By Dr Igor Shagalov, Professor Hareth Al-Janabi, and Dr Yibei Qu
Schools are taking on increasing responsibility for supporting student’s mental health and wellbeing
In recent years, schools in England have taken on a growing role in supporting students’ mental health and wellbeing. But with tight budgets and limited time, school leaders face difficult choices about how to allocate resources. Whether it is staff time, physical space, or external support, investing in pupil wellbeing has become a complex and pressing priority-setting challenge.
Despite this increasing responsibility, we still know surprisingly little about how health-related resource allocation decisions are made in educational settings. What drives some schools to invest more in mental health than others? And what kinds of evidence, if any, do school leaders draw on when making these decisions?
These questions sit at the heart of the WISE study (Wellbeing Investment in Schools and Employers), funded by the Wellcome Trust and conducted at the Health Economics Unit, University of Birmingham.
We explored what drives investment in mental health and wellbeing in English schools, and how some schools become high investors. We also examined the role of different types of evidence, including economic data, in shaping these decisions in practice.
Insights from the ‘schools’ and ‘evidence’ strands of the WISE study suggest that decision-making processes are far more complex than traditional rational decision-making process, and this has important implications for how research is produced and communicated to support the school system.
What Drives Investment in Mental Health?
Larger budgets don’t always translate into greater investment
In the ‘Schools’ work package, we used process tracing, a qualitative method that follows decision-making step by step, to understand why some schools become high investors in mental health, while others (even with larger budgets) do not. For a systematic review of the technique, see Johnson et al.
Our case studies of six English schools revealed that investment was shaped less by formal cost-benefit analysis and more by ethos, trust, relationships, and the ability to draw in external resources. We call this the “Care-as-Capital” model (Johnson et al). In high-investing schools, a strong ethos of inclusion and holistic education, along with deep ties among staff, families, and communities (known in social science as social capital), played a central role. These schools believed that supporting pupils’ mental health enhanced learning.
In contrast, low-investment schools often showed misalignment between school and trust leadership (multi-academy trusts in England are designed to group schools under one umbrella to achieve economic efficiency), higher staff turnover, and a weaker sense of shared purpose. Larger budgets did not necessarily translate into greater investment. Without aligned goals and supportive networks, the investment mechanism broke down (Shagalov et al., 2025, forthcoming).
How Is Information Used in Decision-Making?
The ‘Evidence’ work package explores how schools use different types of evidence, including economic data, when allocating resources for mental health support. For initial findings, see Allard et al.
We then conducted think-aloud interviews with headteachers and senior leaders, who completed a structured resource allocation task involving several mental health interventions while verbalising their thought processes.
Economic evidence was often regarded as being too abstract
Our findings show that school leaders relied heavily on professional judgement, lived experience, and local knowledge. While economic evidence, such as cost-effectiveness or QALYs, was seen as useful in principle, it was often regarded as too abstract or difficult to apply. Internal survey data felt more relevant and trustworthy. Visual formats, like bar charts, were more engaging than dense text, while social media was consistently dismissed as lacking credibility.
These insights suggest that improving the use of evidence in schools requires making economic data more accessible, interpretable, and aligned with educators’ values and professional practices.
Our findings shed light on the complex, value-driven nature of decision-making in schools. Future work will extend this research to workplace settings, offering practical recommendations to support mental health investment in real-world contexts.
Upcoming Events
We will be discussing findings from both strands of our work during a two-day workshop at the University of Birmingham.
Day 1 (18 September): Focused on the interface between decision-making and evidence generation in the health and social care system.
Day 2 (19 September): Introducing process tracing as an emerging method for studying how real-world decisions unfold over time.
Both events are supported by the WISE project.
Everyone is welcome to attend. Link for registration are provided below: https://forms.office.com/Pages/ResponsePage.aspx?id=z8oksN7eQUKhXDyX1VPp8zTTcEYcUshElBpg3v9EOztUMFREVENKQ1MzWklBVzRDWlVKUlc2NjFRQy4u
Registration: Follow the link to register or contact Sally O’Loughlin (s.r.oloughlin@bham.ac.uk) or Hareth Al-Janabi (h.aljanabi@bham.ac.uk) for more information.