Effectiveness of school-based mental well-being interventions among adolescents: A systematic review

Mental well-being trends and school-based protective factors among adolescents in British Columbia (2015-2022): A population-based study

BACKGROUND

Adolescent mental well-being has declined in the past decade. Much research relies on administrative data and population-based research incorporating youth voices and exploring protective factors for mental well-being is scarce. This study examined trends in adolescent mental well-being from 2015 to 2022 in British Columbia (BC), Canada. We examined sex differences in the trends, the role of protective factors in school, and the relative importance of protective factors for mental well-being.

METHODS

We drew from self-report data from eight years of implementation (2015-2022) of the Middle Years Development Instrument (MDI) with grade 7 students (N = 69,391; 49 % girls) in schools. Positive (satisfaction with life; SWL) and negative (depressive symptoms) mental well-being indicators were examined over time using a repeated cross-sectional design. Analyses were stratified by sex. The presence of 0-3 protective factors (adult support at school, peer belonging, school connectedness) and SES were covariates.

RESULTS

SWL significantly declined and depressive symptoms significantly increased across the study period and for most adjacent study years. Girls had significantly lower well-being and a steeper decline than boys. For the subset of students who scored high on all protective factors, the decline in well-being was attenuated but not eliminated and the sex gap was reduced.

CONCLUSIONS

The decline in well-being and the protective nature of modifiable protective factors identified in our study highlight the need for population-level mental health strategies that can be implemented in partnership with school districts.

Well-being, mental health and sleep in children and young people with vision impairment: A narrative review

Multiple studies have shown that vision impairment impacts adults' well-being, mental health, and sleep. However, little attention has been given to these areas in children and young people with vision impairment. This narrative review explores the relationship between vision impairment, well-being, mental ill-health, and sleep in children and young people with vision impairment. Studies examined include children and young people with all levels of vision impairment and those with congenital or acquired vision loss. The evidence suggests that vision impairment affects children's and young people's well-being and mental health with particular links to anxiety, depression, and PTSD. Theoretical mechanisms include low self-esteem affecting mental health and well-being, and loneliness reducing well-being. The efficacy of social and psychological interventions on the mental health of children and young people with vision impairment were reviewed. Psychological therapies, sports, exercise, music, art, and relaxation have all been found to have positive impacts. Gaps in existing knowledge are highlighted, and suggestions are made for future research in this important and under-researched area.

Workplace mental health promotion in a large state organization: Perceived needs, expected effects, neglected side effects

Background

Work ability and mental health in the workplace is increasingly promoted in terms of workplace health management. In order to select suitable interventions at work in a concrete context, employees and managers of a large state organization (science and development sector) were asked about perceived needs, desired effects and possible side effects of health promotion interventions.

Methods

13 semi-structured interviews with managers and three focus group interviews with employees ( N = 20) were conducted in autumn 2020 by a behavior therapist in training. The evaluation was carried out by a qualitative content analysis of the interview transcripts according to a deductive procedure and was checked by two independent raters.

Results

Most frequently, need was expressed for individual case counselling by a health expert due to the diversity of work-related problems. Managers would like to see more health-related leadership training, and a review of the various communication channels of their organization. Expected positive effects are increased self-efficacy, higher person-job-fits and reduced absenteeism. Side effects were mentioned, such as confusion of health management activities with therapy, or sensitization effects when speaking too much about mental health in mentally healthy teams. Lack of competence with the topic of mental health was mentioned as a reason for non-participation in mental health promotion activities.

Conclusions

The role of managers in relation to mental health needs to be more defined. Side effects related to mental health activities should be considered in evaluations. Selection of health interventions should depend on the concrete needs of the organization.

Trajectories of Loneliness During Adolescence Predict Subsequent Symptoms of Depression and Positive Wellbeing

There is a need to identify the outcomes of changes in loneliness during adolescence, and to consider this within a multidimensional framework of loneliness. This study considered the effects of different trajectories of change in Isolation Loneliness and in Friendship Loneliness upon both positive wellbeing and symptoms of depression. To achieve this, 1782 (43% female; 12.92 years old at the start of the study, SD = 1.60) young people took part in a longitudinal study with four data points across 2 years. Four Isolation Loneliness trajectories and five Friendship Loneliness trajectories were identified. Youth who experienced low levels of Isolation Loneliness that subsequently increased appear to be at particular risk for poor outcomes. Similarly, initially high levels of Friendship Loneliness that decreased rapidly, or which began at a low level and only increased marginally, seem to also be a risk. Loneliness is a multi-dimensional construct and its development during adolescence impacts upon young people's depressive symptomatology and positive mental wellbeing.

Physical education and student well-being: Promoting health and fitness in schools

The school students are facing mental health issues, and their performance is not improving in China. Health education policies are not implemented at the school level in China. However, scholars focus on college students' health education, but the school student is neglected. The research's primary objective is to answer the question: What is the impact of health education on the psychological well-being of school students? A sample of 549 10th grade students is collected from China's public and private sector institutes. The partial least square-structural equation modelling (PLS-SEM) is employed to analyze the data. The outcomes highlighted that the impact of health education is significant on the psychological well-being of school students in China. Furthermore, the study introduced that the moderating role of sustainable health exercise and sports participation is critical as it positively influences the relationship between health education and psychological wellbeing. This research improves literature as the novel contribution are highlighted in theory. Furthermore, the government education policies must be reframed under the light of this research' findings to improve students' health.

Current evidence and opportunities in child and adolescent public mental health: a research review

BACKGROUND

A public mental health lens is increasingly required to better understand the complex and multifactorial influences of interpersonal, community and institutional systems on the mental health of children and adolescents.

METHODS

This research review (1) provides an overview of public mental health and proposes a new interactional schema that can guide research and practice, (2) summarises recent evidence on public mental health interventions for children and adolescents, (3) highlights current challenges for this population that might benefit from additional attention and (4) discusses methodological and conceptual hurdles and proposes potential solutions.

RESULTS

In our evidence review, a broad range of universal, selective and indicated interventions with a variety of targets, mechanisms and settings were identified, some of which (most notably parenting programmes and various school-based interventions) have demonstrated small-to-modest positive effects. Few, however, have achieved sustained mental health improvements.

CONCLUSIONS

There is an opportunity to re-think how public mental health interventions are designed, evaluated and implemented. Deliberate design, encompassing careful consideration of the aims and population-level impacts of interventions, complemented by measurement that embraces complexity through more in-depth characterisation, or 'phenotyping', of interpersonal and environmental elements is needed. Opportunities to improve child and adolescent mental health outcomes are gaining unprecedented momentum. Innovative new methodology, heightened public awareness, institutional interest and supportive funding can enable enhanced study of public mental health that does not shy away from complexity.

The evolution of the subjective well-being of the general population during the COVID-19 pandemic period: the case of Belgium

The consequences of the COVID-19 pandemic period on a nation's well-being remain inadequately understood, especially over time. Therefore, this research aims to map the changes in the subjective well-being (SWB) of the general Belgian adult population during the COVID-19 pandemic. Analyses of variances (ANOVA) were performed to evaluate the changes in SWB during the pandemic at five different time points during the period from February 2020 until December 2022 using repeated cross-sectional representative samples of the Belgian population. The differences over time in subjective well-being were investigated in terms of life evaluation, positive affect, and negative affect. The changes in autonomy, competence, relatedness, loneliness and peace of mind were also explored as explanatory variables. Moderation analyses were performed to investigate the differential changes in well-being for different age groups. Our results show the subjective well-being of the Belgian population decreased during the COVID-19 pandemic, notably during the second lockdown and the fifth wave. Furthermore, younger individuals are significantly more susceptible to negative changes in well-being during the pandemic period. Finally, our results show that peace of mind is an important predictor of all SWB components during the pandemic. Based on these results several policy recommendations are formulated.

Age, quality of life and mental well-being in adolescent population: a network model tree analysis

This study presents the results of a network-based analysis of health related quality of life (HRQoL) among Slovenian adolescents. The study aimed to examine the relationship between HRQoL and mental well-being among adolescents of different age and gender groups. A cross-sectional study was conducted from November 2019 to January 2020 in 16 primary and 9 secondary schools in Slovenia. The KIDSCREEN-27 scale was used to collect the data on HRQoL, and the Warwick-Edinburgh Mental Well-being Scale to collect data on mental well-being. We used network model trees to demonstrate differences in psychometric network structure measuring correlations between different concepts in adolescent HRQoL. A total of 2972 students aged 10-19 years participated in the study. The significant split in the network tree (p < 0.001) indicated differences in relations between HRQoL subscale scores and mental well-being score among adolescents younger than 12 years old. In comparison to older adolescents the correlation between mental well-being and mood scores was significantly weaker in this group of the youngest participants (p < 0.001). A network model tree analysis also uncovered an interesting pattern based on gender and age (p < 0.013) where a correlation between mood and family support became weaker for female at the age of 12 and for male at the age of 16. Data mining techniques have recently been used by healthcare researchers and professionals. Network-based analysis is an innovative alternative to classical approaches in HRQoL research. In this study we demonstrate the significant differences in the perceptions of HRQoL and mental well-being among adolescents in different age and gender groups that were discovered using tree-based network analysis.

Efficacy and Effectiveness of Universal School-Based Wellbeing Interventions in Australia: A Systematic Review

The World Health Organisation defines health in terms of wellbeing, and wellbeing has become both a construct and a measure of impact in early intervention and prevention programs in schools. In Australia, schools report on their wellbeing initiatives and there is a plethora of government-funded wellbeing programs already in place in schools. However, education systems and stakeholders worldwide are facing significant challenges with mixed evaluation results of program impact and intervention effect. To better support students, schools, school-based healthcare workers, and community, it is important to know about the effectiveness of school-based programs; yet in the last decade, there has been no national appraisal of these programs in Australia. This systematic review aims to report on the effectiveness of Australian school-based wellbeing programs through a search of 13 databases. Out of 2888 articles, 29 met inclusion criteria. The results found that seventeen interventions comprising 80% of the total number of participants reported no statistically significant intervention effect on wellbeing outcomes. We argue that supporting wellbeing through robust program intervention is important as wellbeing presents both an indication of later onset of more serious mental health issues, and an opportunity for early intervention to break the trajectory leading to full disorder.

Interventions with Digital Tools for Mental Health Promotion among 11-18 Year Olds: A Systematic Review and Meta-Analysis

The availability of digital tools aiming to promote adolescent mental health is rapidly increasing. However, the field lacks an up-to-date and focused review of current evidence. This study thus looked into the characteristics and efficacy of digital, evidence-based mental health programs for youth (11-18 years). The selection procedure followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines and resulted in 27 eligible studies. The high heterogeneity of the results calls for careful interpretation. Nevertheless, small, but promising, effects of digital tools were found with respect to promoting well-being, relieving anxiety, and enhancing protective factors. Some important factors influencing overall efficacy include the given setting, the level of guidance and support, and the adherence to the intervention.

Partnerships at the Interface of Education and Mental Health Services: The Utilisation and Acceptability of the Provision of Specialist Liaison and Teacher Skills Training

Partnerships between school staff and mental health professionals have the potential to improve access to mental health support for students, but uncertainty remains regarding whether and how they work in practice. We report on two pilot projects aimed at understanding the implementation drivers of tailored strategies for supporting and engaging front-line school staff in student mental health. The first project provided regular, accessible mental health professionals with whom school staff could meet and discuss individual or systemic mental health concerns (a school 'InReach' service), and the other offered a short skills training programme on commonly used psychotherapeutic techniques (the School Mental Health Toolbox; SMHT). The findings from the activity of 15 InReach workers over 3 years and 105 individuals who attended the SMHT training demonstrate that school staff made good use of these services. The InReach workers reported more than 1200 activities in schools (notably in providing specialist advice and support, especially for anxiety and emotional difficulties), whilst most SMHT training attendees reported the utilisation of the tools (in particular, supporting better sleep and relaxation techniques). The measures of acceptability and the possible impacts of the two services were also positive. These pilot studies suggest that investment into partnerships at the interface of education and mental health services can improve the availability of mental health support to students.

Systematic Review of Mindfulness-Based Interventions in Child-Adolescent Population: A Developmental Perspective

Human development implies deep changes in cognitive, attentional, emotional, and behavioral skills. Therefore, Mindfulness-Based Interventions (MBIs) should be adapted in terms of dose, frequency, kind of exercises, assessment methods, and expected effects regarding the abilities and limitations of each developmental period. The present review seeks to describe and compare MBIs characteristics, assessment methods, and effects in youth between 3 and 18 years old considering four developmental periods. A systematic review was carried out including experimental primary studies published during the last five years. Results show that the frequency of the sessions and program duration varies widely. Differences were observed in instructors’ training and in assessment strategies. Discrepancies were observed regarding the effects of MBIs both within and between periods in cognitive, socio-emotional, symptoms, and mindfulness variables. Consistency was observed in prosocial behaviors for preschoolers, and in emotional and behavioral problems and hyperactivity in ages between preschool and early adolescence. Nevertheless, it was impossible to compare most results and determine consistency or discrepancy due to the lack of studies. Regarding mindfulness, it is defined and assessed in different ways in each period. Orientations are suggested to move from a compartmentalized view of isolated MBIs, towards an integrative perspective that allows tracing developmental trajectories for mindfulness and other key cognitive and socioemotional skills for children and adolescents.

Supporting Adolescents with Mental Health Problems in Secondary Education: Feasibility of a Supported Education Intervention

Mental health problems in adolescence can have a profound influence on school functioning, educational attainment and thus future societal participation. Supported education (SEd) is a potentially useful method for educational professionals to help adolescents with mental health problems in secondary school improve their functioning by stimulating collaboration, ownership, and participation. In this study, we examined the feasibility of SEd in secondary education by examining its acceptability, implementation, and preliminary effectiveness. We performed a mixed-methods study using quantitative data (questionnaires) and qualitative data (interviews) from educational professionals (EP) and adolescents, aged 13–17, about their experiences with a SEd intervention. Regarding the acceptability of the intervention, three main themes emerged: (a) structure, (b) autonomy, and (c) applicability of the intervention. Themes regarding the implementation were: (a) lack of time, (b) personal attitude, (c) mastery, and (d) complexity of the school environment. The findings show that, for those that followed the intervention, SEd is a promising approach to support adolescents with mental health problems to improve their functioning and participation in school. Further research is needed on the effectiveness of the intervention.