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

Abstract

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 240 min 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.

Appendices

Appendix A

PRISMA Checklist

See Table 1.

Table 1 PRISMA Checklist

Appendix B

Full Search Syntax

TI ( ( “primary school” OR “secondary school” OR “middle school” OR “high school” OR “elementary school” OR “grade school” OR “magnet school” OR “charter school” OR “parochial school” OR “K-12” OR “kindergarten to 12th grade” OR “Pre-K” OR “Preschool” OR “Preschool to 12th grade” OR “Head Start” OR “Homeschool” OR “Special Education” OR “school based” OR “school-based”) AND ( “mental health” OR psychopatholog* OR “mental wellness” OR “mental illness” OR “mental disorder” OR “internalizing” OR “depression” OR “anxiety” OR “mental wellbeing” OR “social wellbeing” OR “emotional wellbeing” OR “well-being” OR “stress”) AND (“intervention” OR “prevention” OR “treatment” OR “program” OR “workshop” OR “training” OR “telehealth”) AND (“randomized” OR “rct” OR “field trial” OR “quasi-experimental” OR “open trial” OR “pilot trial”)) OR AB ( ( “primary school” OR “secondary school” OR “middle school” OR “high school” OR “elementary school” OR “grade school” OR “magnet school” OR “charter school” OR “parochial school” OR “K-12” OR “kindergarten to 12th grade” OR “Pre-K” OR “Preschool” OR “Preschool to 12th grade” OR “Head Start” OR “Homeschool” OR “Special Education” OR “school based” OR “school-based”) AND ( “mental health” OR psychopatholog* OR “mental wellness” OR “mental illness” OR “mental disorder” OR “internalizing” OR “depression” OR “anxiety” OR “mental wellbeing” OR “social wellbeing” OR “emotional wellbeing” OR “well-being” OR “stress”) AND (“intervention” OR “prevention” OR “treatment” OR “program” OR “workshop” OR “training” OR “telehealth”) AND (“randomized” OR “rct” OR “field trial” OR “quasi-experimental “ OR “open trial” OR “pilot trial”)) OR SU ( ( “primary school” OR “secondary school” OR “middle school” OR “high school” OR “elementary school” OR “grade school” OR “magnet school” OR “charter school” OR “parochial school” OR “K-12” OR “kindergarten to 12th grade “ OR “Pre-K” OR “Preschool” OR “Preschool to 12th grade” OR “Head Start” OR “Homeschool” OR “Special Education” OR “school based” OR “school-based”) AND ( “mental health” OR psychopatholog* OR “mental wellness” OR “mental illness” OR “mental disorder” OR “internalizing” OR “depression” OR “anxiety” OR “mental wellbeing” OR “social wellbeing” OR “emotional wellbeing” OR “well-being” OR “stress”) AND (“intervention” OR “prevention” OR “treatment” OR “program” OR “workshop” OR “training” OR “telehealth”) AND (“randomized” OR “rct” OR “field trial” OR “quasi-experimental” OR “open trial” OR “pilot trial”)).

Appendix C

See References in “Full References for Articles Included in Systematic Review/Meta Analysis”.

Appendix D

Study Characteristics

See Tables 2, 3.

Table 2 Study Characteristics

Table 3 Additional study characteristics

Appendix E

Intervention Characteristics

See Table 4.

Table 4 Intervention Characteristics

Appendix F

Forest Plots

See Figs. 2, 3, 4, 5, 6.

Fig. 2

Forest plot of one-month effects

Fig. 3

Forest plot of six-month effects

Fig. 4

Forest plot of one-year effects

Fig. 5

Forest plot of two-year effects

Fig. 6

Forest plot of longer than two-year effects

Appendix G

Moderation Analyses

See Tables 5, 6, 7, 8.

Table 5 One month moderation analysis

Table 6 Six-month moderation analysis

Table 7 One-year moderation analysis

Table 8 Two-year moderation analysis

Appendix H

Intervention Effectiveness

See Tables 9, 10, 11, 12, 13, 14, 15, 16, 17, 18.

Table 9 Intervention effects on anxiety problems/phobias

Table 10 Intervention effects on mood problems/depression

Table 11 Interventions effects on well-being

Table 12 Intervention effects on self-injurious thoughts and behaviors

Table 13 Intervention effects on eating/body image problems

Table 14 Interventions effects on substance use problems

Table 15 Interventions effects on conduct/behavioral problems

Table 16 Interventions effects on hyperactivity/inattention

Table 17 Interventions effects on trauma symptoms

Table 18 Intervention effects on general distress or combined problems

Appendix I

Risk of Bias

See Table 19.

Table 19 Risk of bias

Appendix J

Funnel Plots

See Figs. 7, 8, 9, 10, 11.

Fig. 7

Funnel plot for outcomes collected less than or equal to one-month post-intervention

Fig. 8

Funnel plot for outcomes collected greater than one-month and less than or equal to six-month post-intervention

Fig. 9

Funnel plot for outcomes collected greater than six months and less than or equal to one-year post-intervention

Fig. 10

Funnel plot for outcomes collected greater than one-year and less than or equal to two-year post-intervention

Fig. 11

Funnel plot for outcomes collected greater than two-year post-intervention