Implementing an evidence-based 'identification-to-intervention' approach through school Mental Health Support Teams: A qualitative study of expected implementation determinants
Abstract
Background: Anxiety disorders are highly prevalent in childhood and are associated with academic and social difficulties. Although effective early interventions exist, many children do not access support due to complex referral routes and limited-service provision. ‘Identification-to-intervention’ (i2i) approaches address these barriers by combining universal screening with a targeted therapist-guided parent-led online intervention. In England, Mental Health Support Teams (MHSTs) deliver evidence-based interventions in schools so may be well-placed to implement i2i approaches. We lack understanding of factors which might influence implementation of i2i for child anxiety problems in a routine practice context.
Method: Semi-structured interviews were conducted with MHST staff (n=16), primary school staff (n=6), and parents/carers (n=6) across England. Interviews were guided by the Consolidated Framework for Implementation Research (CFIR 2.0)’s implementation determinants and analysed using template analysis.
Findings: i2i was viewed as a simplified and accessible route to early mental health support. Participants identified barriers to parents/carers accessing i2i, including stigma-related concerns, literacy or language challenges, and limited familiarity with MHSTs. MHST staff felt i2i aligned with their remit and current skillset. Although some school and MHST staff viewed i2i as timesaving, others anticipated workload increases. Usual referral and clinical data management systems would need adjustment to allow direct contact from parents and the collection of screening data.
Conclusions: i2i approaches are considered acceptable and appropriate across parents/carers, school staff and MHSTs, but structural barriers associated with MHSTs would need to be addressed to optimise implementation.
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BibTeX
@misc{phillips2026implementing,
title = {{Implementing an evidence-based 'identification-to-intervention' approach through school Mental Health Support Teams: A qualitative study of expected implementation determinants}},
author = {Alice Phillips and Rosie Underhill and Michael Larkin and Professor Cathy Creswell and Rachel McGuire and Hollie Edwards and Catherine Gallop and Ian MacDonald and Falko Sniehotta and Tessa Reardon},
howpublished = {PsyArXiv},
year = {2026},
month = sep,
doi = {10.31234/osf.io/v5jsz_v1},
url = {https://osf.io/preprints/psyarxiv/v5jsz_v1/},
note = {CC BY 4.0},
}
RIS
TY - UNPB
TI - Implementing an evidence-based 'identification-to-intervention' approach through school Mental Health Support Teams: A qualitative study of expected implementation determinants
AU - Alice Phillips
AU - Rosie Underhill
AU - Michael Larkin
AU - Professor Cathy Creswell
AU - Rachel McGuire
AU - Hollie Edwards
AU - Catherine Gallop
AU - Ian MacDonald
AU - Falko Sniehotta
AU - Tessa Reardon
PY - 2026
DA - 2026/09/11
PB - PsyArXiv
DO - 10.31234/osf.io/v5jsz_v1
UR - https://osf.io/preprints/psyarxiv/v5jsz_v1/
AB - Background: Anxiety disorders are highly prevalent in childhood and are associated with academic and social difficulties. Although effective early interventions exist, many children do not access support due to complex referral routes and limited-service provision. ‘Identification-to-intervention’ (i2i) approaches address these barriers by combining universal screening with a targeted therapist-guided parent-led online intervention. In England, Mental Health Support Teams (MHSTs) deliver evidence-based interventions in schools so may be well-placed to implement i2i approaches. We lack understanding of factors which might influence implementation of i2i for child anxiety problems in a routine practice context. Method: Semi-structured interviews were conducted with MHST staff (n=16), primary school staff (n=6), and parents/carers (n=6) across England. Interviews were guided by the Consolidated Framework for Implementation Research (CFIR 2.0)’s implementation determinants and analysed using template analysis. Findings: i2i was viewed as a simplified and accessible route to early mental health support. Participants identified barriers to parents/carers accessing i2i, including stigma-related concerns, literacy or language challenges, and limited familiarity with MHSTs. MHST staff felt i2i aligned with their remit and current skillset. Although some school and MHST staff viewed i2i as timesaving, others anticipated workload increases. Usual referral and clinical data management systems would need adjustment to allow direct contact from parents and the collection of screening data. Conclusions: i2i approaches are considered acceptable and appropriate across parents/carers, school staff and MHSTs, but structural barriers associated with MHSTs would need to be addressed to optimise implementation.
ER -