DfE心理健康干预评估 正念 放松 求助意愿
英国教育部资助的 Education for Wellbeing 评估，在 2025 年 2 月 7 日一次性公布了六份文件，把五种学校心理健康干预做法的效果放在一起比较。这项工作同时做了两项整群随机对照试验，AWARE 针对九年级，INSPIRE 覆盖小学四五年级与中学七八年级。结论并不整齐，三种做法显示出希望，另外两种被写进了不建议名单。
The Department for Education funded Education for Wellbeing, a programme that tested five different ways of supporting pupils' mental health in English schools. Six documents were published together on gov.uk on 7 February 2025, covering two cluster randomised controlled trials; AWARE ran in Year 9 while INSPIRE covered Years 4 and 5 in primary schools and Years 7 and 8 in secondary schools. The overall picture is mixed, with three approaches judged promising and two left off the recommended list.
评估的规模与三阶段时间线
这项评估从 2018 年做到 2024 年，分三个阶段推进，中间被疫情打断过一次。技术报告记录的数字是 47,625 名学生、513 所学校，覆盖英格兰的小学与中学。规模最大的是第一阶段，有 21,679 名学生与 257 所学校；接下来是 14,970 名学生、147 所学校，以及 10,976 名学生、109 所学校。执行方是 Anna Freud 的学校团队，评估方是伦敦大学学院的循证实践单元。出资、执行、评估三方分开，这在教育评估里并不常见，好处是结论不容易被交付方带走。
The programme ran in three waves from 2018 to 2024 and lost part of one wave to school closures; the technical report records 47,625 pupils across 513 schools. Wave one was the largest with 21,679 pupils from 257 schools, followed by 14,970 pupils from 147 schools and 10,976 pupils from 109 schools; delivery sat with the Anna Freud Schools Division and evaluation with the Evidence-Based Practice Unit at UCL.
两项试验怎么分工 AWARE 与 INSPIRE
两项试验针对的年龄段不同，这是理解后面所有结论的前提。AWARE 的全称是 Approaches for Wellbeing and Mental Health Literacy: Research in Education，只在中学做，随机分配到九年级。INSPIRE 的全称是 Interventions in Schools for Promoting Wellbeing: Research in Education，同时覆盖小学与中学，投放年级是小学四年级五年级、中学七年级八年级。前者检验的是市面上已经存在的课程，后者检验的是为本项目专门开发、此前没有试验过的做法。把两者分开看，才能解释为什么同一份报告里既有认可也有明确的保留意见。
The two trials covered different age groups, which is the key to reading every finding that follows; AWARE was secondary only and randomised within Year 9, while INSPIRE ran in Years 4 and 5 of primary schools and Years 7 and 8 of secondary schools. AWARE tested curricula that already existed elsewhere in the world, whereas INSPIRE tested approaches developed for this programme and never trialled before; keeping the two apart explains why one set of reports contains both endorsements and clear reservations.
AWARE 的三个分组 YAM 与 The Guide
AWARE 把学校随机分到三个组：YAM、The Guide、以及照常上课的对照组。YAM 是瑞典与美国开发的五节课，由校外受训人员用角色扮演的方式讲，目标是提高学生对心理健康的理解并降低自杀风险。The Guide 是加拿大开发的教师培训课程，先培训教师理解心理健康，再教他们怎么在班上讲这件事、怎么减少污名。对照组在试验期间照常上课，试验结束后可以免费获得一次心理健康与福祉培训。三个组的分配在学校层面完成，具体讲授在班级层面进行。
AWARE assigned schools at random to YAM, The Guide or usual practice; YAM is a five-lesson programme from Sweden and the United States delivered by a trained outsider using role play, while The Guide is a Canadian teacher training course that builds staff understanding first and then helps them teach pupils and reduce stigma. Schools in the usual practice arm carried on as normal and were offered free mental health training once the trial ended; randomisation happened at school level and delivery at classroom level.
YAM 的结果 五节课与没上完的班级
YAM 在主要结局上没有显示出统计显著的效果，时间点是干预后 3 到 6 个月的随访。报告把一个很重要的原因写在了前面：不少被分配到 YAM 的学校最终没有把课上完。在真正完整交付的学校里，学生的情绪困难在短期内确实下降了，也就是说效果被实施缺口掩盖了一部分。反直觉的发现同样存在，在原本心理健康支持很少的学校里，YAM 反而与短期内的负面变化相关。学生视角的报告写得更直接：YAM 与 The Guide 都不被推荐在英格兰中学推广，因为长期效果里出现了需要进一步研究的负面信号。
YAM showed no statistically significant effect on emotional difficulties at the three to six month follow-up, and a large part of that flat result traces back to schools that never delivered the lessons; where the programme was completed, short-term emotional difficulties did fall. One counterintuitive finding is that in schools with little existing mental health provision, YAM was linked to negative short-term changes. Pupil and cost briefings are blunter still: neither YAM nor The Guide is recommended for English secondary schools, because longer-term effects raised questions that need exploring.
The Guide 的两项小效应
The Guide 走的是教师培训路线，它留下的是两项幅度不大但统计上站得住的效应。在第二次随访里，学生的心理健康知识有所增加，效应量是 0.10，95% 置信区间 0.03 到 0.17；更积极的心理健康行为也有增加，效应量 0.07，区间 0.003 到 0.14。报告同时指出，上完全部课程的班级比只上了一部分课程的班级获益更多，交付完整性在两项试验里都起了作用。效应量接近 0.1 意味着差距很小，单个学生的感受不会明显，但对一个年级的整体分布有影响。想让这类课程发挥作用，把课时排满比换教材更重要。
The Guide followed a teacher training route and left two small but statistically solid effects at the second follow-up: pupils knew more about mental health, with an effect size of 0.10 and a 95 per cent confidence interval of 0.03 to 0.17, and reported more positive mental health behaviours, with an effect size of 0.07 and an interval of 0.003 to 0.14. The briefing also notes that classes receiving every session gained more than those receiving only some, so delivery completeness mattered in both trials. An effect size near 0.1 is modest and invisible to any single pupil, yet it shifts the distribution of a whole year group.
INSPIRE 的四个分组与两万人的样本
INSPIRE 把学校随机分成四组：正念练习、放松练习、安全与福祉策略、照常上课。正念与放松都是每天五分钟、嵌进正常上课日的短练习，训练对象是学生本人。安全与福祉策略不同，它是八节课的心理健康素养课程，重点在个人安全与情绪管理，让学生认清楚自己遇到困难时可以找谁。这项试验的样本是 20,489 名学生、213 所学校，测量的是学生自报的情绪困难，以及将来遇到心理问题时是否打算求助。后一个指标叫求助意愿，它是这批文件里唯一出现正向显著结果的地方。
INSPIRE split schools into four arms: mindfulness exercises, relaxation techniques, Strategies for Safety and Wellbeing, and usual practice; the first two were five-minute daily practices woven into the school day, while the third was an eight-lesson mental health literacy course about personal safety and identifying who to turn to. The trial covered 20,489 pupils in 213 schools and measured self-reported emotional difficulties alongside intended help-seeking; help-seeking is the one outcome where a positive and statistically significant result appears.
正念练习 中学有希望小学不建议
正念练习在整体上没有产生统计显著的改善，短期与 9 到 12 个月后的随访都是这个结果。分组分析里出现了更细的图景：小学女生的情绪困难在短期内有所缓解，中学里原本情绪困难较多的学生在短期也看到改善。反方向的信号同样存在，小学里有特殊教育需要的学生、以及原本症状较多的学生，在 9 到 12 个月后情绪困难反而更高。报告因此给出的建议是中学在持续稳定交付的前提下可以尝试正念，小学不建议采用。这条结论提醒读者，同一套做法落到不同年龄段，风险与收益可以完全不同。
Mindfulness showed no overall statistically significant improvement at either follow-up, but subgroup analysis adds nuance; girls in primary schools and pupils with higher prior difficulties in secondary schools improved in the short term. The reverse signal is equally real, since primary pupils with special educational needs or higher prior symptoms reported more emotional difficulties nine to twelve months later. The briefing therefore suggests mindfulness is promising in secondary schools when delivered consistently, and recommends against it in primary schools.
放松练习 小学可行中学不建议
放松练习的整体结果与正念类似，两次随访都没有统计显著差异。差别出在实施强度上：在小学，如果放松练习能规律持续地做，学生的情绪困难会下降。在中学，做得越频繁反而与更高的情绪困难水平相关，而且这个现象在中等与高交付水平上都出现了。分组分析还发现，小学里少数族裔学生的获益更明显，中学里女生与原本有心理健康困难的学生也看到改善。报告的落点是放松练习在小学值得推荐，前提是规律、持续；在中学不推荐。很多学生以为练习越勤越好，这份数据恰好说明强度不是越高越好。
Relaxation produced similarly flat overall results across both follow-ups, and the difference sits in delivery intensity; regular and consistent practice in primary schools came with a fall in emotional difficulties, whereas more frequent use in secondary schools was associated with higher emotional difficulties at both moderate and high compliance. Subgroup analysis found clearer gains for pupils from minority ethnic groups in primary schools and for girls and pupils with prior difficulties in secondary schools; the briefing recommends relaxation in primary schools only, provided it is delivered regularly.
安全与福祉策略 八节课与求助意愿
八节课的安全与福祉策略是五套做法里唯一在主要结局上拿到显著结果的一套。在小学，它显著提高了学生的求助意愿；在中学，只有把全部课都上完的学校才出现求助意愿上升。分组分析显示，小学里没有特殊教育需要、也不领取免费校餐的学生改善更明显，城市学校的效果也更好。报告给出的解释是，这些孩子过去较少接触支持服务，如果没有这门课，他们可能更不了解去哪里求助。结论是小学推荐采用，但可能需要在后续学年安排复习课来维持效果；中学属于有希望，前提是把课上全。
Strategies for Safety and Wellbeing is the only one of the five approaches with a statistically significant result on the main outcome; it lifted intended help-seeking in primary schools, and in secondary schools the rise appeared only where every session was delivered. Improvements concentrated among primary pupils without special educational needs or free school meal eligibility, and in urban schools, possibly because those children had less prior contact with support services. The briefing recommends it for primary schools with refresher sessions in later years, and calls it promising in secondary schools only when delivered in full.
为什么小学与中学的结论会相反
同一套做法在两个学段表现相反，这不是数据出错，而是交付条件不同。小学生的情绪表达更依赖老师带着做，五分钟练习只要天天做就有机会变成习惯；中学生的课表更碎、科目更多，同样五分钟很容易被其他安排挤掉。报告反复提到交付剂量与完整性，两者直接决定结果的方向。中学的反向结果集中在放松练习与正念练习上，暗示青春期学生对被安排的放松可能有抵触。学校在选做法时，先看本校能不能稳定执行，再看效果数据，顺序反了就容易白花钱。很多学生以为这类课程是走过场，实际上交付记录本身就是评估的一部分。
The reversal between phases reflects delivery conditions rather than faulty data; primary pupils rely more on a teacher leading a five-minute practice, which has a fair chance of becoming a habit when it happens daily, while secondary timetables fragment easily and the same five minutes gets squeezed out. The reports return repeatedly to dosage and completeness, because those two variables decide the direction of the result; the negative secondary findings cluster around relaxation and mindfulness, hinting at teenage resistance to scheduled calming. Schools should first ask whether they can deliver a practice consistently and only then look at the effect data.
评估方法 整群随机对照与两次随访
两项试验都采用整群随机对照设计，随机化的单位是学校，不是单个学生。这样做是为了避免同校学生互相交流造成的干扰，也让整班一起上课的安排更自然。测量时点有两个，干预开始后 3 到 6 个月的短期随访，以及干预后 9 到 12 个月的长期随访。主要结局是学生自报的情绪困难，量表覆盖焦虑与低落两类体验。次要结局包括心理健康知识、积极行为与求助意愿，部分指标只在特定试验里测量。整群设计会影响统计功效，这也是为什么报告在解读小效应时会格外谨慎。
Both trials used a cluster randomised controlled design, randomising whole schools rather than individual pupils so that classmates could not contaminate each other and lessons could run with intact classes; measurement happened at three to six months and again at nine to twelve months. The primary outcome was self-reported emotional difficulties covering anxiety and low mood, while knowledge, positive behaviours and intended help-seeking served as secondary outcomes measured in selected trials only; cluster designs affect statistical power, which is why the reports treat small effects carefully.
教育部下一步 推广哪一套做法
评估结果直接接到了政策动作上。英国教育部已确认会为安全与福祉策略提供教师培训，先在小学与中学两个学段铺开，让学生在课上接触求助路径与情绪管理。这个选择有数据依据：它是五套做法里唯一在主要结局上显著的，也是唯一被推荐为主流做法的课程。正念与放松被限定在特定学段与特定交付条件下，YAM 与 The Guide 则因为长期效果中的负面信号没有进入推荐名单。成本与效果并不总是一致，成本效果分析显示部分做法在健康相关生活质量指标上有较高概率被认为划算。主要结局没有改善时，这个结论不足以支撑推广，这一点在报告里写得很清楚。
The findings fed straight into policy: the Department for Education has confirmed training for staff to deliver Strategies for Safety and Wellbeing across primary and secondary schools, so pupils meet help-seeking routes and emotional management in lessons. That choice follows the evidence, since it is the only approach with a significant main-outcome result and the only one recommended as mainstream practice; mindfulness and relaxation stay tied to particular phases and delivery conditions, while YAM and The Guide are left out because of negative longer-term signals. Cost and effect do not always align, and cost-effectiveness results based on health-related quality of life are not enough on their own when the main outcome does not move.
心理健康支持团队与全校方法的现况
课程之外，英格兰还在铺开心理健康支持团队，由教育与医疗系统共同出资。gov.uk 公布的 2025 至 2026 学年数据里，覆盖范围内的学生约 580 万名，占全部学生的 60%，公立中学的覆盖率接近 79%。团队以巡回方式服务多所学校，平均一支团队对接 17 所学校、约 8,200 名学生。每所学校还要设一名高级心理健康负责人，这个岗位自 2021 年 9 月起配有每人 1,200 英镑的培训拨款，首批覆盖约 7,800 所学校。课程、团队、负责人三条线并行，是这批文件里反复提到的全校方法。很多学校目前只做到其中一条线，另外两条还在补。
Beyond lessons, England has been rolling out mental health support teams funded jointly by education and health; figures published on gov.uk for the 2025 to 2026 academic year put coverage at about 5.8 million pupils, or 60 per cent, with nearly 79 per cent of secondary schools reached. Teams travel between schools and each one supports roughly 17 settings and 8,200 pupils on average, while every school is expected to name a senior mental health lead supported by a 1,200 pound training grant from September 2021, initially covering about 7,800 schools. Lessons, teams and named leads running in parallel is the whole-school approach these documents keep returning to, and many schools have only one of the three in place.
家长与学校怎么用这份评估结果
对家长而言，这份报告最有用的部分不是结论标签，而是交付条件。如果学校说在做正念或放松，问清频率、由谁带、持续多久，比问效果好不好更实际。如果学校在小学阶段推安全与福祉策略，可以留意后面学年有没有安排复习课，报告明确说效果需要维持。常见的错误是看到无显著差异就认定做法没用，实际上不少做法在特定人群与特定交付水平下是有改善的。另一个常见的错误是把成本效果分析当成效果证据，两者测量的东西不同。很多学生以为心理健康课就是聊聊天，真正被评估的部分包括知识、行为与求助意愿三类可测指标。
For parents, the useful part of this report is delivery rather than labels; when a school says it runs mindfulness or relaxation, ask how often, who leads it and for how long, because those answers predict more than a general verdict. Where a primary school adopts Strategies for Safety and Wellbeing, check whether refresher sessions appear in later years, since the briefing is explicit that effects need maintaining. A common mistake is reading no significant difference as proof that an approach is useless, when several approaches helped particular groups at particular delivery levels; another is treating cost-effectiveness analysis as evidence of effect, because the two measure different things.
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