A scoping review of randomised evaluations of school-based indicated prevention interventions targeting adolescent mental health: understanding theory, screening processes, and outcomes

Reed, Hayley ORCID: https://orcid.org/0000-0002-3388-8902, McCann, Nyree, Renold, Rohen, Airdrie, Jac ORCID: https://orcid.org/0000-0002-1619-3172, Hewald, Erin and Shenderovich, Yulia ORCID: https://orcid.org/0000-0002-0254-3397 2026. A scoping review of randomised evaluations of school-based indicated prevention interventions targeting adolescent mental health: understanding theory, screening processes, and outcomes. SSM Mental Health , 100712. 10.1016/j.ssmmh.2026.100712

PDF - Accepted Post-Print Version Available under License Creative Commons Attribution. Download (1MB)

Abstract

Subthreshold anxiety and depression in childhood and adolescence is a risk for later disorder onset. An abundance of school-based indicated interventions aim to prevent this. Reviews of these interventions have focused on effectiveness with a lack of synthesis of their underpinning theories, screening processes, and outcomes which are important to understand how interventions operate for replication and adaptation purposes. This gap was addressed through a scoping review including interventions assessed through randomised evaluations. A systematic search of seven electronic bibliographic databases, cross-referencing with seven systematic reviews, citation tracking and consultations with experts. Titles, abstracts and full texts were independently screened by two reviewers. Of 15,013 unique articles, 56 studies of 39 interventions were included. Data were charted, tabulated and subjected to a directed content analysis. Findings showed 35% of child/adolescent intervention change mechanisms targeted cognitive and behavioural domains, 16% focused on emotional and 14% on the interpersonal domains. A third of interventions included parents to make change in families, but only one study attempted to change adolescents’ connection to school. The review found 22 screening instruments that predominately focused on symptoms rather than social functioning. Further, 20% of studies excluded participants based on their or their parents’ language proficiency, and 16% based on conduct issues. This review demonstrates that the indicated prevention field predominately takes a ‘treatment light’ approach adapting interventions from treatment approaches, targeting cognitive and/or behavioural mechanisms, and utilising symptom-based screening. This medicalised model may lead to the under detection of certain subgroups. A future direction could be to develop and evaluate interventions that identify adolescents based on their levels of social functioning and target other socio-ecological levels of health, including school-system change, to assess whether this leads to enhanced outcomes for adolescents.

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	Research Institutes & Centres > Centre For Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer) Schools > Psychology Schools > Social Sciences (Includes Criminology and Education) Schools > School of Social and Spatial Sciences Research Institutes & Centres > Wolfson Centre for Young People's Mental Health (WCYPMH)
Publisher:	Elsevier
ISSN:	2666-5603
Date of First Compliant Deposit:	12 November 2026
Date of Acceptance:	6 October 2026
Last Modified:	12 Nov 2026 10:15
URI:	https://orca.cardiff.ac.uk/id/eprint/190876

Actions (repository staff only)

Edit Item