Adolescent Depression and Anxiety Treatment in Rural Schools: A Systematic Review.

Depression and anxiety are the most common mental illnesses in adolescents. Rural schools are well-positioned to narrow the access gap confronting rural adolescents experiencing depression and anxiety; however, there is a paucity of research on the treatment of depression and anxiety in rural high schools. This critical review summarized the state of the field on rural school-based interventions to reduce adolescent depression and anxiety. Literature searches were conducted using PubMed, PsychINFO, EMBASE, ERIC, and CINAHL databases. Inclusion criteria identified peer-reviewed articles evaluating rural high-school based interventions for the treatment of depression and/or anxiety. Of the 322 articles screened, 82 articles were reviewed, with four articles satisfying inclusion criteria. All studies examined a group- or classroom-based program to reduce depression. Three studies reported either significant pre- to post-intervention improvements or clinical change in depressive symptoms or coping skills; one study found null effects. While promising, there is an on-going need for additional rigorous investigations on rural high-school based interventions for the treatment of depression and anxiety among teens.