Department of General Practice.
Melbourne School of Population and Global Health.
Curr Opin Psychiatry. 2020 Jul;33(4):391-396. doi: 10.1097/YCO.0000000000000619.
Schools are increasingly at the forefront of mental healthcare for young people internationally. This review aims to describe recent developments in school-based mental health activities to respond to mental health needs in adolescents, with a focus on empirical studies aimed at preventing, ameliorating or treating mental disorders.
The field is characterized by substantial heterogeneity in program design and research methods. Evidence for effectiveness of single-faceted school-based mental health programs is equivocal. Recent systematic reviews and meta-analyses have reported mixed findings across a variety of single-faceted universal and targeted programs at post-intervention, short-term and long-term follow-up. The largest and most recent review and network meta-analyses conclude there is limited evidence in support of these forms of school-based anxiety and depression prevention programs. Feasibility studies, which include consideration of appropriate service providers, suggest a need to consider schools as complex systems when designing interventions. Recent models adopting whole-school approaches appear feasible, effective and potentially sustainable with modest levels of resourcing.
Greater evidence is needed regarding long-term impact and sustainability of interventions. Recent trials of multifaceted and multilevel interventions show particular promise. Future research should further explore strategies embedded within school systems and processes.
学校在国际上越来越成为青少年心理健康保健的前沿阵地。本综述旨在描述最近基于学校的心理健康活动的发展，以满足青少年的心理健康需求，重点是针对预防、改善或治疗精神障碍的实证研究。
该领域在项目设计和研究方法上存在很大的异质性。单一面向的学校心理健康项目的有效性证据尚无定论。最近的系统综述和荟萃分析报告了各种单一面向的普遍和有针对性的项目在干预后、短期和长期随访时的混合结果。最大和最新的综述和网络荟萃分析得出的结论是，这些形式的基于学校的焦虑和抑郁预防计划的证据有限。可行性研究包括对合适服务提供者的考虑，表明在设计干预措施时需要将学校视为复杂系统。最近采用全学校方法的模型似乎具有可行性、有效性和潜在的可持续性，只需适度的资源投入。
需要更多关于干预措施的长期影响和可持续性的证据。最近针对多方面和多层次干预措施的试验显示出特别有希望的结果。未来的研究应进一步探索嵌入在学校系统和流程中的策略。
