Debate: Where to next for universal school-based mental health interventions? Tensions in prevention – To build better school-based programming, we must start with what we know

Katherine A. Cohen; Eric J. Bruns; Jessica L. Schleider

doi:10.1111/camh.12758

Debate: Where to next for universal school-based mental health interventions? Tensions in prevention – To build better school-based programming, we must start with what we know

Katherine A. Cohen, Eric J. Bruns, Jessica L. Schleider^*

^*Corresponding author for this work

Medical Social Sciences

Research output: Contribution to journal › Comment/debate › peer-review

Abstract

Researchers and education leaders have suggested that universal school-based prevention programs could improve youth mental health at a population level, yet recent trials of universal school-based prevention programs (e.g., MYRIAD, CSC) found null or iatrogenic results. In this debate piece, we argue that these results must be contextualized alongside existing knowledge that universal programs are ideally implemented within multitiered systems, promoting student autonomy tends to promote uptake and adherence, and individual trials do not outweigh decades of academic and community expertise. We offer suggestions for moving forward in research on and implementation of universal school-based prevention programs.

Original language	English (US)
Journal	Child and Adolescent Mental Health
DOIs	https://doi.org/10.1111/camh.12758
State	Accepted/In press - 2025

Funding

KAC receives funding from the National Institute of Mental Health (F31MH139185). JLS has received funding from the National Institute of Health Office of the Director (DP5OD028123), National Institute of Mental Health (R43MH128075), the Upswing Fund for Adolescent Mental Health, the National Science Foundation (2141710), Health Research and Services Association (U3NHP45406\u201001\u201000), the Society of Clinical Child and Adolescent Psychology, HopeLab, Child Mind Institute, and the Klingenstein Third Generation Foundation. EJB currently receives funding from the National Institute of Mental Health (P50MH115837 and R43MH126793); Institute of Education Sciences (R305A230391); and U.S. Department of Education (S184X220017). The funders had no input on the current manuscript at any stage. KAC receives funding from the National Institute of Mental Health (F31MH139185). KAC is a part\u2010time employee at Lyra Health. EJB currently receives funding from the National Institute of Mental Health (P50MH115837 and R43MH126793); Institute of Education Sciences (R305A230391); and U.S. Department of Education (S184X220017). JLS has received funding from the National Institute of Health Office of the Director (DP5OD028123), National Institute of Mental Health (R43MH128075), the Upswing Fund for Adolescent Mental Health, the National Science Foundation (2141710), Health Research and Services Association (U3NHP45406\u201001\u201000), the Society of Clinical Child and Adolescent Psychology, HopeLab, Child Mind Institute, and the Klingenstein Third Generation Foundation. JLS serves on the Scientific Advisory Board for Walden Wise and the Clinical Advisory Board for Koko; has received consulting fees from UnitedHealth, Woebot, Kooth, and TikTok; is cofounder and codirector of Single Session Support Solutions; and receives book royalties from New Harbinger, Oxford University Press, and Little Brown Book Group.

Keywords

School mental health
universal prevention
youth mental health

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Psychiatry and Mental health

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10.1111/camh.12758

Cite this

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title = "Debate: Where to next for universal school-based mental health interventions? Tensions in prevention – To build better school-based programming, we must start with what we know",

abstract = "Researchers and education leaders have suggested that universal school-based prevention programs could improve youth mental health at a population level, yet recent trials of universal school-based prevention programs (e.g., MYRIAD, CSC) found null or iatrogenic results. In this debate piece, we argue that these results must be contextualized alongside existing knowledge that universal programs are ideally implemented within multitiered systems, promoting student autonomy tends to promote uptake and adherence, and individual trials do not outweigh decades of academic and community expertise. We offer suggestions for moving forward in research on and implementation of universal school-based prevention programs.",

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Debate: Where to next for universal school-based mental health interventions? Tensions in prevention – To build better school-based programming, we must start with what we know

Abstract

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Keywords

ASJC Scopus subject areas

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