TY - JOUR
T1 - 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
T2 - The MYRIAD cluster randomised controlled trial
AU - Kuyken, Willem
AU - Ball, Susan
AU - Crane, Catherine
AU - Ganguli, Poushali
AU - Jones, Benjamin
AU - Montero-Marin, Jesus
AU - Nuthall, Elizabeth
AU - Raja, Anam
AU - Taylor, Laura
AU - Tudor, Kate
AU - Viner, Russell M.
AU - Allwood, Matthew
AU - Aukland, Louise
AU - Dunning, Darren
AU - Casey, Tríona
AU - Dalrymple, Nicola
AU - De Wilde, Katherine
AU - Farley, Eleanor Rose
AU - Harper, Jennifer
AU - Kappelmann, Nils
AU - Kempnich, Maria
AU - Lord, Liz
AU - Medlicott, Emma
AU - Palmer, Lucy
AU - Petit, Ariane
AU - Philips, Alice
AU - Pryor-Nitsch, Isobel
AU - Radley, Lucy
AU - Sonley, Anna
AU - Shackleford, Jem
AU - Tickell, Alice
AU - Blakemore, Sarah Jayne
AU - Team, The Myriad
AU - Ukoumunne, Obioha C.
AU - Greenberg, Mark T.
AU - Ford, Tamsin
AU - Dalgleish, Tim
AU - Byford, Sarah
AU - Williams, J. Mark G.
N1 - Publisher Copyright:
©
PY - 2022/8/1
Y1 - 2022/8/1
N2 - Background Systematic reviews suggest school-based mindfulness training (SBMT) shows promise in promoting student mental health. Objective The My Resilience in Adolescence (MYRIAD) Trial evaluated the effectiveness and cost-effectiveness of SBMT compared with teaching-as-usual (TAU). Methods MYRIAD was a parallel group, cluster-randomised controlled trial. Eighty-five eligible schools consented and were randomised 1:1 to TAU (43 schools, 4232 students) or SBMT (42 schools, 4144 students), stratified by school size, quality, type, deprivation and region. Schools and students (mean (SD); age range=12.2 (0.6); 11-14 years) were broadly UK population-representative. Forty-three schools (n=3678 pupils; 86.9%) delivering SBMT, and 41 schools (n=3572; 86.2%) delivering TAU, provided primary end-point data. SBMT comprised 10 lessons of psychoeducation and mindfulness practices. TAU comprised standard social-emotional teaching. Participant-level risk for depression, social-emotional-behavioural functioning and well-being at 1 year follow-up were the co-primary outcomes. Secondary and economic outcomes were included. Findings Analysis of 84 schools (n=8376 participants) found no evidence that SBMT was superior to TAU at 1 year. Standardised mean differences (intervention minus control) were: 0.005 (95% CI -0.05 to 0.06) for risk for depression; 0.02 (-0.02 to 0.07) for social-emotional-behavioural functioning; and 0.02 (-0.03 to 0.07) for well-being. SBMT had a high probability of cost-effectiveness (83%) at a willingness-to-pay threshold of £20 000 per quality-adjusted life year. No intervention-related adverse events were observed. Conclusions Findings do not support the superiority of SBMT over TAU in promoting mental health in adolescence. Clinical implications There is need to ask what works, for whom and how, as well as considering key contextual and implementation factors. Trial registration Current controlled trials ISRCTN86619085. This research was funded by the Wellcome Trust (WT104908/Z/14/Z and WT107496/Z/15/Z).
AB - Background Systematic reviews suggest school-based mindfulness training (SBMT) shows promise in promoting student mental health. Objective The My Resilience in Adolescence (MYRIAD) Trial evaluated the effectiveness and cost-effectiveness of SBMT compared with teaching-as-usual (TAU). Methods MYRIAD was a parallel group, cluster-randomised controlled trial. Eighty-five eligible schools consented and were randomised 1:1 to TAU (43 schools, 4232 students) or SBMT (42 schools, 4144 students), stratified by school size, quality, type, deprivation and region. Schools and students (mean (SD); age range=12.2 (0.6); 11-14 years) were broadly UK population-representative. Forty-three schools (n=3678 pupils; 86.9%) delivering SBMT, and 41 schools (n=3572; 86.2%) delivering TAU, provided primary end-point data. SBMT comprised 10 lessons of psychoeducation and mindfulness practices. TAU comprised standard social-emotional teaching. Participant-level risk for depression, social-emotional-behavioural functioning and well-being at 1 year follow-up were the co-primary outcomes. Secondary and economic outcomes were included. Findings Analysis of 84 schools (n=8376 participants) found no evidence that SBMT was superior to TAU at 1 year. Standardised mean differences (intervention minus control) were: 0.005 (95% CI -0.05 to 0.06) for risk for depression; 0.02 (-0.02 to 0.07) for social-emotional-behavioural functioning; and 0.02 (-0.03 to 0.07) for well-being. SBMT had a high probability of cost-effectiveness (83%) at a willingness-to-pay threshold of £20 000 per quality-adjusted life year. No intervention-related adverse events were observed. Conclusions Findings do not support the superiority of SBMT over TAU in promoting mental health in adolescence. Clinical implications There is need to ask what works, for whom and how, as well as considering key contextual and implementation factors. Trial registration Current controlled trials ISRCTN86619085. This research was funded by the Wellcome Trust (WT104908/Z/14/Z and WT107496/Z/15/Z).
KW - Child & adolescent psychiatry
KW - Depression & mood disorders
UR - http://www.scopus.com/inward/record.url?scp=85134702522&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85134702522&partnerID=8YFLogxK
U2 - 10.1136/ebmental-2021-300396
DO - 10.1136/ebmental-2021-300396
M3 - Review article
C2 - 35820992
AN - SCOPUS:85134702522
SN - 1362-0347
VL - 25
SP - 99
EP - 109
JO - Evidence-Based Mental Health
JF - Evidence-Based Mental Health
IS - 3
ER -