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Prior research on relations between mental health and pain has focused on negative mental health aspects (e.g. depression), while the literature is scarce in terms of positive aspects, such as mental well-being. This study aims to investigate prospective associations of mental well-being at baseline with pain and functional impairment due to pain in the following year.

Data stem from a Danish nationally representative survey of 5,000 adults (aged 15+) conducted in 2019 and 2020, which was linked to register data. The Short Warwick–Edinburgh Mental Well-being Scale was used to assess mental well-being, both continuously (range 7–35) and categorically (low, moderate, high). Logistic regressions were conducted to assess associations between mental well-being in 2019 and pain and functional impairment due to pain (among those reporting any pain) in 2020.

In the fully adjusted models, each point increase in mental well-being was inversely associated with pain (OR = 0.97, 95%CI 0.95–0.99) and functional impairment due to pain (OR = 0.96, 95%CI 0.94–0.99). As compared to low mental well-being, moderate mental well-being was associated with an OR of 0.76 (95%CI 0.58–0.99) for pain and an OR of 0.63 (95%CI 0.46–0.87) of functional impairment due to pain, while high mental well-being was associated with an OR of 0.56 (95%CI 0.40–0.77) for pain and an OR of 0.53 (95%CI 0.34–0.79) for functional impairment due to pain.

Higher mental well-being levels may be protective against pain and functional impairment due to pain. Wider mental health promotion may be considered to prevent pain and associated functional impairments in the general population.

The purpose of this paper is to examine the evaluation of a universal, mental well-being and mindfulness programme in a UK graduate entry medical school.

Mixed methods used in the paper were the measurement of mental well-being and mindfulness in two cohorts at three time points over 15 months; descriptive, regression and repeated measures analysis with post hoc pairwise comparisons; qualitative interviews with purposive sample of 13 students after one year analysed thematically; and spontaneous anonymous feedback on the course.

The course was a surprise to students, and reactions were mixed. Respect for its contents grew over the first year. Most students had actively implemented a well-being strategy by the end of the course, and an estimated quarter was practicing some mindful activity. In the context of an overall decline in well-being and limited engagement with mindfulness practice, increases in mindfulness were protective against this decline in both cohorts (p<001). A small minority of students thought that the course was a waste of time. Their attitudes influenced engagement by their peers. The mindfulness and well-being practices of the facilitators were evident to students and influenced perceived effects.

The uncontrolled nature of this observational study and low response rates to the survey limit conclusions. Further research in other medical education settings is needed.

Results are encouraging, suggesting modest benefit in terms of changing attitudes and practices and a modest protective effect on the well-being of students who engaged.

This is the first study of a universal well-being and mindfulness programme in a UK medical school. Universal programmes are rare and evaluation studies are scarce.

Reviews previous studies of the universal approach to mental health promotion, and disease prevention programmes or interventions in schools. Over 8,000 publications were identified initially and 425 studies obtained for further review. The inclusion criteria were met by 17 (mostly US) studies investigating 16 interventions. Positive evidence of effectiveness was obtained for programmes that adopted a whole‐school approach, were implemented continuously for more than a year, and were aimed at the promotion of mental health as opposed to the prevention of mental illness. Provides evidence that universal school mental health promotion programmes can be effective and suggests that long‐term interventions promoting the positive mental health of all pupils and involving changes to the school climate are likely to be more successful than brief class‐based mental illness prevention programmes.

There is a growing policy imperative to promote positive mental health as well as prevent the development of mental health problems in children. This paper summarises the findings of published systematic reviews evaluating such interventions. A search was undertaken of ten electronic databases using a combination of medical subject headings (MeSH) and free text searches. Systematic reviews covering mental health promotion or mental illness prevention interventions aimed at infants, children or young people up to age 19 were included. Reviews of drug and alcohol prevention programmes and programmes to prevent childhood abuse and neglect were excluded because these have been the subject of recent good quality reviews of reviews. A total of 27 systematic reviews were included. These targeted a range of risk and protective factors, and a range of populations (including parents and children). While many lacked methodological rigour, overall the evidence is strongly suggestive of the effectiveness of a range of interventions in promoting positive mental well‐being, and reducing key risk factors for mental illness in children. Based on this evidence, arguments are advanced for the preferential provision of early preventive programmes.

This paper reviews current evidence of the significance of interpersonal relationships ‐ at community, workplace, school and family levels ‐ in influencing mental health and well‐being. It argues that the parent‐child relationship is of pre‐eminent importance both because of its direct effect on future mental health and because it sets the scene for future relationships. It also argues that, because of the reciprocal nature of the relationships, the mental health of society can be improved by improving the mental health of any of its individual members. From this it follows that to focus mental health promotion programmes entirely on the most vulnerable limits the potential for improvement, because working with people who are not mentally ill will increase their ability to support those who are. Universal mental health promotion programmes should therefore have relationships ‐ and parent‐child relationships in particular ‐ at their heart, aiming to improve everyone's capacity to relate supportively and respectfully to others.

The paper's purpose is to participate in a debate about the role of randomised controlled trials in evaluation of preventive interventions for children.

The paper is a response to critiques on Stewart‐Brown et al. published in the Journal of Children's Services, Vol. 6 No. 4, pp. 228–35.

Randomised controlled trials are likely to be at their best in the evaluation of interventions that do not require the active engagement and personal development of participants. The latter may depend on a series of interventions and events that potentiate each other over time. Randomised controlled trials are likely to be least valuable in evaluating universal level interventions that aim to change population norms. Because of the challenges involved in conducting RCTs in this setting they cannot be relied upon to give accurate estimates of programme effect and therefore do not deserve the privileged position that has been accorded them in the hierarchy of evidence.

This paper develops the argument that the privileged position of RCTs in the evidence hierarchy of preventive services for children is undeserved.

The aim of this article is to summarise the available evidence from systematic reviews about the effectiveness of interventions to prevent or treat child physical abuse and neglect. A computerised search was undertaken of major electronic databases up to December 2005 using key search terms. Only systematic reviews were included in which the primary studies evaluated the effectiveness of targeted or indicated interventions for child physical abuse or neglect. A total of 31 systematic reviews were identified and 15 met all the inclusion criteria. They covered a range of interventions/services, including home visiting, parenting programmes, multi‐component interventions, intensive family preservation services, family‐focused casework and multi‐systemic family therapy. There was limited evidence of the effectiveness of services in improving objective measures of abuse and neglect, due in part to methodological issues involved in their measurement, but good evidence of modest benefits in improving a range of outcomes that are associated with physical abuse and neglect, including parental and family functioning and child development. The results also showed some interventions (eg. media‐based and perinatal coaching) to be ineffective with high‐risk families. The evidence provided by these reviews has clear implications for children's services in the UK and other western developed countries.