Recent years have seen an emphasis on delivering mental health and wellbeing support in school settings. However, the process by which schools meet this resource allocation challenge is largely undocumented. Our study used theory-building process tracing to develop a mechanistic understanding of the process of mental health investment in schools. We conducted in-depth case study work with four school sites in England, comprising 29 interviews and the retrieval and analysis of 95 documents. The empirical work was used to develop process theories to explain how and why high-investing schools allocated resources to wellbeing and mental health. Our work suggested high mental health investment was catalysed by either a perceived need or a change in ethos. The decision-making process then proceeded with some elements that aligned with conventional rational choice models (such as the comparison of alternatives) but also some important differences. Notably schools reacted to tradeoffs by seeking alternative, often informal, sources of funding and support for initiatives. In doing this they could develop "care capital" and enter a virtuous cycle of network building and investment. While this theory requires further exploration in other settings, it maybe be useful for researchers and policy-makers seeking to better understand how to support schools in allocating resources for mental health and wellbeing. In particular, it suggests that schools may benefit from support in how to harness external resources for mental health and wellbeing equitably and efficiently, alongside making best use of their internal resources.
Keywords: Case study; Decision-making; Mental health; Priority setting; Process tracing; Qualitative research; Resource allocation; Schools; Wellbeing.
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