School-based Mental Health Interventions Research Articles

Mental Health Interventions in Middle Schools: A 10-Year Review of Research.

Schools can play an important role in addressing growing concerns about adolescent mental health. Mental health of high school students has predominantly been the focus in literature with less emphasis on younger adolescents. This review identified articles published in the last decade that described evaluations of middle school-based mental health interventions and randomized participants to an intervention or control condition. Fourteen interventions met the inclusion criteria. About two-thirds of interventions were based on mindfulness or cognitive behavioral therapy. Many trials utilized racially diverse, low-income samples. All interventions were delivered to groups, and three contained a parent component. Five trials increased rigor by using an active control condition. Almost two-thirds of the interventions were effective (p < .10) in reducing at least one depression, anxiety, affect, or internalizing symptom outcome compared to a control group. This article provides information about intervention characteristics, efficacy, theoretical framework, and acceptability/feasibility.

School-Based Mental Health Counseling with Black Males in Title I Elementary School

Our study investigated changes in Black male children’s (N = 22) psychosocial functioning who participated in a school-based mental health counseling intervention at three Title I elementary schools. We collected the participating children’s psychosocial functioning data before their first counseling session, after the fifth session, and again after the tenth session. The results of the analyses for this single group design identified that the participants’ emotional and social behaviors changed over time, per parent report (η2 = .214). This study provides valuable implications for counselors working with Black male youth, highlighting the effectiveness of school-based mental health interventions in addressing the psychosocial needs of this population. This study’s findings also suggest that interventions focused on improving social-emotional functioning can have significant positive impacts on the mental health and wellbeing of Black male children.

Stress, Mental Health, and Risk-Taking: Associations among a Sample of Agricultural Adolescents.

Farm stress and mental health research has largely focused on adult producers, even though youths live and work on farms. The purpose of this study is to describe the stress and mental health experience of agricultural youths and describe participation in risk-taking behaviors. Farm families in the U.S. were invited to participate in an online survey that inquired about farm economics, stress (ASQ-S), mental health (PHQ-A and SCARED), parenting, social support, and risk-taking behaviors during the summers in 2021 and 2022. This analysis is limited to adolescent respondents (N = 298). Just over 70% of the farm adolescent sample met the criteria for at least mild symptoms of depression (PHQ-A score ≥ 5). Among anxiety disorders, 62.8% of the farm adolescent sample met the criteria for probable panic disorder, and 70.5% met the criteria for probable separation anxiety disorder. Adolescents reported the most stress around future uncertainty and school performance. The stress scores were significantly associated with more symptoms of depression. Over a quarter (27.7%) of the participants reported carrying a weapon at least 1 day in the past month, and 22.5% reported carrying a weapon on school property at least 1 day in the past month. Violence-related risk-taking behaviors were also associated with increased symptoms of depression. The results underscore the need for community- and school-based stress and mental health interventions in rural and agricultural communities.

Brief School-Based Interventions Targeting Student Mental Health or Well-Being: A Systematic Review and Meta-Analysis.

Brief, school-based mental health interventions hold promise for reducing barriers to mental health support access, a critical endeavor in light of increasing rates of mental health concerns among youth. However, there is no consensus on whether or not brief school-based interventions are effective at reducing mental health concerns or improving well-being. This systematic review and meta-analysis aims to provide consensus and determine directions for future work. Articles were included if they examined a brief (≤ four sessions or 240min of intervention time) psychosocial intervention, were conducted within a Pre-K through 12th-grade school setting, included at least one treatment outcome evaluating mental health or well-being, and were published since 2000. A total of 6,702 papers were identified through database searching, of which 81 papers (k studies = 75) were ultimately selected for inclusion. A total of 40,498 students were included across studies and a total of 75 unique interventions were examined. A total of 324 effect sizes were extracted. On average, interventions led to statistically significant improvements in mental health/well-being outcomes versus control conditions up to one-month (g = .18, p = .004), six-month (g = .15, p = .006), and one-year (g = .10, p = .03) post-intervention. There may be benefits to brief school-based interventions from a preventative public health standpoint; future research may focus on how to optimize their real-world utility. Prospero pre-registration: CRD42021255079.

Sustaining mental health and wellbeing programmes in schools: recommendations from an online roundtable

Despite recent investments in school-based mental health and wellbeing promotion in England, the sustainability of mental health interventions remains a substantial challenge. This article brings together potential solutions to sustaining interventions in schools, drawing on insights from an online roundtable discussion held in July 2022. Facilitated by researchers and informed by recent research on barriers and facilitators to sustaining school-based mental health interventions, 16 participants came together to discuss challenges and solutions. Participants included school staff, policy makers, educational psychologists, researchers and mental health intervention developers. The discussion explored the need for accountability at all levels (e.g., from school leaders to policy makers and Ofsted) and the potential value of engaging schools more consistently with academic evidence. Participants also discussed the importance of creating a healthy and sustainable ecosystem for interventions (underscoring the significance of staff wellbeing, adequate resourcing, and longer-term funding commitments), and moving beyond separate, isolated interventions. The findings offer a range of recommendations for school decision makers, mental health researchers, intervention developers, and those working in the wider system around schools.

School-Based Mental Health Interventions: Recommendations for Selecting and Reporting Implementation Strategies.

School-Based Mental Health Interventions: Recommendations for Selecting and Reporting Implementation Strategies.

Research recommendations for assessing potential harm from universal school-based mental health interventions

Research recommendations for assessing potential harm from universal school-based mental health interventions

Streaking and self-care planning: the influence of integrating a well-being initiative in one teacher education program

ABSTRACT Concerns about teacher burnout, compassion fatigue, and retaining early career professionals have prompted teacher education programs to seek out ways to promote mental and emotional health during pre-service teacher training. This two-year, educational design study explored pre-service teachers’ experiences with the implementation of two school-based mental health interventions: the intentional introduction of self-care planning during field experience practicums, and the promotion of ‘streaking’, a health promotion event, to encourage pre-service teachers to implement a daily individual mental health intervention. Data were collected at several different points over a two-year period through surveys and individual interviews. The data analysis indicated that this two-tiered approach holds promise as a health promotion activity, however other intentional and educational actions were needed to ensure that pre-service teachers had the resources and tools required to support their mental and emotional health during their practicum courses. A further finding suggested that the term ‘self-care’ was widely misunderstood by study participants and work is needed to help pre-service teachers understand the importance of self-care during their practicum as a prevention strategy for well-being once they begin their teaching career.

Examining the Classroom Impact of the Bounce Back Trauma Intervention: Implications for Selecting Progress Monitoring Tools

Limited research has examined the impact of Bounce Back (BB), a trauma-focused intervention for elementary-age students, on student academic engagement and daily classroom behavior. This study utilized both ongoing direct and indirect measures of student functioning to evaluate student progress and inform the implementation of BB. Participants were six U.S. students (four male and two female). We employed an AB single-subject design across cases with follow-up, and we collected data via the Direct Behavior Rating–Single Item Scale (DBR-SIS). We also employed a quasi-experimental pretest–posttest design using the Strengths and Difficulties Questionnaire (SDQ), Social, Academic, and Emotional Behavior Risk Screener (SAEBRS), and mySAEBRS across raters before/after intervention implementation. We found either direct or indirect assessment could be used to monitor intervention effectiveness for youth who presented with some internalizing and externalizing problems, whereas indirect measures (i.e., rating scales) showed the primary effect for youth with solely internalizing problems, and direct assessment (i.e., DBR-SIS) showed the primary effect for youth with predominantly externalizing behaviors. Selecting progress-monitoring tools based on presenting concerns is important to adequately monitor the effectiveness of school-based mental health interventions. Implications for practice are discussed.

Effects of a school-based, post-pandemic recovery intervention on Canadian educators

Although copious research has documented elevated stress and burnout in teachers worldwide during the COVID-19 pandemic, few studies have provided empirical evidence of effective interventions to support post-pandemic educator recovery and resilience. Attention to educator well-being is essential not only to healthy schools, but also to preventing teacher shortages. In the current study, Canadian educators (n = 621) who participated in a school-based mental health intervention program offered by a national mental health organization demonstrated significantly higher levels of well-being and recovery post-intervention than pre-intervention. Moreover, when compared with a control group (n = 86), the intervention group demonstrated significantly higher levels of connectedness, recovery, well-being, and resilience, although no differences in organizational commitment were demonstrated. Implications on teacher attrition and shortages are discussed.

33.3 Improv Training as a School-Based Mental Health Intervention

33.3 Improv Training as a School-Based Mental Health Intervention

Depressed, disconnected, and distraught: School-based mental health intervention for rural youth.

Depressed, disconnected, and distraught: School-based mental health intervention for rural youth.

Effectiveness of Adolescent School-Based Digital Mental Health Interventions: A Systematic Review

Purpose: This review aimed to investigate the effectiveness of digital school-based mental health interventions for adolescents in Sub-Saharan Africa. Method: The authors conducted a comprehensive search of digital school-based mental health interventions to identify studies conducted in Sub-Saharan Africa targeting adolescents between the ages of (10–19) years. Peer-reviewed studies published in English between 2009 and May 2023 were obtained through electronic bibliographic databases. Result: Only one study met the full inclusion criteria for this review. The included study tested a digital mental health intervention (“Shamiri Digital”) for treating depression, anxiety, and well-being in adolescents. The “Shamiri Digital” intervention demonstrated positive outcomes on depressive symptoms within the full sample. Discussion: The dearth of studies investigating digital mental health solutions for adolescents in low-income countries demonstrates a critical gap in intervention and research for adolescent mental health in resource constrictive settings

Health Services Use Among Children With Prenatal Substance Exposure or Neonatal Abstinence Syndrome.

Infants with prenatal substance exposure or neonatal abstinence syndrome (NAS) use health services more often than other children; however, little is known about their use of mental health services and psychotropic medication. The sample (N=1,004,085) consisted of infants born in 2016 in 38 states who were followed through the fifth year of life and enrolled each year in Medicaid or the Children's Health Insurance Program. Infants with prenatal substance exposure or NAS were identified with ICD-10 diagnosis codes; procedure and revenue codes documented their service use. Rates of any mental health visit and of psychotropic medication use were higher among infants with prenatal substance exposure or NAS compared with infants without either condition; these patterns persisted during most years of the 5-year study. Infants' elevated mental health services use through their first 5 years of life highlights the importance of early screening and subsequent engagement in school-based mental health interventions.

Co-Creation of a School-Based Motor Competence and Mental Health Intervention: Move Well, Feel Good.

Low motor competence (MC) and inhibited psychosocial development are associated with mental health difficulties. Improving children's MC through school-based physical activity interventions emphasising psychosocial development may therefore be a mechanism for promoting positive mental health. This study describes and provides reflective insights into the co-creation of 'Move Well Feel Good', a primary school physical activity intervention to improve children's MC and mental health. Class teachers, school leaders, physical activity specialists, and children (aged 8-9 years) participated in a series of co-creation workshops. Stakeholders' knowledge and experiences were integrated with existing research evidence using creative methods (e.g., post-it note tasks, worksheets, and drawings) to facilitate discussion. The co-creation process culminated in stakeholder consensus voting for one of three proposed intervention ideas. Children cited physical and mental health benefits, enjoyment with friends, and high perceived competence as motives for being physically active. Opportunities to develop MC across the different segments of the school day were identified by adult stakeholders, who perceived children's lack of resilience, an overloaded curriculum, and poor parental support for physical activity as barriers to intervention implementation. The chosen intervention idea received six out of a possible twelve votes. Co-creation projects are specific to the contexts in which they are implemented. This study reinforces the complex nature of school-based intervention development and highlights the value of engaging with stakeholders in co-creation processes.

Understanding interventions as social practices: How a school-based mental health intervention for migrant adolescents in Denmark interacted with context

The rise of school-based mental health interventions calls for an understanding of how such interventions interact with context as well as analytical tools for examining these interactions. This article explores how learners and teachers in two classrooms for newly-arrived migrant adolescents in Denmark (one urban, highly diverse classroom and one small-town classroom mainly serving youth who had fled armed conflict) experienced and implemented the same teacher-led, classroom-based intervention differently. Based on participant observations and interviews with three teachers and 12 learners, we draw on practice theory to disentangle how the same intervention came to life differently in the two classrooms. First, there were important differences in how teachers and learners in the two classrooms made sense of their participation in the intervention, reflecting the different life situations and psychosocial needs of the learners. Second, local ways of structuring educational practices (weekly schedules, expectations about homework, and different local educational policies) critically shaped intervention experiences and implementation. Third, the possibility of establishing a safe social space during the intervention depended on the stability of existing social relationships and conditions for teachers’ relational work in the classrooms. To aid analyses of how school-based interventions interact with classroom practices, and to help identify ways of consolidating interventions with their contexts, we propose future avenues for examining school-based mental health interventions in context from a social practice perspective.

Non-Positive Experiences Encountered by Pupils During Participation in a Mindfulness-Informed School-Based Intervention

Mindfulness-informed school-based mental health curricula show much promise in cultivating a positive school climate which supports the well-being and mental health of pupils and staff. However, non-positive pupil outcomes and experiences of school-based mental health interventions are often under-recognised and under-reported. This study sought to capture non-positive pupil experiences of a popular mindfulness-informed curriculum. Some pupils across all schools in the study described non-positive experiences, including having troubling thoughts and emotions, and not finding the programme effective. Contexts surrounding these experiences are explored and linked to existing literature, and subsequent recommendations for improvements are made, including the importance of having clear programme structure, definitions and aims, acknowledging and accommodating fidelity issues as best as possible, and better highlighting the potential for non-positive experiences and how they may be reduced.

Minding the gap: Evidence, implementation and funding gaps in mental health services delivery for school-aged children

State and local educational agencies are grappling with growing mental health needs among school-aged children that intensified during the COVID-19 pandemic. We undertake a case study of the experiences of one state, Tennessee, to examine the landscape of mental health interventions that are being deployed and to illuminate contextual factors that can support their implementation or exacerbate state and local challenges in addressing children’s fast-rising mental health needs. We begin with an examination of the knowledge base on interventions and approaches that are commonly employed in K-12 schools to address children’s mental health needs, including in Tennessee, with the aim to identify notable gaps in what we understand about their implementation and impacts on student outcomes. We find a lack of rigorous research that can inform efforts to improve the implementation and effectiveness of school-based mental health interventions. We bring this insight to our case-study analysis, which shows that this lack of guidance from research is compounded by inadequate, time-limited and fluctuating public funding that hinders local efforts to establish strong, ongoing programs that provide or connect K-12 students to essential mental health services. We call for more federal funding to support state and local implementation of proven and promising interventions for addressing children’s mental health needs and more rigorous evaluations to strengthen the evidence base on their implementation and impacts.

School Mental Health as a Public Health Strategy: Progress, Implementation, and Sustainability Considerations

Mental health is an immediate concern for public health and government officials due to the increase in mental ill health issues among young people and adults. School-based mental health services (SBMHSs) have grown rapidly in recent years, in response to this, as policy debates focus on the health and economic implications of mental for individuals and society. School-based mental health programs are focused on identifying, intervening, and providing mental health support to children and young people through the promotion of mental health and well-being within schools. With their increased presence and funding in both high- and low-income countries, concerns have been raised regarding their effectiveness, implementation, and sustainability as a means of early intervention and reducing adult mental health issues. While there are some promising results on the effectiveness of SBMHS, many barriers have been identified which hinder the implementation and sustainability of these services. Barriers include cultural and contextual factors for local adaptation; the specifics of intervention delivery; school capacity, leadership, and commitment; and system-level factors such as frameworks, policies, and government support. The research findings highlight that barriers and facilitators for the implementation and sustainability of school-based mental health interventions are not dissimilar to those observed in health, improvement, and educational interventions. As such, further research is needed to provide clarity on the principles needed to implement and sustain school-based mental services which effectively provide relevant and timely access to mental health support and services to children and young people.

Missing the context: The challenge of social inequalities to school-based mental health interventions.

Given well-established links between socio-economic adversity and mental health, it is unsurprising that young people's mental health is deteriorating amidst economic crises. The World Health Organisation (WHO) recognises mental health as "crucial to personal, community, and socio-economic development" and outlines goals to reshape environments such as schools to protect mental health. Schools offer an ideal setting to promote wellbeing and prevent mental ill-health during a key developmental window. We describe how social inequalities present a challenge to designing school-based interventions for prevention and promotion for mental health and wellbeing, and suggest priorities to aid and evaluate their effectiveness.