Do no harm: can school mental health interventions cause iatrogenic harm?
Open accessAbstract
In recent years, there have been extensive efforts in secondary schools to prevent, treat and raise awareness of adolescent mental health problems. For some adolescents, these efforts are essential and will lead to a reduction in clinical symptoms. However, it is also vital to assess whether, for others, the current approach might be causing iatrogenic harm. A growing body of quantitative research indicates that some aspects of school-based mental health interventions increase distress or clinical symptoms, relative to control activities, and qualitative work indicates that this may be partly due to the interventions themselves.
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The negative outcomes or adverse effects of the program were linked to the program itself.
“The negative outcomes or adverse effects of the program were linked to the program itself (Foulkes and Stringaris, 2023).”
From Outcome domains and assessment measures in school-based youth mentoring programs: a systematic review (2026) · cites this paper as Foulkes and Stringaris, 2023
In “The problem with school mental health interventions,” the paper defines iatrogenic harm as adverse effects from the treatment approach itself and reports instances in which students were worse off receiving an intervention than not receiving it. It supports the general link, but does not identify or assess the particular program implied by “the program.” (LLM, conf=0.82)
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Caldwell, D. M., Davies, S. R., Hetrick, S. E., Palmer, J. C., Caro, P., López-López, J. A., Gunnell, D., Kidger, J., Thomas, J., French, C., et al. (2019) · The Lancet Psychiatry · doi:10.1016/s2215-0366(19)30403-1 · Cited by 336 · see citing works
Foulkes, L., & Andrews, J. L. (2023) · New Ideas in Psychology · doi:10.1016/j.newideapsych.2023.101010 · Cited by 329 · see citing works
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Research works printed but not linked: 9
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The Lancet Psychiatry Commission on youth mental health
McGorry, P. D., Mei, C., Dalal, N., Alvarez-Jimenez, M., Blakemore, S.-J., Browne, V., Dooley, B., Hickie, I. B., Jones, P. B., McDaid, D., et al. (2024) · The Lancet Psychiatry · doi:10.1016/s2215-0366(24)00163-9 · Cited by 663 · see citing works
Tiraieyari, N., & Krauss, S. (2026) · Frontiers in Education · doi:10.3389/feduc.2026.1518053
- Authors
- Foulkes, L., & Stringaris, A.
- Affiliations
- University of Oxford (GB)
- University College London (GB)
- Corresponding author
- Foulkes, Lucy
- Venue
- BJPsych Bulletin
- Publisher
- Royal College of Psychiatrists
- Published
- 2023-02-27
- Volume
- 47
- Issue
- 5
- Pages
- 267-269
- ISSN
- 2056-4694 (ISSN-L)
- 2056-4708
- PMC
- PMC10764817
- OpenAlex
- W4322495277
- Cited by
- 106
- References
- 2
- Citations by year
- 2026: 25 · 2025: 34 · 2024: 25 · 2023: 22
- FWCI
- 38.86
- Type
- journal article
- Language
- en
- Update notices
- correction (2023-02-27)
- Open access
- diamond
- doi.org
- Locations
- BJPsych Bulletin (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
- Keywords
- iatrogenic injury, school-based mental health programs, adolescent mental health, high school students, adolescent distress, clinical symptoms, mental health promotion
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