Debate: Where to next for universal school-based mental health interventions?

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.

Do school-based prevention programs impact co-occurring alcohol use and psychological distress during adolescence?

Background: Adolescence is a critical period for preventing substance use and mental health concerns, often targeted through separate school-based programs. However, co-occurrence is common and is related to worse outcomes. This study explores prevention effects of leading school-based prevention programs on co-occurring alcohol use and psychological distress.

Across the multiverse: exploring a diverse set of specifications related to cross-sectional and prospective associations between adolescent alcohol use and emotional problems.

Background: The relationship between adolescent alcohol use and emotional problems remains unclear and contradictory. These inconsistencies may in part be due to differences in the measurement and operationalization of alcohol use and emotional problems across studies, as well as confounder selection and missing data decisions. This study explores the associations between common specifications of adolescent alcohol use and emotional problems in a large sample of adolescents.

Co-development of general psychopathology and high-risk personality traits during adolescence.

There is strong evidence for a general psychopathology dimension which captures covariance among all forms of psychopathology, yet its nature and underlying association with personality remain unclear. This study examined the co-development of general psychopathology and four high-risk personality traits: anxiety sensitivity, negative thinking, sensation seeking, and impulsivity. Data from two large Australian school-based randomised controlled trials of substance use prevention programs were analysed ( = 2,083, mean age at baseline = 13.

Adolescent behavioural intentions: Secondary outcomes from a cluster randomized controlled trial of the Health4Life school-based lifestyle modification intervention.

Intervention: Health4Life: a school-based eHealth intervention targeting multiple health behaviour change (MHBC).

Research Question: Does Health4Life impact secondary outcomes of self-reported intentions regarding six lifestyle behaviours in adolescents (alcohol use, tobacco smoking, screentime, physical activity, discretionary beverage consumption, and sleep)?

Methods: We implemented a cluster randomized controlled trial within secondary schools across three Australian states. Schools were randomly assigned (1:1) to receive either the Health4Life intervention, which consisted of a six-module, web-based program and accompanying smartphone app, or an active control (standard health education).