The implementation and effectiveness of sports-based mental health programmes in schools: a systematic review

Schools are increasingly recognised as promising settings for the promotion of mental health among children and adolescents. In this context, sport-plus interventions which combine sport or physical activity with explicit mental health components are also gaining attention. This systematic review synthesises the evidence on school-based sport-plus interventions aimed at promoting mental health. A systematic literature search across seven databases identified 16 studies reporting on 14 distinct interventions. Studies varied in design, target group, adopted sport, delivery, and intervention components. Most studies reported positive effects on mental health-related outcomes such as resilience, well-being, and self-esteem. However, effectiveness varied, with several studies showing limited or no impact. Process evaluations revealed key implementation challenges, including insufficient staff training, lack of student engagement, and cultural appropriateness. Many interventions also lacked a clear theoretical grounding, and the overall methodological quality was limited. Despite these limitations, the review indicates that school-based sport-plus interventions have potential to promote youth mental health. To strengthen future practice and research, there is a need for greater theoretical coherence, contextual relevance, and rigorous evaluation designs.