MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

The ‘My Resilience in Adolescence (MYRIAD) Trial’evaluated the effectiveness and cost-effectiveness of SBMT compared with teaching-as-usual (TAU).

MYRIAD was a parallel group, cluster-randomised controlled trial. Eighty-five eligible schools consented and were randomized 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.

An analysis of the data from 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.

The authors concluded that the findings do not support the superiority of SBMT over TAU in promoting mental health in adolescence.

Even though the results are negative, MYRIAD must be praised for its scale and rigor, and for highlighting the importance of large, well-designed studies before implementing measures of this kind on a population basis. Co-author Tim Dalgliesh, director of the Cambridge Centre for Affective Disorders, said: “For policymakers, it’s not just about coming up with a great intervention to teach young people skills to deal with their stress. You also have to think about where that stress is coming from in the first place.”

“There had been some hope for an easy solution, especially for those who might develop depression,” says Til Wykes, head of the School of Mental Health and Psychological Sciences at the Institute of Psychiatry, Psychology, and Neuroscience, King’s College London. “There may be lots of reasons for developing depression, and these are probably not helped by mindfulness,” she says. “We need more research on other potential factors that might be modified, and perhaps this would provide a more targeted solution to this problem.”

Personally, I feel that mindfulness has been hyped in recent years. Much of the research that seemed to support it was less than rigorous. What is now needed is a realistic approach based on sound evidence and critical thinking.

8 Responses to School-based mindfulness training is not effective

  • I am having also fact based research on Mindfulness and Meditation.

  • For once, I will provide anecdotal evidence: mindfulness training has always driven me almost crazy and when I had to do it (e.g. also in job training) I felt it was encroaching. It’s just not for me. And apparently I’m not alone in this. To proclaim mindfulness as a general therapy method seems inappropriate to me. For a long time there have been indications of real adverse effects, not only on a small scale, and recent studies have confirmed this more and more.

    https://www.psychologytoday.com/us/blog/mindfulness-insights/202107/the-potential-dangers-mindfulness

  • Although the study said no intervention-related adverse events were observed, I wonder if they included whether or not those who received MT then had an increased propensity to believe in other BS? Could the participants be ‘de-programmed’ afterwards to counter what thay had been taught?

  • It seems to me that every time there is a new Government, one of the things that they do is to change the educational system on the basis of somebody’s untested theories. This trial is to be commended as a demonstration that it is possible to perform a rigorous randomised trial in schools and (hopefully) to have an outcome that informs educational practice in the future.

    The NHS has been striving to be evidence-based for a long time. I hope the UK state education system can take notice of this study and follow suite.

  • Vipassana meditation (www.dhamma.com) cured my more than a decade long severe (suicidal ideation) depression. I remember precisely the exact moment it lifted during a retreat, never to return. But originally to get out of the bottom of the hole that I was in I did a lot of nutritional supplementation. That probably got me 60-80% back so that I could at least function, so that I could handle several 10 day meditation retreats. I think crappy nutrition is a big factor in how widespread depression and other psychological disorders are in modern society. IMO, Its usually going to be a combination of factors including societal & family pressures; personally I didnt have much of that.

    Not all mindfulness is the same. There is no one answer for depression.

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