Judi Kidger

• University of Bristol

Mental health problems lead to earlier mortality, poor physical health and socioeconomic disadvantage. Some people, including those from black and minority ethnic groups and low-income households, are at higher risk of poor mental health and are less likely to seek support from statutory services. Community Protect (CP) is a model in which a local...

Introduction The PRIME-UK randomised controlled trial (RCT) aims to establish whether a model of care that seeks to be proactive, integrated and empower participants, caregivers and healthcare professionals can improve outcomes in people with parkinsonism. Given that this intervention is novel and complex, understanding whether and how the interven...

Introduction The PRIME-UK randomised controlled trial (RCT) aims to establish whether a model of care that seeks to be proactive, integrated and empower participants, caregivers and healthcare professionals can improve outcomes in people with parkinsonism. Given that this intervention is novel and complex, understanding whether and how the interven...

Background: Rates of common mental disorders (CMD), such as anxiety and depression, treated in primary care have increased among young adults in the UK. However, it remains unclear whether this increase reflects a greater tendency to seek help for CMD or a rise in CMD symptoms over time. Additionally, it is not clear if these increases are more pro...

Introduction Peer education interventions are widely used in secondary schools with an aim to improve students’ health literacy and/or health behaviours. Although peer education is a popular intervention technique with some evidence of effectiveness, we know relatively little about the key components that lead to health improvements among young peo...

Background Growing numbers of students now seek mental health support from their higher education providers. In response, a number of universities have invested in non-clinical well-being services, but there have been few evaluations of these. This research addresses a critical gap in the existing literature. Aims This study examined the impact of...

Adolescence is a key time to prevent or reduce poor mental health outcomes. Supportive school environments play an important role in this, and the concept of health-promoting schools have been supported globally. Participatory action research (PAR) combines theory, practice, action, and reflection by developing practical solutions to address concer...

Background Addressing the wider determinants of mental health alongside psychological therapy could improve mental health service outcomes and population mental health. Objectives To estimate the effectiveness of an enhanced ‘Improving Access to Psychological Therapies’ (IAPT) mental health service compared with traditional IAPT in England. Alongs...

Growing concern for the mental health and wellbeing of higher education students has been linked to increasing financial pressures associated with studying at university, a factor potentially magnified by the recent global pandemic and economic downturn. With limited longitudinal research to date, this study used cross-sectional survey data collect...

Introduction Associations between structural inequalities and health are well established. However, there is limited work examining this link in relation to mental health, or that centres public perspectives. This study explores people's experience and sense‐making of inequality in their daily lives, with particular consideration of impacts on ment...

OBJECTIVES. Real-world evidence is playing an increasingly important role in health technology assessment, but is prone to selection and confounding bias. We demonstrate how to conduct a real-world within-study cost per quality-adjusted life-year (QALY) analysis. We combined traditional within-trial bootstrapped regression-baseline-adjustment with...

Background Mental health challenges faced by young people are increasing. Women and girls experience higher levels of internalised mental illness, such as depression and anxiety. This may be because of biological development and/or social risks. Schools could support good mental health and detect areas for intervention. Moreover, aspects of the sch...

Background Improving the health and well-being of young people is a public health priority. Schools present an ideal setting to implement strategies to improve young people’s health and well-being. Conducting health improvement research in schools is, however, challenging. Schools can find it difficult to participate and adhere to research processe...

Background Schools offer a valuable setting to promote good health and mental well-being amongst young people. Schools are complex systems and as such systems interventions are needed to improve student health and well-being. Despite an increase in the use of systems-based approaches in public health research, there remain limited examples of apply...

Poor adolescent mental health calls for universal prevention. The Mental Health Foundation's 'Peer Education Project' equips older students ('peer educators') to teach younger students ('peer learners') about mental health. The peer-led lessons cover defining good and bad mental health, risk and protective factors, self-care, help-seeking and looki...

Background Improving the health and well-being of young people is a public health priority. Schools present an ideal setting to implement strategies to improve young people’s health and well-being. A key strategy involves conducting surveys to assess student health needs, inform interventions, and monitor health over time. Conducting research in sc...

Background A new Health and Wellbeing pathway was introduced into the Improving Access to Psychological Therapies (IAPT) service in one geographical area of the UK in 2021 to address the wider determinants of mental health problems. It comprised assisted signposting to wider services and physical health promotion. This qualitative study aimed to un...

Schools offer a valuable setting to promote good health and mental well-being amongst young people. Schools are complex systems and therefore systems interventions are needed to improve pupil health and well-being. This paper presents a qualitative process evaluation of the South West- School Health Research Network, a systems level intervention. T...

In England, approximately 1 in 6 people have a common mental health condition, with certain groups experiencing worsening mental health since the start of the COVID-19 pandemic. Therefore, improving mental health remains a key priority for policy makers and practitioners. Community-based interventions are increasingly used to improve health and red...

Background There is an increased need for prevention and early intervention surrounding young people’s health and well-being. Schools offer a pivotal setting for this with evidence suggesting that focusing on health within schools improves educational attainment. One promising approach is the creation of School Health Research Networks which exist...

Food insecurity amongst households with children is a growing concern globally. The impacts in children include poor mental health and reduced educational attainment. Providing universal free school meals is one potential way of addressing these impacts. This paper reports findings on the impact of a universal free school meals pilot in two English...

Introduction Attention deficit/hyperactivity disorder (ADHD) is a prevalent and impairing cluster of traits affecting 2%–5% of children. These children are at risk of negative health, social and educational outcomes and often experience severe difficulties at school, so effective psychosocial interventions are needed. There is mixed evidence for ex...

Background In the UK, one in five households with children experienced food insecurity in 2022, defined as a household-level economic and social condition of limited or uncertain access to adequate food. Free school meals are a public health intervention aimed at reducing food insecurity amongst children. The provision of universal free school meal...

Information sharing is a frequently discussed yet divisive suicide prevention strategy in universities. This study aimed to investigate which students are most and least likely to opt-in to university permission to notify an emergency contact if there are serious concerns about their mental health. Routine cross-sectional data were obtained from 29...

Many mental health problems begin in adolescence and occur on a spectrum of severity: early recognition and intervention is important. This study is a quantitative feasibility study of the Mental Health Foundation’s Peer Education Project (PEP). Attrition, psychometric properties of questionnaires, indications of improvement on a range of outcomes,...

Introduction Peer education, whereby peers (‘peer educators’) teach their other peers (‘peer learners’) about aspects of health is an approach growing in popularity across school contexts, possibly due to adolescents preferring to seek help for health-related concerns from their peers rather than adults or professionals. Peer education intervention...

Background A new Health and Wellbeing pathway was introduced into the Improving Access to Psychological Therapies (IAPT) service in one geographical area of the UK in 2021 to address the wider determinants of mental health problems. It comprised assisted signposting to wider services and physical health promotion. This qualitative study aimed to un...

Schools play a significant role in promoting health and well-being and the reciprocal links between health and educational attainment are well-evidenced. Despite recognition of the beneficial impact of school-based health improvement programmes, significant barriers to improving health and well-being within schools remain. This study pilots a Schoo...

The COVID-19 ‘lockdown’ and multiple school closures disrupted the daily lives and routines of the entire UK population. However, adolescents were likely particularly impacted by such measures due to this time being key for social and educational development. This qualitative study explored young people’s experiences of lockdowns and school closure...

School closures and social distancing measures during the pandemic have disrupted young people’s daily routines and social relationships. We explored patterns of change in adolescent mental health and tested the relationship between pre-pandemic levels of school and peer connectedness and changes in mental health and well-being between the first lo...

Evidence on how different types of social media use contribute to digital stress in early adolescence is lacking. In-depth interviews were conducted with 24 13–14-year-olds. Interviews were transcribed verbatim, coded and thematically analysed. Themes were generated based on digital stressors specific to passive social media use (time-wasting and d...

Background There is consistency of evidence on the link between school culture and student health. A positive school culture has been associated with positive child and youth development, effective risk prevention and health promotion efforts, with extensive evidence for the impact on student mental health. Interventions which focus on socio-cultur...

Mental health (MH) difficulties are on the increase among children and young people (CYP). Evidence has shown that educational settings contain both risk and protective factors for MH. This review investigated which structural and cultural factors and interventions within educational settings promote positive MH and prevent poor MH in 4–18 year old...

Background: There is mixed evidence as to the effects of different types of social media use on mental health, but previous research has been platform-specific and has focused on an oversimplified distinction between active and passive use. This study aimed to identify different underlying subgroups of adolescent social media user based on their p...

Background Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) have impairing levels of difficulty paying attention, impulsive behaviour and/or hyperactivity. ADHD causes extensive difficulties for young people at school, and as a result these children are at high risk for a wide range of poor outcomes. We ultimately aim t...

Evidence on how different types of social media use contribute to digital stress in early adolescence is lacking. In-depth interviews were conducted with twenty-four 13-14-year-olds. Interviews were transcribed verbatim, coded and thematically analysed. Themes were generated based on digital stressors specific to passive social media use (time-wast...

Despite a rising prevalence of mental health difficulties in the young, existing prior to, but also exacerbated by the current COVID-19 pandemic, mental health needs in this population remain unmet even in economically wealthy countries. Increasingly, supportive school environments have been suggested as having a significant impact on young people'...

Background : When students experience serious mental health difficulties, universities face the dilemma of deciding whether to notify trusted others such as parents. This study investigates the key factors underpinning students’ decisions to opt-out of a ‘consent to contact’, which would allow their university to notify an emergency contact of thei...

Background Teachers are at heightened risk of poor mental health and well-being, which is likely to impact on the support they provide to students, and student outcomes. We conducted a cluster randomised controlled trial, to test whether an intervention to improve mental health support and training for high school teachers led to improved mental he...

Background The COVID-19 pandemic, school closures, and social distancing measures have disrupted young people's daily routines, learning, and social relationships. We examine the changes in adolescent mental health over time and explore the relationship between how connected students felt to their school and peers before the pandemic and how this a...

Background Health and Safety Executive data show that teachers are at heightened risk of mental health difficulties, yet few studies have attempted to address this. Poor teacher mental health may impact on the quality of support provided to young people, who also report increased mental health difficulties themselves. Objective To test the effecti...

Background: Young people spend a large proportion of their time in school, which presents both risk and protective factors for their mental health. A supportive school culture can promote and protect good mental health by creating experiences of safety and belonging amongst staff and students. In this qualitative study, we seek to explore whether a...

Background Emotional disorders in young people are increasing but studies have found that this age group do not always recognise the signs and symptoms of mental health problems in themselves or others. The Mental Health Foundation’s school-based Peer Education Project (PEP) has the potential to improve young people’s understanding of their own men...

Background There is mixed evidence as to the effects of different types of social media use on mental health, but previous research has been platform-specific and has focused on an oversimplified distinction between active and passive use. This study aimed to identify different underlying subgroups of adolescent social media user based on their pat...

Background Connectedness to family and peers is a key determinant of adolescent mental health. Existing research examining associations between social media use and social connectedness has been largely quantitative and has focused primarily on loneliness, or on specific aspects of peer relationships. In this qualitative study we use the displaceme...

Background There is increasing evidence that domestic violence is an important risk factor for suicidal behaviour. The level of risk of domestic violence (DV) and its contribution to the overall burden of suicidal behaviour has not been quantified in South Asia, where 37% of suicide deaths globally occur. We examined the association between DV and...

Background Connectedness to school, family and peers is a key determinant of adolescent mental health. The relationship between social media use (SMU) and social connectedness is complex, potentially improving closeness to peers, whilst possibly diminishing school connectedness. Evidence to date has been piecemeal and contradictory with particular...

Aims and Hypothesis: The study will seek to identify and develop a logic model and a school culture toolkit that can be utilised to inform public health interventions to promote mental health in a range of educational settings. Background: While most mental health issues begin during youth, they are often first detected later in life. One way to ad...

Background Schools in the UK increasingly have to respond to anxiety, depression and conduct disorder as key causes of morbidity in children and young people. Objective The objective was to assess the comparative effectiveness of educational setting-based interventions for the prevention of anxiety, depression and conduct disorder in children and...

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Introduction Adverse childhood experiences (ACE) have been recognized as an important risk factor for suicidal behaviour among adults, but evidence from low and middle-income countries is lacking. This study explored associations between ACE and hospital admission due to non-fatal self-poisoning in Sri Lanka. Methods This was a case-control study....

BACKGROUND Concern about the mental health and wellbeing of students in university education continues to mount. Psychoeducation has the potential to support students experiencing varying levels of distress and help meet the demand for support, however there is a need to understand how these programmes are used and experienced. Online diaries are a...

Background Psychoeducation has the potential to support students experiencing distress and help meet the demand for support; however, there is a need to understand how these programs are experienced. Web-based diaries are a useful activity for psychoeducation because of their therapeutic benefits, ability to capture naturalistic data relevant to we...

For over a decade, pandemics have been on the UK National Risk Register as both the likeliest and most severe of threats. Non-infectious ‘lifestyle’ diseases were already crippling our healthcare services and our economy. COVID-19 has exposed two critical vulnerabilities: firstly, the UK’s failure to adequately assess and communicate the severity o...

Background: There is increasing evidence that domestic violence (DV) is an important risk factor for suicidal behaviour. The level of risk and its contribution to the overall burden of suicidal behaviour among men and women has not been quantified in South Asia. We carried out a large case-control study to examine the association between DV and se...

Background: Improving children and young people's provision for mental health is a current health priority in England. Secondary school teachers have worse mental health outcomes than the general working population, which the Wellbeing in Secondary Education (WISE) cluster randomised controlled trial aimed to improve. The WISE intervention compris...

Objectives Most of the evidence on the effects of internet use on mental health derives from cross-sectional research. We set out to explore prospective associations between internet use (hours online and specific internet experiences) and future mental health problems. Methods Participants were 1,431 respondents from the Avon Longitudinal Study o...

Background: Improving children and young people’s provision for mental health is a current health priority in England. Secondary school teachers have worse mental health outcomes than the general working population, which the Wellbeing in Secondary Education (WISE) cluster randomised controlled trial aimed to improve. The WISE intervention comprise...

Heavy alcohol use and associated needs are prevalent amongst arrestees. The custody suite offers an opportunity to identify and intervene with this population. However, it is unclear whether functions of care can be effectively delivered within an environment of containment. This study aimed to examine custody staff experiences of screening and del...

Background: Depressive symptoms show different trajectories throughout childhood and adolescence that may have different consequences for adult outcomes. Aims: To examine trajectories of childhood depressive symptoms and their association with education and employment outcomes in early adulthood. Method: We estimated latent trajectory classes...

Background: Improving children and young people’s provision for mental health is a current health priority in England. Secondary school teachers have worse mental health outcomes than the general working population, which the Wellbeing in Secondary Education (WISE) cluster randomised controlled trial aimed to improve. The intervention tested delive...

Background: Improving children and young people’s provision for mental health is a current health priority in England. Secondary school teachers have worse mental health outcomes than the general working population, which the Wellbeing in Secondary Education (WISE) cluster randomised controlled trial aimed to improve. The WISE intervention comprise...

Background: Improving children and young people’s provision for mental health is a current health priority in England. Secondary school teachers have worse mental health outcomes than the general working population, which the Wellbeing in Secondary Education (WISE) cluster randomised controlled trial aimed to improve. The WISE intervention comprise...

Background: Rates of anxiety and depression are increasing among children and young people. Recent policies have focused on primary prevention of mental disorders in children and young people, with schools at the forefront of implementation. There is limited information for the comparative effectiveness of the multiple interventions available. Me...

Background School teachers are at heightened risk of mental health difficulties. A small number of trials have introduced teacher training to improve support for students, but none have increased support available for teachers themselves. We aimed to evaluate the effect of a mental health support and training intervention on secondary school teache...

Background Factors within the school environment may impact young people's mental health and wellbeing. The aim of this study was to understand the association between teacher and student mental health and wellbeing. Further, it seeked to identify possible explanations by examining whether the strength of any association is weakened once quality of...

Background: Factors within the school environment may impact young people's mental health and wellbeing. The aim of this study was to understand the association between teacher and student mental health and wellbeing. Further, it seeked to identify possible explanations by examining whether the strength of any association is weakened once quality...

Background: Secondary school teachers have low levels of wellbeing and high levels of depression compared with the general population. Teachers are in a key position to support students, but poor mental health may be a barrier to doing so effectively. The Wellbeing in Secondary Education (WISE) project is a cluster randomised controlled trial (RCT...

Background: Alcohol Screening and Brief Intervention (ASBI) helps reduce risky drinking in adults, but less is known about its effectiveness with young people. This article explores implementation of DrinkThink, an ASBI co-produced with young people, by health, youth and social care professionals trained in its delivery. Methods: A qualitative e...

Background Systematic reviews of alcohol screening and brief interventions (ASBI) highlight the challenges of implementation in healthcare and community-based settings. Fewer reviews have explored this through examination of qualitative literature and fewer still focus on interventions with younger people. Methods This review aims to examine quali...

Background: Teachers are reported to be at increased risk of common mental health disorders compared to other occupations. Failure to support teachers adequately may lead to serious long-term mental disorders, poor performance at work (presenteeism), sickness absence and health-related exit from the profession. It also jeopardises student mental h...

Background Secondary school teachers are at heightened risk of psychological distress, which can lead to poor work performance, poor quality teacher-student relationships and mental illness. A pilot cluster randomised controlled trial (RCT) – the WISE study – evaluated the feasibility of a full-scale RCT of an intervention to support school staff’s...

Background: Teachers have been shown to have high levels of stress and common mental disorder, but few studies have examined which factors within the school environment are associated with poor teacher mental health. Methods: Teachers (n=555) in 8 schools completed self-report questionnaires. Levels of teacher wellbeing (Warwick Edinburgh Mental...

Several aspects of school life are thought to be associated with increased risk of self-harm in adolescence, but these have rarely been investigated in prospective studies.Methods Members of the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort completed postal surveys of school experiences aged 14, and self-harm behaviour aged...

Background There is a lack of consensus about whether self-harm with suicidal intent differs in aetiology and prognosis from non-suicidal self-harm, and whether they should be considered as different diagnostic categories. Method Participants were 4,799 members of the Avon Longitudinal Study of Parents and Children (ALSPAC), a UK population-based...

Parental suicidal behavior is associated with offspring's risk of suicidal behavior. However, much of the available evidence is from population registers or clinical samples. We investigated the associations of self-reported parental suicide attempt (SA) with offspring self-harm and suicidal thoughts in the Avon Longitudinal Study of Parents and Ch...

Low IQ is associated with an increased risk of suicide and suicide attempt in adults, but less is known about the relationship between IQ and aspects of suicidal/self-harm behaviours in adolescence. We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based prospective UK cohort. Binomial and multinomial logi...

Purpose: Socio-economic position (SEP) during childhood and parental social mobility have been associated with subsequent health outcomes in adolescence and adulthood. This study investigates whether parental SEP during childhood is associated with subsequent self-harm in adolescence. Methods: This study uses data from a prospective birth-cohort...

Background: Substantial numbers of adolescents self-harm, but the majority of cases do not reach the attention of medical services, making community studies essential. The prevalence of suicidal thoughts and plans at this age, and the inter-relationships between suicidal thoughts, plans and self-harm remain largely unexplored. Method: Cross-sect...

Flow Chart of Cohort Participants.

Comparison of relationship between self-harm (SH) and background variables for different imputation samples.

Questions on self-harm.

The evidence base for the importance of the school environment for adolescent emotional health has never been systematically reviewed. We aimed to synthesize the evidence for the effect on adolescent emotional health of (1) interventions targeting the school environment and (2) the school environment in cohort studies. Searches of Medline, Embase,...

The associations between admissions to an emergency department following attempted suicide and personal bankruptcy in the preceding and subsequent 2 years were evaluated. Records from a level 1 trauma center (June 1993-December 2002) in Seattle, WA, were linked with case files from the local U.S. District Bankruptcy Court (June 1991 onward). Univar...

The need for schools to support children and young people’s mental and emotional health is increasingly emphasised in policy initiatives, yet the role of teachers in this has been under explored. This paper reports findings from qualitative, semi‐structured interviews with 14 school staff at eight secondary schools in England, examining emotional h...

Schools have been identified as an important place in which to support adolescent emotional health, although evidence as to which interventions are effective remains limited. Relatively little is known about student and staff views regarding current school-based emotional health provision and what they would like to see in the future, and this is w...

To explore the factors that influence treatment decision-making in a gynaecological cancer team (MDT). Qualitative study using interviews and observations. Gynaecological cancer MDT meetings and participants' offices. A gynaecological cancer MDT and members of that team. Observations of ten MDT meetings and semistructured interviews with 16 team me...