate actions aimed at improving health and wellbeing in “real life” (www.schoolsforhealth.org/resources/glossary/action-competencies-and-individual-health-skills).
For children in school this could involve any action at classroom or community level aimed at improving collective or personal health and wellbeing. The emergence of transformative social and emotional learning (Jagers, Rivas-Drake & Williams, 2019) in the United States, which is anchored in social justice and citizenship, may offer further coherence with the notion of action competence given the commitment to student empowerment, collective action and appreciation of underlying social determinants.

In relation to student voice and empowerment, evidence suggests that students need to feel they have influence in everyday school and classroom decision making, including teaching and learning approaches. Student voice is about genuine consultation and the authentic involvement of all students, with particular attention to ensuring that marginalised students have their voices heard (Weare, 2015).
Evidence also points to the importance of interactive and experiential learning approaches and of integrating learning into the mainstream processes of school life (Weare, 2015). Furthermore, social and emotional competencies must be sequenced in the sense that the activities need to be coordinated and developmentally appropriate (Durlak et al., 2011; O’Reilly, Svirydzenka, Adams et al., 2018).
Mental health literacy (MHL), which refers to knowledge and beliefs about mental disorders, reducing stigma and encouraging help-seeking behaviour, has also been targeted in some literature (Campos, Dias, Duarte, et al., 2018). However, there is concern that MHL can reinforce deficit-based notions of mental disorder’ and ‘maladaption’. Mansfield, Patalay & Humphrey (2020) recommend a shift to ‘critical MHL’ which involves the integration of culturally sensitive models and acknowledgment of the interaction between individuals and their social and contextual circumstances. The concept of critical MHL would seem to echo a similar shift in toward critical health literacy espoused by Chinn (2011) and others, which centres on information appraisal, understanding social determinants, and empowerment for collective action.

School climate, culture and ethos
School climate and ethos refer to the core values, attitudes, beliefs and culture of the school and classroom. It is a tone which permeates every aspect of school and classroom life (Weare, 2015). A climate and ethos which supports a feeling of being accepted, respected, and bonded to the school environment has been shown to be one of the key determinants of wellbeing and mental health in schools (Greenberg, Domitrovich & Bambarger, 2001; Millings, Buck, Montgomery et al, 2012).
At a concrete level, efforts to foster a supportive culture and ethos includes many everyday adjustments to school life, including ensuring a safe and welcoming physical environment, ensuring smooth transitions from one type of activity to another, fostering a sense of warmth and responsiveness, offering multiple opportunities for success and recognition through core curriculum and extra-curricular activities, and modelling appropriate expressions of emotion, respectful communication and problem solving (Jennings & Greenberg, 2009; O’Reilly, et al., 2018; Roeser & Eccles, 2014). Familiar and predictable school and class routines help build a sense of security and environments where everyone feels listened to, understood and empowered (Weare, 2015).

Relationships
The quality of interpersonal relationships formed in schools is fundamental to mental health promotion. Successful schools foster positive relationships at multiple levels including, attuned and supportive student-teacher relationships, positive peer relationships, and collaborative partnerships with parents, families and communities, including local referral services and supports. A robust body of literature highlights that teacher–student relationships influence socio-emotional and cognitive development as early as preschool and continue to influence students’ social and intellectual capacities throughout childhood and adolescence. Students who reported better quality teacher-student relationships, characterised by mutual respect, active listening, warmth and attunement, are more likely to have higher levels of psychological engagement, academic achievement and school attendance and reduced levels of disruptive behaviors, suspension, and dropout (Barile, Donohue, Anthony, et al., 2012; Fredriksen & Rhodes, 2004; Lan & Lanthier, 2003)
Children who enjoy positive relationships with peers tend to experience higher levels of emotional wellbeing, more positive beliefs about the self, and engage in prosocial forms of behaviour and social interaction, than do children without such friendships. It is important that school staff have an understanding of the peer ecology (i.e., the social dynamics and ways children interact with, influence, and socialise with one another) and model respectful and compassionate relationships (Farmer, McAuliffe Lines & Hamm, 2011). Furthermore, with appropriate training and support, children and young people can become active players in mental health promotion rather than passive recipients.
Students can be effective peer educators in teaching social and emotional skills, participating in buddying initiatives and conflict resolution (Rones & Hoagwood, 2000; Weare, 2015). The involvement and participation of students supports sustainability of initiatives by developing a real sense of ownership and engagement (Adi et al., 2007).
Relationships with parents’ families and community are a vital part of school-based mental health promotion. The school has an important role in encouraging family participation in ways that boost mental health and wellbeing. Partnering with families is a sensitive area, however, particularly where students are in difficulty. It is important that schools adopt a strengths-based approach, acknowledging the diverse experiences, resourcefulness and aspirations of families, and that parents and carers do not feel patronised, stigmatised and blamed for their children’s difficulties (Weare, 2015). Parents should feel that their views, wishes and feelings are taken into account; they should be kept fully informed of decisions affecting their child and feel supported in their role (Weare, 2015).
Mental health promotion in schools is best achieved through the provision of a continuum of support in recognition that individual children and young people can have different needs at different times.
Those at greater risk and with greater needs may require more specific and targeted support, in addition to the universal support provided to all children and young people in their age-related classbased groups (Weare & Nind, 2011; Werner-Seidler, Perry, Calear, Newby & Christensen, 2017). It is also important for schools to have clear referral pathways for children and young people who have a higher level of mental health needs. Developing partnerships between health and educational sectors could support a co-ordinated and wrap-around response to children in the most difficult circumstances (O’Reilly et al., 2018; Weist & Murray, 2007). This is especially important in working towards inclusive educational systems.

Policies and Procedures
Successful mental health promotion in school requires systemic and organisational support in terms of school policies, procedures, including the prioritisation of support for teacher wellbeing and staff professional development. Particularly key to mental health and wellbeing are the school’s policies and practice around behaviour, diversity, and the challenging of prejudice around ability, disability, gender, race, sexual orientation and perceived social status. Anti-bullying and homophobia policies and practice generally need to be strengthened and linked with cyber safety policies (Weare, 2015). Schools also need to make provision for high quality continuing professional development (CPD) for teachers. This is central to successfully develop teachers’ understanding, competence and confidence in delivering and sustaining mental health promotion with their pupils (O’Reilly, et al., 2018).
 

• Barriers and facilitators of whole school mental health promotion

The extant literature highlights many barriers and facilitators for positive change; these are discussed next and summarised in Figure 3.
Evidently, when it comes to mental health promotion in schools, teachers are our greatest asset. They are the main drivers for change in their schools and it is important that they are included in decision making relating to school change (Rowling, 2009). High levels of teacher stress and burnout, poor relationships with colleagues, students and families, and work intensification are significant barriers to mental health promotion (Jennings & Greenberg, 2009). Better teacher wellbeing is associated with better student wellbeing and with lower student psychological difficulties (Harding, Morris Gunnell, et al., 2019). Thus, prioritising teacher wellbeing is just as important as a focus on mental health for
students (Rowling, 2009). There is concern that teachers feel they are working outside their area of competence, and they will need to be comfortable and confident in promoting and teaching for mental health. Gaps in teacher training and continuing professional development in this respect are a noted challenge in the literature (Bond et al, 2004; O’Reilly, et al., 2018).
There is also a need for time to be devoted for sharing ideas and brainstorming (O’Reilly et al, 2018). In addition, some authors have recommended professional, reflective supervision be made available to teachers (similar to that offered to other frontline professionals (Lawrence, 2020). This would allow teachers to share some of the distressing encounters their job entails with a trusted colleague so they can be emotionally and practically supported as they engage in increasingly complex and demanding roles (O’Toole & Simovska, in press, a )
Strong, proactive leadership is essential to the success of mental health promotion initiatives. The school principal is often critical in leading and supporting change, but distributed leadership is also essential for large scale educational reform. Characteristics of effective leadership in school health promotion include sound decision making; effective human resource management; a moral purpose; understanding change processes; relationship and capacity building; teamwork and multi-professional work; promoting coherence and “joined up thinking” (Fullan, 2005; Reynolds & Teddlie, 2001; Rowling,
2009; Weare & Markham, 2005; Paulus & Hundeloh, 2020). The nominating of a proactive and enthusiastic ‘mental health champion’ is also considered essential. This is someone who - as a trained teacher in school health promotion - can act as a strategic lead in implementing interventions, influence other staff, and not have too many competing priorities (Dix, Slee & Lawson, 2012; O’Reilly, et al.,
2018).

The adoption of a complex multilevel, whole school approach to mental health promotion in schools requires allocation of substantial resources including, investing in high quality professional development, paying for teacher release time, and developing curriculum resources. It is important that governments
adequately resource school-based mental health promotion initiatives, otherwise the demonstrated value of these initiatives will not be realised, and emerging knowledge, capabilities and practices will be lost (Slee, Dix & Askell-Williams, 2011; Shediac-Rizkallah & Bone, 1998; Patalay, Giese, Stankovic et al, 2016; Pluye et al, 2004). Building partnerships between health and education sectors requires appropriate multi-sectoral support and funding (Bond et al., 2004).
In terms of implementation and sustainability, existing literature emphasises that achieving positive change is a long-term commitment. Multilevel school-based health promotion is fundamentally complex, and success requires commitment by funders, government departments, communities, and an understanding that such interventions are not short term, quick fix solutions (Bond et al., 2004; Dowling & Barry, 2020). Access to appropriate information or local data and the capacity to use these data to guide priorities and strategies is an important component of this work. Schools require continued training and support in accessing and using data to inform their decision making (Bond et al, 2004)
Attention also needs to be paid to the school culture and context, to ensure that any the programme or intervention components are fitted to the actual needs of the community, and that the specificities of the school context are taken into account and used as levers.
Mental health promotion competes with other demands on schools, particularly the pressures for academic outcomes. Currently, education systems are typically unbalanced with over-emphasis on exams, qualifications and academic attainment, and not enough focus on the wellbeing of students (National Children’s Bureau; 2017; O’Toole & Simovska in press, b). A legislative commitment by governments is needed to support schools in prioritising and resourcing high quality mental health promotion.
 

節錄自
Schools for Health in Europe〈Mental health promotion in Schools〉State of the art(2021/8/15)
https://www.schoolsforhealth.org/newsroom/mon-23082021-1424-new-she-factsheet-mental-health-promotion-schools