Only approximately half of children and young people (CYP) with mental health difficulties access mental health services in England, with under-identification of need as a contributing factor. Schools may be an ideal setting for identifying mental health difficulties in CYP, but uncertainty remains about the processes by which these needs can best be identified and addressed. In this study, we conducted a two-round, three-panel Delphi study with parents, school staff, mental health practitioners, and researchers to inform the development of a program to identify mental health difficulties in primary schools. We aimed to assess and build consensus regarding (a) the aims of such a program, (b) identification model preferences, (c) key features of the identification model, and (d) key features of the implementation model. A total of 54 and 42 participants completed the Round 1 and 2 questionnaires, respectively. In general, responses indicated that all three panels supported the idea of school-based identification of mental health difficulties. Overall, 53 of a possible 99 items met the criteria for inclusion as program core components. Five main priorities emerged, including that (a) the program should identify children experiencing mental health difficulties across the continuum of severity, as well as children exposed to adversity, who are at greater risk of mental health difficulties; (b) the program should train staff and educate pupils about mental health in parallel; (c) parental consent should be obtained on an opt-out basis; (d) the program must include clear mechanisms for connecting identified pupils to care and support; and (e) to maximize implementation success, the program needs to lie within a school culture that values mental health and wellbeing. In highlighting these priorities, our study provides needed stakeholder consensus to guide further development and evaluation of mental health interventions within schools.

在英格兰，只有大约一半有心理健康困难的儿童和青少年 (CYP) 获得了心理健康服务，而对需求的认识不足是一个促成因素。学校可能是识别 CYP 中心理健康困难的理想场所，但如何最好地识别和解决这些需求仍存在不确定性。在这项研究中，我们与家长、学校工作人员、心理健康从业者和研究人员进行了一项两轮、三组的德尔福研究，以告知制定一项识别小学心理健康困难的计划。我们的目标是评估和建立关于 (a) 此类计划的目标、(b) 识别模型偏好、(c) 识别模型的关键特征和 (d) 实施模型的关键特征的共识。共有 54 名和 42 名参与者分别完成了第一轮和第二轮问卷。总体而言，答复表明所有三个小组都支持以学校为基础识别心理健康困难的想法。总体而言，可能的 99 个项目中有 53 个符合纳入计划核心组成部分的标准。出现了五个主要优先事项，包括 (a) 该计划应确定在整个严重程度中遇到心理健康困难的儿童，以及面临更大心理健康困难风险的逆境儿童；(b) 该方案应同时培训工作人员和教育学生有关心理健康的知识；(c) 应在选择退出的基础上获得父母同意；(d) 该计划必须包括明确的机制，将确定的学生与关怀和支持联系起来；(e) 为最大限度地提高实施成功率，该计划需要置于重视心理健康和福祉的学校文化中。在强调这些优先事项时，我们的研究提供了必要的利益相关者共识，以指导学校内心理健康干预的进一步发展和评估。