Birrell Louise, Grummitt Lucinda, Smout Scarlett, Maulik Pallab, Teesson Maree, Newton Nicola
The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia.
The George Institute for Global Health, New Delhi, India.
Child Adolesc Ment Health. 2025 Feb;30(1):92-95. doi: 10.1111/camh.12749. Epub 2025 Jan 9.
In this article, we evaluate the current state of universal school-based mental health prevention. We argue that the field is at another pivotal turning point, with many unanswered questions. As youth mental health issues rise in prominence and prevalence, schools increasingly adopt mental health and well-being programmes. However, recent large-scale trials have reported varied effects, raising questions about their effectiveness. We critically analyse these findings and place them in a global context. We contend results in high-income countries should not be seen as a failure of universal prevention overall and unpack key learnings from trials that have not found significant preventive effects. A comprehensive perspective of the data reveals both negative and positive aspects, as well as some signposts for the way forward. We advocate for programme adaptation based on feedback, embracing proportionate universalism and exploring alternative prevention strategies without discarding universal prevention. We urge continued research with stakeholder involvement, emphasising a nuanced approach to universal school-based mental health prevention, is urgently needed to move the field forward.
在本文中，我们评估了基于学校的普遍心理健康预防的现状。我们认为，该领域正处于另一个关键转折点，存在许多未解答的问题。随着青少年心理健康问题日益突出和普遍，学校越来越多地采用心理健康和幸福计划。然而，最近的大规模试验报告了不同的效果，引发了对其有效性的质疑。我们批判性地分析这些发现，并将其置于全球背景下。我们认为，高收入国家的结果不应被视为普遍预防整体的失败，并剖析了那些未发现显著预防效果的试验中的关键经验教训。对数据的全面审视揭示了消极和积极方面，以及一些前进方向的路标。我们主张根据反馈调整计划，秉持适度普遍主义，并探索替代预防策略，同时不摒弃普遍预防。我们敦促在利益相关者参与下持续开展研究，强调迫切需要一种细致入微的方法来推进基于学校的普遍心理健康预防，以推动该领域向前发展。
