Wellbeing Investments in Schools and Employers (WISE) study

The WISE project will provide a comprehensive understanding of the processes by which schools and workplaces invest in mental health and wellbeing promotion. This is urgently needed, as these organisations, though not traditionally designed for this function, are increasingly required to support individuals’ mental health across the life-course. To date, economics has contributed valuable information on the cost-effectiveness of specific interventions. However, this only goes part of the way to informing how resources could be best allocated. A better understanding of processes, needs, and values, within these organisations is required to establish how they can be best supported and connect evidence to practice. 

The WISE programme of work seeks to establish how schools and workplaces invest resources in mental wellbeing. This includes how money, time, and space are allocated to wellbeing interventions, staffing, culture, and infrastructure. The study will generate models of decision-making processes, establish how schools and workplaces can be best supported to make equitable and efficient decisions, and develop new research methods for studying investment decisions in organisations.

The project aims to establish:

1. Causal processes involved in allocating resources to mental wellbeing in schools and workplaces;

2. How decision-makers in schools and workplaces use evidence in allocating resources;

3. The diversity of viewpoints on investing in mental wellbeing in schools and workplaces.

We are using a range of qualitative and mixed-methods to investigate these issues.

There are four work packages in the WISE project.

SCHOOLS: In this work package we will conduct in-depth case studies with schools to investigate how they invest in mental wellbeing. We will apply ‘process-tracing’ (a method primarily used in political science) to understand the sequence of events and who is involved, synthesise diverse sources of data, and ‘get inside the black box’ of decision-making.

WORKPLACES: In this work package, we will study decision-making in large workplaces.  As with SCHOOLS we will be using process tracing methods to investigate how workplaces invest in mental wellbeing, with the aim of understanding how they can be best supported in their resource allocation decisions.

EVIDENCE: In this work package we will study how schools and workplaces use evidence, particularly economic evidence, in allocating resources for mental wellbeing promotion. The emphasis will be on understanding both current uses of evidence and future needs for evidence. We will also be using cognitive interviews to study how ‘decision-makers’ respond to different sources of evidence.

PERSPECTIVES: This work package will focus on the different viewpoints individuals (including workers, policy-makers, and the public) hold about mental wellbeing investment in schools and workplaces.  We will identify and analyse these perspectives using qualitative research and Q-methodology.

October 2023: This spring and summer have shown some exciting developments for the WISE study with fieldwork continuing in schools and the first workplaces case study being recruited with initial interviews taking place. 

Rebecca Johnson has been working with a set of primary and secondary schools to develop a process theory to help explain school investment decisions. Rebecca will be finalising this theory and then moving to working with school case studies to test this theory.  This will particularly focus on engaging with schools with characteristics which are different from the theory building group.

Luke Henstock (PhD student) has been conducting interviews with the first workplace case study to understand how large workplaces invest in wellbeing for their employees.  Over the next few months Luke will also be developing a process theory and looking to recruit follow-on case studies.   

Camille Allard has been working alongside the schools and workplaces work packages and conducting exploratory interviews to build a framework to explain evidence use for resource allocation within these settings.  Camille is now moving on to the design of think-aloud tasks to explore evidence use in priority setting with school decision makers.   

Yusuf Ozdemir (PhD student) has been building a ‘concourse’ of viewpoints about investing in mental health in schools and workplaces.  The ethics approval has now been received, and the Q-sort task is ready to be piloted over the coming months.

The WISE project team have also been involved in early activities to disseminate the research.  Further information can be found in the ‘Dissemination and Impact’ section of our website. 

March 2023: We are pleased to say that we now have ethics approval for the WISE study fieldwork with workplaces.

In the coming months we will work with our first case study workplace to understand how large workplaces invest in mental wellbeing and the role of evidence in these decisions.

If you are a large workplace that is either currently investing in staff mental health and wellbeing, or thinking of doing so, and interested in participating in our research, please contact Camille Allard.

We have also been working with a set of schools over the last year, to understand how and why they allocate resources to mental health and wellbeing. The findings from this work is being used to develop a process theory to explain school investment decisions and a framework for thinking about how different forms of evidence are used or not used by schools.

Finally we are starting to build a ‘concourse’ of viewpoints about investing in mental health in schools and workplaces. This will be refined and tested over the coming months.

These emerging findings will be presented and written up over the next year and will also inform the 2nd phase of the WISE project – testing and refining the theories in different school and workplace contexts, exploring decision-makers’ values and how they make use of evidence, and ultimately identifying how organisations (schools and workplaces) can be best supported in allocating resources to mental health and wellbeing.

April 2022: We are pleased to say that we now have ethics approval for the WISE study fieldwork in schools. In the coming months we will work with schools to understand more about their processes for investing in mental wellbeing. Currently, we are at the stage of sampling schools and identifying potential case study sites in the West Midlands.

Alongside this we have started to conduct focused reviews of the literature to inform each of the four work packages. The reviews will identify what we can learn about:

1. How process tracing methods have been applied in the health field;
2. How different sources of evidence are used by schools and workplaces to guide their health investments;
3. How workplaces allocate resources to mental wellbeing services;
4. Individuals’ attitudes to mental health investment in schools and workplaces;

The findings from these reviews will provide important insights in their own rights, as well as helping to inform the design and interpretation of the fieldwork.

We continue to work closely with our collaborators on the project, meeting every six weeks to steer progress, as well as providing insight into our review work

If you work in a school in the West Midlands and are interested in participating in the WISE study, please contact Rebecca Johnson.

November 2021: The WISE study team has been steadily growing over the summer and autumn and, with the recent addition of PhD students Luke and Yusuf, we are now at full strength. Over these first six months, we are focusing on laying the groundwork for the project. This will include:

• Reviewing the literature in this new field, including that on process tracing, organisational theory and mental wellbeing support in schools and workplaces
• Understanding the policy and practice context for this work
• Developing study research plans
• Developing research and professional networks
• Training in health economics

We are looking forward to our first external advisory group meeting in mid-November and starting to identify our case study sites.

• Information sheet for schools [PDF, 192kb]

• Information sheet for school interviews [PDF, 117kb]

• Information sheet for workplaces [PDF, 68kb]
  
  
• Think Aloud Interview Information Sheet [PDF, 68kb]
  
  
• Perspectives on Wellbeing Investments in Schools and Employers Study Interview Information Sheet [PDF, 215kb]

Denmark

In October, Luke Henstock, a 3^rd year PhD student leading the workplaces work package, visited Aarhus University in Denmark for a Process Tracing methods workshop.  The three-day course was led by project collaborator Derek Beach. The sessions were designed to foster an in-depth understanding of how processual theories are formulated and refined. The overarching goal was to equip participants with the skills to capture intricate activities and their underlying causal linkages. Derek focused on the methodological tools used in process tracing, in addition to developing an understanding of the historical underpinnings of the qualitative technique. Seminars explored how processual theories can be developed and improved, focusing on how to capture the activities and their underlying causal linkages to understand how a process works and evidence it empirically.

Given the small size of the group, Luke was able to present the different aspects of his data from the first case study. Derek and the workshop participants provided invaluable insights, challenging various aspects of Luke's work, and contributing significantly to the development of his process theory.

HESG

In January Luke Henstock (PhD student) and Prof Hareth Al-Janabi (Project Lead and supervisor) attended the Health Economics Study Group winter conference in Exeter. The conference is centred on work in progress and Luke had a paper accepted which combined two chapters from his PhD: 1) a systematic review on barriers to workplace mental health and wellbeing investments, and 2) the early findings from his first case study (drawing on interviews and document analysis).

HESG is designed to give researchers feedback that can be incorporated into the final version of their work. The paper was presented by a researcher from the University of Exeter who raised some interesting points for discussion and also reflected on the areas the authors wanted feedback on. The conference presented opportunities for Luke to network with other people in the discipline, get feedback on how process tracing is received/ can be used by health economists, and to chair the discussion of a paper.

May 2023

Professor Hareth Al-Janabi and Dr Rebecca Johnson presented emerging findings from the WISE study at the Joint Masterclass series with West Midlands Combined Authority on Wednesday 24^th May. They drew on the hard work of the wider WISE Team: Dr Camille Allard, PhD Students Luke Henstock and Yusuf Ozdemir, and Research Administrator Sally O’Loughlin. Staff and students from the Health Economics Unit also participated in The Centre for Urban Wellbeing event.  Stakeholders from Community, Academic and Policy perspectives joined together to discuss investing in mental health and wellbeing. A priority setting exercise was undertaken by all attendees, tasked with allocating resources for supporting mental health and wellbeing in an imagined local authority, with different groups focusing on two different priority themes – ‘Crisis’ and ‘Prevention’. It was a unique opportunity to forge connections and gain insights into different priorities and perspectives on investing in mental health and wellbeing and facilitate wider opportunities through the Centre for Urban Wellbeing.