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1945 Breathe education: developing an annual census of wellbeing in pupils from schools in Birmingham UK
  1. Colin Palmer1,
  2. Paul Patterson2,
  3. Helena Tuomainen3
  1. 1Birmingham Women’s and Children’s NHS Hospital Trust/University of Warwick
  2. 2Forward Thinking Birmingham
  3. 3University of Warwick


Objectives A major aim of the Breathe Education project is to develop digital infrastructure and online resources to increase earlier support for young peoples mental health and wellbeing in schools and early years settings. As part of the initial strategy we planned and initiated an annual wellbeing census of children and young people’s mental wellbeing, providing strategically useful big-data supporting early intervention and prevention practices in all primary and secondary schools in Birmingham. The pilot study, reported here, was planned as a ‘proof of concept’ to identify and address an appropriate methodology to ensure positive functionality of the bespoke survey software (Breathe Digital:, and to explore wellbeing within the pilot schools. This work is a collaboration between staff from local NHS services; Birmingham City Council’s Public Health & Education departments; Birmingham Education Partnership and the University of Warwick.

Methods We developed an annual longitudinal survey of students’ wellbeing employing the bespoke survey software. It allows for the collection of wellbeing data from large cohorts of pupils, and is intended to be repeated with them and expanded to other schools over an initial 5 year period. For the pilot study, in spring/summer 2021, we recruited 11 primary and 5 secondary schools. Pupils completed the Stirling Children’s Wellbeing Scale (SCWBS, primary schools) or the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS, secondary schools), along with a 4-item questionnaire on school connectedness. Demographic data was obtained from existing data available from schools.

Results N=3,437 participants completed the census, representing a recruitment rate of 48% of all pupils on school rolls (7,500). Across primary schools, the overall mean score for wellbeing was 46.6, (SD:8.06), higher than the population average of 43.5 (SD:6.66). Across secondary schools, the overall average score for wellbeing was 46.8 (SD:9.2), slightly lower than the population average of 48.3. There was a significant difference between school connectedness scores for primary (Mean = 16.5, SD = 3.5) and secondary schools (Mean = 13.6, SD:3.9) t= 22.42, p<.000) with secondary schools scoring on average 2.8 lower than primary schools.

Conclusions The pilot project was successful in creating shared wellbeing data across different schools in Birmingham, for use as a measure to inform individual school wellbeing policies and for the creation of a regional metric for ongoing public health planning and comparison work. Despite the pressures of the COVID-19 pandemic we were able to recruit a sample of primary and secondary school pupils at similar levels to national population studies. The 2022 wellbeing census is currently being completed with involvement of over 10,000 pupils. We have demonstrated that a collaborative strategic annual census of student wellbeing can be developed as part of the intelligence infrastructure required to contribute to strategic improvement of young peoples mental health and improved targeting of health and wellbeing resources.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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