Andrews Jack L, Foulkes Lucy
Department of Experimental Psychology, University of Oxford, Oxford, UK.
Child Adolesc Ment Health. 2025 Feb;30(1):102-104. doi: 10.1111/camh.12753. Epub 2024 Dec 7.
There is an urgent need to improve mental health outcomes among young people. One approach taken to address this problem has been the design and delivery of universal school-based prevention, based on therapeutic models such as CBT and mindfulness. Such interventions are delivered to groups of young people, irrespective of risk or need. However, in this commentary, we argue that the initial appeal of universal interventions has not been supported by the evidence: universal school-based prevention is less effective than targeted approaches, often leads to null or unsustained positive effects, has the potential to elicit negative effects and is not well liked by young people themselves. In addition, many young people in each classroom already meet the criteria for a mental disorder, meaning that prevention approaches may not be appropriate or effective for this group. In this commentary, we respond to Birrell et al.'s (2025) paper by arguing that the field should move away from universal prevention and instead invest our limited resources in the refinement and dissemination of interventions with a stronger evidence base, such as one-to-one, targeted and indirect approaches.
迫切需要改善年轻人的心理健康状况。为解决这一问题所采取的一种方法是设计并实施基于学校的普遍预防措施，这些措施基于认知行为疗法（CBT）和正念等治疗模式。此类干预措施面向青少年群体实施，无论其风险或需求如何。然而，在本评论中，我们认为普遍干预措施最初的吸引力并未得到证据支持：基于学校的普遍预防措施不如针对性方法有效，往往导致零效果或效果难以持续，有可能引发负面影响，且不受年轻人自身欢迎。此外，每个班级中的许多年轻人已经符合精神障碍的标准，这意味着预防措施可能对此群体不合适或无效。在本评论中，我们回应了比雷尔等人（2025年）的论文，认为该领域应摒弃普遍预防措施，转而将我们有限的资源投入到完善和推广有更坚实证据基础的干预措施上，比如一对一、有针对性和间接的方法。
