In contrast to previous meta-analytic findings, our results indicate that CBM-I has potential but weak anxiolytic effects in youth. Our findings suggest that it may be premature to disregard the potential value of CBM-I research and further research in this field is warranted.

Abstract. First responders are routinely exposed to traumatic critical incidents, placing them at higher risk for developing stress-related psychopathology and associated health problems than the general population. Interventions which could improve resilience to stress may help to protect the health of this high risk population. We systematically reviewed such interventions for first responders to determine which ones work and why. We searched the Cochrane and Campbell Collaboration Library, EMBASE, IBSS, Medline, PILOTS, PubMed, PsycINFO, and SCOPUS from January 1, 1980 to June 28, 2018 for randomized and quasi-randomized controlled studies aiming to improve well-being, resilience, or stress management for police, ambulance, fire, or search and rescue workers using non-pharmacological interventions. Data were extracted from published reports and obtained from authors. Within- and between-group effect sizes were calculated for mental and physical health outcomes. Risk of bias was assessed using the Cochrane Collaboration’s Risk of Bias Tool. The initial search identified 3,816 studies, 13 of which were eligible for analysis ( n = 634 cases, n = 628 controls). Six studies demonstrated intervention-related improvements. However, risk of bias was mostly unclear or high. Within-group intervention effect sizes ranged from −0.82 (95% CI [−1.48, −0.17]) to 2.71 [1.99, 3.42] and between-group intervention effect sizes ranged from −0.73 [−1.25, −0.21] to 1.47 [0.94, 2.01], depending on the outcome. Largest effects were seen for interventions that targeted modifiable risk factors for trauma-related psychiatric disorders. Targeting modifiable predictors of trauma-related psychiatric disorders through training may protect the health of first responders who routinely face trauma in their line of work.

Objective: Recent studies suggest mental health in youths is deteriorating. The current policy in the United Kingdom emphasizes the role of schools for mental health promotion and prevention, but little data exist on what aspects of schools influence mental health in pupils. This study explored school-level influences on the mental health of young people in a large school-based sample from the United Kingdom. Method: Baseline data from a large cluster randomized controlled trial collected between 2016 and 2018 from mainstream secondary schools selected to be representative in relation to their quality rating, size, deprivation, mixed or single-sex pupil population, and country were analyzed. Participants were pupils in their first or second year of secondary school. The study assessed whether school-level factors were associated with pupil mental health. Results: The study included 26,885 pupils (response rate ¼ 90%; age range, 11-14 years; 55% female) attending 85 schools in the United Kingdom. Schools accounted for 2.4% (95% CI: 2.0%-2.8%; p < .0001) of the variation in psychopathology, 1.6% (95% CI: 1.2%-2.1%; p < .0001) of depression, and 1.4% (95% CI: 1.0%-1.7%; p < .0001) of well-being. Schools in urban locations, with a higher percentage of free school meals and of White British, were associated with poorer pupil mental health. A more positive school climate was associated with better mental health. Conclusion: School-level variables, primarily related to contextual factors, characteristics of pupil population, and school climate, explain a small but significant amount of variability in mental health of young people. This information might be used to identify schools that are in need of more resources to support mental health of young people.

The available evidence suggests a likely prevalence high enough to make it worthwhile screening hospital inpatients for depression and initiating treatment where appropriate. Further, higher quality, research is needed to clarify the prevalence of depression in specific settings and to further explore the reasons for the observed heterogeneity in estimates.