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Review of mental health promotion interventions in schools
Open accessAbstract
PURPOSE: The prevalence of mental disorders amongst children and adolescents is an increasing global problem. Schools have been positioned at the forefront of promoting positive mental health and well-being through implementing evidence-based interventions. The aim of this paper is to review current evidence-based research of mental health promotion interventions in schools and examine the reported effectiveness to identify those interventions that can support current policy and ensure that limited resources are appropriately used. METHODS: The authors reviewed the current state of knowledge on school mental health promotion interventions globally. Two major databases, SCOPUS and ERIC were utilised to capture the social science, health, arts and humanities, and education literature. RESULTS: Initial searches identified 25 articles reporting on mental health promotion interventions in schools. When mapped against the inclusion and exclusion criteria, 10 studies were included and explored. Three of these were qualitative and seven were quantitative. CONCLUSIONS: A range of interventions have been tested for mental health promotion in schools in the last decade with variable degrees of success. Our review demonstrates that there is still a need for a stronger and broader evidence base in the field of mental health promotion, which should focus on both universal work and targeted approaches to fully address mental health in our young populations.
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“Mental health promotion for young people has been increasingly embedded within education systems, 330 with an emphasis on sleep hygiene, physical activity, little alcohol and drug use, social connection, and cognitive-behavioural skills.”
From The Lancet Psychiatry Commission on youth mental health (2024) · cites this paper as [330]
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“Educational settings have a central role in promoting mental health, 329,330 recognising the warning signs of mental ill health, 331 and delivering prevention and intervention programmes.”
From The Lancet Psychiatry Commission on youth mental health (2024) · cites this paper as [330]
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Cited by
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The Lancet Psychiatry Commission on youth mental health
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Health education and global health: Practices, applications, and future research
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“Modern students live in a technological era in which cell phones, tablets, computers, and video games are core elements of daily life.[20] Thus, it is necessary to digitize programs that focus on student mental health and wellbeing.”
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“…defined by the World Health Organisation as actions to create an environment that supports mental health [13] is likely to be best achieved in schools that offer a continuum of interventions, including a focus on social and emotional learning, and the active involvement of students [14, 15].”
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“It is postulated that schools provide a crucial, universal access point to deploy services that enhance prevention and early detection of mental health difficulties, and provide timely support (O’Reilly et al., 2018).”
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“Looking to existing evidence on mental health promotion in schools, longer-term, whole-school approaches appear to achieve greater impact (O’Reilly et al., 2018; Wells et al., 2003).”
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“In addition to the family, because adolescents spend a significant amount of time at school, the school environment can impact their well-being (O’Reilly et al., 2018).”
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“However, there is still a need for a stronger, broader evidence base in the field of mental health promotion and prevention in school settings (O’Connor et al., 2018; O’Reilly et al., 2018).”
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“In terms of health promotion, healthy habits, such as tooth brushing (World Health Organization, 2023) and good sleep habits (Bathory & Tomopoulos, 2017; Matricciani et al., 2019), and the promotion of mental health (Fenwick-Smith et al., 2018; O ’ Reilly et al., 2018), are essential for children.”
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“…of the counseling profession (Myers, 1992), school counselors should address SDOMH through holistic and collaborative approaches that promote equity and support the prevention of mental health problems in schools (Johnson & Brookover, 2021; Lopez-Perry & Whitson, 2022; O’Reilly et al., 2018).”
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“…greater choice over how this is done using personally and socially relevant tools (such as emojis), would appear important for enhancing pupils’ knowledge and awareness of mental health, and developing SEL (Clarke et al., 2015; MacSweeney et al., 2019; O’Connor et al., 2018; O’Reilly et al., 2018).”
BackgroundMethodInfluentialManaging chronic health conditions
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“However, substantial research has focused on younger people, for example mental [14, 15] and oral health promotion to adolescents [16, 17].”
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“They can include yoga, mindfulness, or meditation, which were found to reduce stress, improve mood, sleep, and school performance among children in the USA [34].”
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“Implementation parameters like motivation, commitment, skills, or invested time have a strong impact [33,66].”
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“…online bullying, worries about climate change, and loneliness, that do not meet the threshold for a clinical diagnosis of a named condition, but still have a significant impact on their daily life and wellbeing (Goodfellow et al., 2022; O’Reilly et al., 2018a, b; Ma et al., 2022; Suh & Lee, 2023).”
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“School-based approaches to youth mental health promotion are supported internationally through public policies encouraging their implementation (O’Reilly et al., 2018), with a growing emphasis on wholeschool preventative approaches (Eisenstein et al., 2019).”
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Health promotion strategy as part of Vision 2050 in Oman: the way forward
Hinai, H. S. A., Mufarji, K. A., Alsiyabi, H., Anqoudi, Z. A., Al-Saadi, R., & Awaidy, S. A. (2020) · Global Health Promotion · doi:10.1177/1757975920909115 · Cited by 12
Winder, L., Stanley-Clarke, N., Maris, R., Hay, A., & Knook, J. (2024) · The Journal of Agricultural Education and Extension · doi:10.1080/1389224x.2024.2351545 · Cited by 11
“While there is a growing body of literature around the benefits of delivering wellbeing programmes for tertiary students there have been varying degrees of success (Ashwood et al. 2015; Ferris et al. 2019; O’Reilly et al. 2018; Winzer et al. 2018; Young et al. 2020).”
Competences for promoting mental health in primary school
Lahti, M., Korhonen, J., Sakellari, E., Notara, V., Lagiou, A., Istomina, N., Grubliauskienė, J., Makutienė, M., Šukytė, D., Erjavec, K., et al. (2023) · Health Education Journal · doi:10.1177/00178969231173270 · Cited by 11
“…particular are viewed as providing ideal settings for enhancing and protecting children’s physical and mental well-being (Notara and Sakellari, 2013; O’Reilly et al., 2018; Sakellari et al., 2021), since in European countries schools reach nearly all children and their parents/caregivers and…”
BackgroundInfluentialBrown, R., Godwin, J. V., Edwards, A., Burdon, M., & Moore, G. (2023) · Health Education Research · doi:10.1093/her/cyad002 · Cited by 11
“Capturing and recognizing existing practices is also associated with greater acceptability for new approaches among stakeholders [44] and is a means to acknowledge existing good work.”
BackgroundMorin, A. H. (2022) · International Journal of Educational Research · doi:10.1016/j.ijer.2022.101966 · Cited by 11
Eglitis, E., Simpson, C., Singh, B., Olds, T., Machell, A., Virgara, R., Richardson, M., Brannelly, K., Grant, A., Gray, J., et al. (2024) · Children · doi:10.3390/children11080887 · Cited by 11
“This is most likely because summer program interventions are much shorter than school-based interventions, which can continue for a year or more [85].”
BackgroundInfluentialThabrew, H., Biro, R., & Kumar, H. (2023) · School Mental Health · doi:10.1007/s12310-023-09577-y · Cited by 14
“This is despite the availability of multiple evidence-based interventions for the prevention and treatment of common mental health issues in schools (O’Reilly et al., 2018).”
BackgroundRussell, A., Curtin, E., Widnall, E., Dodd, S., Limmer, M., Simmonds, R., & Kidger, J. (2023) · Community mental health journal · doi:10.1007/s10597-022-01059-w · Cited by 10
“To reach the widest number of young people, universal prevention programmes set in schools are increasingly being explored as avenues for intervention delivery (O’Reilly et al., 2018; Weare, 2013).”
BackgroundMental Health Provision in UK Secondary Schools
Garside, M., Wright, B., Nekooi, R., & Allgar, V. L. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182212222 · Cited by 17
“Over recent years, there has been an emphasis on the role of schools in providing evidence-based early intervention support [13,14] with”
Sælid, G. A., Czajkowski, N. O., Aarø, L. E., Andersen, J. R., Idsøe, T., Helleseter, M. A. D., & Holte, A. (2022) · BMC Psychology · doi:10.1186/s40359-022-00721-y · Cited by 25
Lee, J. A., Heberlein, E., Pyle, E., Caughlan, T., Rahaman, D., Sabin, M., & Kaar, J. L. (2021) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2021.100721 · Cited by 11
O'Dea, B., King, C., Achilles, M., Calear, A., & Subotic-Kerry, M. (2021) · Health Services Insights · doi:10.1177/11786329211017689 · Cited by 10
Influence of internet addiction on academic, sportive, and recreative activities in adolescents
Koca, T. T., & Berk, E. (2018) · Journal of Public Health · doi:10.1007/s10389-018-0965-x · Cited by 14
“Schools have been positioned at the forefront of promoting positive mental health and well-being by implementing evidence-based interventions (O'Reilly et al. 2018).”
BackgroundOberle, E., Ji, X. R., Molyneux, T. M., Guhn, M., Forer, B., Thomson, K., Alkawaja, M., Kassan, A., & Gadermann, A. (2025) · Social Science & Medicine · doi:10.1016/j.socscimed.2025.118201 · Cited by 13
Berg, A., Appoh, L., & Ørjasæter, K. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1454280 · Cited by 9
Adolescent-Centric Design of an Online Safety Chatbot
Roehrer, E., Pokawinkoon, P., Watters, P., Sauer, J. D., & Scanlan, J. D. (2024) · Journal of Computer Information Systems · doi:10.1080/08874417.2024.2401991 · Cited by 11
“14 School-based programs have long shown positive impacts on various aspects of adolescent well-being, including mental health, social-emotional skills, and academic outcomes.”
Bleile, A. C. E., Koppenol‐Gonzalez, G. V., Orech, B., Verreault, K., & Jordans, M. J. D. (2024) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2024.2330073 · Cited by 14
“These findings are particularly relevant given the absence of strong evidence for mental health promotion (Barbui et al., 2020; Barry et al., 2013; O’Reilly et al., 2018; Purgato et al., 2018; Tol, 2015; Uppendahl et al., 2020) and high demand of evidence-based interventions in the field of MHPSS…”
Meilsmeidth, G., Trigueiro, M. J., Simões-Silva, V., de Almeida, R. S., Portugal, P., Gomes, P. V., de Sousa, S., Campos, F., Monteiro, P., Soutelo, A. P., et al. (2024) · BMC Psychology · doi:10.1186/s40359-024-01591-2 · Cited by 8
“Although, in this study, some significant improvements are found in the increase in knowledge in MHL and its relationship with the reduction of stigma, the magnitude of these changes was small, when compared to those found by Milin and collaborators [74].”
ResultCalvert, H. G., McQuilkin, M., Havlicak, A., Lewis, T., & Turner, L. (2023) · Implementation Science Communications · doi:10.1186/s43058-023-00478-4 · Cited by 9
“Although many universal interventions for improving student mental health and social-emotional learning have been shown effective in research [2–4], in practice, evidence-based programming that broadly supports students’ behavioral health and social-emotional needs is often not provided in schools…”
BackgroundSalvador‐Carulla, L., Fernández, A., Sarma, H., Mendoza, J. A., Wands, M., Gandré, C., Chevreul, K., & Lukersmith, S. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18157924 · Cited by 11
“An integrated school-based mental health approach has potential to reach a large portion of children and adolescent to promote mental health and well-being [30].”
BackgroundKlomsten, A. T., & Uthus, M. (2020) · Nordisk tidsskrift for utdanning og praksis · doi:10.23865/up.v14.2210 · Cited by 16
Smith, A. W. (2020) · European Physical Education Review · doi:10.1177/1356336x20947554 · Cited by 16
“It is against this backdrop of concern regarding the mental health of CYP and their experience of mental illness that increasing emphasis has been placed globally upon prevention and early intervention in educational policy, and especially the role schools (and individual subjects such as physical education (PE)) and…”
BackgroundSvensson, Å., & Warne, M. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1292520 · Cited by 8
Hay, A., Stanley-Clarke, N., Maris, R., Winder, L., & Knook, J. (2024) · Health Education Journal · doi:10.1177/00178969231225089 · Cited by 8
“There is consequently an increasing focus on mental health within education, with previous research showing that schools and universities play a crucial role in promoting positive mental health and wellbeing (O’Reilly et al., 2018; Reavley et al., 2012).”
BackgroundInfluentialFrancis-Oliviero, F., Loubières, C., Grové, C., Marinucci, A., Shankland, R., Salamon, R., Perez, E., Garancher, L., Galéra, C., Gaillard, E., et al. (2023) · JMIR Research Protocols · doi:10.2196/51096 · Cited by 8
“Accordingly, to increase children’s psychological well-being, mental health promotion strategies have been encouraged worldwide [12,13].”
Lekamge, R. B., Jain, R., Sheen, J., Solanki, P., Zhou, Y., Romero, L., Barry, M. M., Chen, L., Karim, M. N., & Ilić, D. (2025) · Campbell Systematic Reviews · doi:10.1002/cl2.70024 · Cited by 10
Enabling pupils to flourish: six evidence-based principles of whole-school wellbeing promotion
Edwards, R., Byrne, J., & Grace, M. M. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1335861 · Cited by 11
Teacher perspectives on enhancing wellbeing education through integrating arts‐based practices
Moar, S., Burke, K., & Watson, M. (2024) · British Educational Research Journal · doi:10.1002/berj.4029 · Cited by 15
Predictive analytics and early intervention in healthcare social work: a scoping review
Kumar, D., & Suthar, N. (2024) · Social Work in Health Care · doi:10.1080/00981389.2024.2316700 · Cited by 15
“Studies by O’Reilly et al. (2018) and Janke et al. (2016) illustrate how this information aids resource allocation and coordinated care.”
BackgroundHolte, A. (2024) · Mental Health & Prevention · doi:10.1016/j.mhp.2024.200321 · Cited by 7
Goodwin, J., Behan, L., Saab, M. M., O’Brien, N., O’Donovan, Á., Hawkins, A., Philpott, L. F., Connolly, A., Goulding, R., Clark, F., et al. (2023) · Mental Health Review Journal · doi:10.1108/mhrj-05-2023-0027 · Cited by 16
Chui, H., Luk, S., Fung, K.-O.-K., & Huang, Y.-H. (2023) · Journal of School Psychology · doi:10.1016/j.jsp.2023.05.002 · Cited by 7
A creative ecological approach to supporting young people with mental health challenges in schools
Harris, A., & Jones, S. H. (2023) · International Journal of Qualitative Studies in Education · doi:10.1080/09518398.2023.2233938 · Cited by 14
“Recent research reflects the growing body of evidence regarding the efficacy of creative arts approaches to supporting young people with poor mental health (Fortuna et al, 2020; García-Carrión et al, 2019; Jensen & Bonde, 2018; O”Reilly et al., 2018).”
BackgroundANDERSON, N. W., Halfon, N., Eisenberg, D., Markowitz, A. J., Moore, K. A., & Zimmerman, F. J. (2023) · Milbank Quarterly · doi:10.1111/1468-0009.12634 · Cited by 8
Machailo, R., Koen, D., & Matsipane, M. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20031725 · Cited by 7
Tognin, S., Catalán, A., Kempton, M. J., Nelson, B., McGorry, P. D., Riecher‐Rössler, A., Bressan, R. A., Neus Barrantes-vidal, A., Krebs, M., Nordentoft, M., et al. (2023) · European Psychiatry · doi:10.1192/j.eurpsy.2022.2351 · Cited by 8
“Although a previous review highlighted that there is still a need for stronger and broader evidence base in the field of mental health promotion in young people within a school setting [55], a multidimensional and integrated approach to mental health promotion in this population is recommended [56].”
BackgroundPitkänen, J., Remes, H., Aaltonen, M., & Martikainen, P. (2022) · BMC Psychiatry · doi:10.1186/s12888-021-03654-9 · Cited by 7
“However, the effectiveness of these interventions remains largely an open question [44].”
BackgroundQuarshie, E., Waterman, M., & House, A. (2020) · BMC Psychiatry · doi:10.1186/s12888-020-02718-6 · Cited by 7
Teachers and schools as change agents in improving mental health among adolescents
Manjari, A., & Srivastava, A. (2020) · doi:10.25215/0801.092 · Cited by 7
Montagne, A., Rousseau, C., & Gómez-Carrillo, A. (2025) · The Lancet Regional Health - Americas · doi:10.1016/j.lana.2025.101310 · Cited by 6
“31,35 Crucially, progress should be measured not only against normative benchmarks or symptom reduction, but instead through growth in relational capacity, embodied self-efficacy, and community-centered development.”
Metadata
- Authors
- O’Reilly, M., Svirydzenka, N., Adams, S., & Dogra, N.
- Affiliations
- University of Leicester (GB)
- De Montfort University (GB)
- Corresponding author
- O’Reilly, Michelle
- Venue
- Social Psychiatry and Psychiatric Epidemiology
- Published
- 2018-05-11
- Volume
- 53
- Issue
- 7
- Pages
- 647-662
- ISSN
- 0933-7954 (ISSN-L)
- 1433-9285
- PMC
- PMC6003977
- OpenAlex
- W2801053462
- Cited by
- 408
- References
- 52
- Citations by year
- 2026: 52 · 2025: 54 · 2024: 78 · 2023: 63 · 2022: 51 · 2021: 35 · 2020: 54 · 2019: 7 · 2018: 13
- FWCI
- 6.38
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Social Psychiatry and Psychiatric Epidemiology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Open Research Online - ORO (The Open University) (acceptedVersion)
- DMU Open Research Archive (De Montfort University) (submittedVersion)
- Leicester Research Archive (University of Leicester) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › School Health and Nursing Education
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Keywords
- school-based mental health promotion, child and adolescent mental health, evidence-based interventions, intervention effectiveness, universal prevention, targeted interventions, school mental health policy, well-being
- MeSH terms
- Adolescent, Child, Female, Health Promotion, Humans, Male, Mental Health, School Health Services, Schools
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