Universal school-based mental health programmes in low- and middle-income countries: A systematic review and narrative synthesis

Depression and anxiety pose a significant burden during adolescence, which may have consequences for adulthood and future generations. The mental health needs of children and adolescents in lowand middle income countries are not adequately addressed due to a lack of availability and access to services, and limited intervention research in these contexts. Universal school-based interventions provide a unique and potentially scalable opportunity to prevent and address mental health concerns amongst children and adolescents in low and middle-income countries. This systematic review aimed to identify and provide a narrative synthesis of universal school-based programmes delivered to children (aged 6-18 years) in lowand middle-income countries reporting on anxiety and/or depression outcomes. We searched Academic Search Premier, ERIC, PsycINFO, PubMed, Scopus, Web of Science, and ProQuest Dissertations using a pre-specified search strategy. Of the 12,478 articles identified, 12 studies met our inclusion criteria and were included in this review. The included studies report on a variety of interventions differing in approach, format and content. Given the small number of studies and concerns with study quality, we are unable to conclude that universal school-based interventions may reduce symptoms of anxiety and depression in children in lowand middle-income countries.

Automated summary

Depression and anxiety are significant burdens during adolescence that can have long-term consequences for future generations. Existing universal school-based interventions for children and adolescents in low and middle-income countries are limited in research and availability, making it difficult to draw conclusions on their effectiveness in reducing symptoms of anxiety and depression.