This article describes the research methodology, findings, and authors’ conclusions regarding a study designed to evaluate the effectiveness as well as cost-effectiveness of school-based mindfulness training compared with teaching-as-usual for adolescents.
Systematic reviews suggest school-based mindfulness training (SBMT) shows promise in promoting student mental health. This article reports on the My Resilience in Adolescence (MYRIAD) Trial, which evaluated the effectiveness and cost-effectiveness of SBMT compared with teaching-as-usual (TAU). MYRIAD was a parallel group, cluster-randomized controlled trial. Eighty-five eligible schools consented and were randomized 1:1 to TAU or SBMT, stratified by school size, quality, type, deprivation, and region. Schools and students were broadly UK population-representative. Forty-three schools delivering SBMT, and 41 schools 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-behavioral functioning, and well-being at the one-year follow-up were the co-primary outcomes. Secondary and economic outcomes were included. Analysis of 84 schools found no evidence that SBMT was superior to TAU at the one-year follow-up. The authors discuss the standardized mean differences (intervention minus control) for risk for depression, social-emotional-behavioral functioning, and well-being. SBMT had a high probability of cost-effectiveness (83 percent) at a willingness-to-pay threshold of £20 000 per quality-adjusted life year. No intervention-related adverse events were observed. The authors conclude that findings do not support the superiority of SBMT over TAU in promoting mental health in adolescence. They also state that there is need to ask what works, for whom and how, as well as considering key contextual and implementation factors. Publisher Abstract Provided