July 12, 2022

expert reaction to studies investigating the effectiveness of universal school-based mindfulness training in adolescents aged 11 to 14

A series of 7 papers investigating the effectiveness of universal school-based mindfulness training to promote adolescents’ good mental health have been published as a special edition of Evidence-Based Mental Health.

This Roundup accompanied an SMC Briefing.

Prof Stella Chan, Charlie Waller Chair in Evidence-based Psychological Treatment, School of Psychology & Clinical Language Sciences, University of Reading, said:

“Young people’s mental health is one of the most urgent health challenges we are facing across local and international communities. Large scale studies like this, with such scientific rigour, are critical in identifying what works and what doesn’t. While the key finding that mindfulness training does not improve young people’s mental health is disappointing, this study has made a significant contribution by highlighting the importance of the wider school culture and teachers’ wellbeing. It is important to note that the findings do not completely rule out the potential of mindfulness-based therapy for young people; as in any therapy, it works for some people but not all. The important questions are who can benefit from it, when and how. Finding ways to improve young people’s engagement in the practice and working with young people to re-design the programme are likely to be key.  Overall, it is an impressive study.”

Professor Dame Til Wykes, Head of the School of Mental Health and Psychological Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London (IoPPN), said:

“Despite the potential for teaching mindfulness in secondary schools, this rigorous trial shows no overall benefit for the adolescents. This is disappointing as there had been some hope for an easy solution, especially for those who might develop depression. There may be lots of reasons for developing depression and these are probably not helped by mindfulness. We need more research on other potential factors that might be modified and perhaps this would provide a more targeted solution to this problem.

“The one optimistic aspect of the study was its positive effects on teachers. One might speculate that this is because the techniques were beneficial personally for the teachers or that they were pleased to have some intervention to offer their students.”

Dr Julieta Galante, NIHR Postdoctoral Fellow and Senior Research Associate, Universoty of Cambridge, said:

“This work shows the importance of large well-designed randomised trials to assess health interventions before any large-scale universal roll out. The mindfulness-based programme tested in this study had been thought to be effective based on a few small studies, and had already begun to be implemented in some schools. But we need to be very sure of benefit before rolling out any universal health intervention because the opportunity cost of implementing ineffective interventions can be high. For example, instead of investing their time in the .b programme, teachers and children can in the future invest that time in more effective programmes. New programmes need to be developed and tested using best practice, and mindfulness training may or may not be part of them. Large, well-designed trials also save taxpayers’ money in the long-term and avoid potential large-scale harm.”

“The study also shows the importance of measuring follow-up outcomes, say after a year, rather than just measuring them right after the intervention ends – when more biases can be at play and fleeting benefit could be confused with long-term benefit.”

A series of 7 papers, including 2 perspective pieces are being published as a special edition of Evidence-Based Mental Health:

‘Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial’ by Willem Kukyen et al.

DOI: 10.1136/ebmental-2021-300396

‘Effectiveness of universal school-based mindfulness training compared with normal school provision on teacher mental health and school climate: results of the MYRIAD cluster randomised controlled trial’ by Willem Kukyen et al.

DOI: 10.1136/ebmental-2022-300424 

‘School-based mindfulness training in early adolescence: what works, for whom and how in the MYRIAD trial?’ by Jesus Montero-Marin et al.

DOI: 10.1136/ebmental-2022-300439 ‘The impact of mindfulness training in early adolescence on affective executive control, and on later mental health during the COVID-19 pandemic: a randomised controlled trial’ by Daren Dunning et al.

DOI: 10.1136/ebmental-2022-300460

‘Do mindfulness-based programmes improve the cognitive skills, behaviour and mental health of children and adolescents? An updated meta-analysis of randomised controlled trials’ by Daren Dunning et al.

DOI: 10.1136/ebmental-2022-300464

(Perspective) ‘Universal prevention of depression at schools: dead end or challenging crossroad?’ By Pim Cuijpers

DOI: 10.1136/ebmental-2022-300469

‘How can we optimise learning from trials in child and adolescent mental health?’

(Perspective) by Nick Axford et al.

DOI: 10.1136/ebmental-2022-300500

They were published at 23:30 UK time on Tuesday 12th July.

Declared interests

Prof Dame Til Wykes: “No conflicts.”

Dr Julieta Galante: “No conflicts. Some of the MYRIAD team researchers are collaborating with me on other projects.”

For all other experts, no reply to our request for DOIs was received.