Current evidence and opportunities in child and adolescent public mental health: a research review

Abstract

BackgroundA public mental health lens is increasingly required to better understand the complex and multifactorial influences of interpersonal, community and institutional systems on the mental health of children and adolescents.MethodsThis research review (1) provides an overview of public mental health and proposes a new interactional schema that can guide research and practice, (2) summarises recent evidence on public mental health interventions for children and adolescents, (3) highlights current challenges for this population that might benefit from additional attention and (4) discusses methodological and conceptual hurdles and proposes potential solutions.ResultsIn our evidence review, a broad range of universal, selective and indicated interventions with a variety of targets, mechanisms and settings were identified, some of which (most notably parenting programmes and various school‐based interventions) have demonstrated small‐to‐modest positive effects. Few, however, have achieved sustained mental health improvements.ConclusionsThere is an opportunity to re‐think how public mental health interventions are designed, evaluated and implemented. Deliberate design, encompassing careful consideration of the aims and population‐level impacts of interventions, complemented by measurement that embraces complexity through more in‐depth characterisation, or ‘phenotyping’, of interpersonal and environmental elements is needed. Opportunities to improve child and adolescent mental health outcomes are gaining unprecedented momentum. Innovative new methodology, heightened public awareness, institutional interest and supportive funding can enable enhanced study of public mental health that does not shy away from complexity.

The social determinants of mental health and disorder: evidence, prevention and recommendations

“…Greater cross‐sector collaboration and more inclusive outcome measures may help advance prevention efforts, particularly where these include approaches aimed at whole populations. At present, many promising interventions that target social determinants are not assessed in terms of mental health effects, which represents a lost opportunity to learn about their potential individual‐, community‐, and society‐level impacts 440 . For example, there are a wide range of innovative approaches being implemented within the education, social care and criminal justice sectors that may be beneficial for mental health but are not currently recognized as such due to an absence of formalized measurement of mental health outcomes.…”

Adolescent Mental Health Care: Time for Revolution

“…Recently, Fazel and Soneson [93] have proposed a new conceptual framework of interventions entitled "the Interactional Schema" of child and adolescent public mental health. This schema places an enhanced emphasis on the interactional nature of three factors influencing child and adolescent mental health: interpersonal, community and institutional.…”

Population mental health science: Guiding principles and initial agenda.

“…Participants built upon momentum growing in related fields, including the World Health Organization (2022) movement toward global mental health and New York City’s public health approach to mental health (Vasan et al, 2023). They drew upon Fazel and Soneson’s (2023) call for a “public mental health” and Sampson et al’s (2023) suggestion that a population health perspective is needed to address the U.S. mental health crisis and to transform the well-being of the U.S. population. Summit participants declared the goal and metric of accountability for psychological scientists and practitioners must change from improvement for individuals who are treated to improvement for the entire population.…”