The role of schools in mental health promotion and prevention: a document analysis of Swedish local mental health policies

It has been recognized that schools play a key role in promoting well-being and preventing mental health problems among children and adolescents. The local context is crucial for realizing the school's health-promotive potential. This study aimed to explore how the role of schools is approached in Swedish municipal policy documents governing mental health efforts. A qualitative document analysis using the READ approach was conducted. Seventy-three municipalities were selected and asked to provide policy documents on mental health; twelve policy documents met the inclusion criteria and were analyzed using conventional content analysis. The analysis identified the school as a central actor across the documents. Four categories were constructed: (i) the school as a context influencing mental health, (ii) the school as a platform for reaching all children and adolescents with mental health interventions, (iii) the school as responsible for detecting mental health problems, and (iv) the school as a collaborating partner in mental health efforts. The analysis highlighted a primarily individualized and often medicalized understanding of mental health problems, positioning health professionals as key actors. Although the school's role as a context influencing mental health was clearly acknowledged, teachers, pedagogical support and social relationships were overlooked in relation to this role. The school's role in mental health efforts was thus largely detached from its educational mission. Finally, there was substantial variation in the activities expected of schools across municipalities. Hence, despite schools' recognized importance, their role in mental health efforts was subject to local interpretation of national policy within a decentralized school system.