School-based Mental Health and Wellbeing in Adolescents: An Umbrella Review

AbstractBackgroundAdolescent mental disorders affect approximately 15% of young people worldwide with a stark rise in mental health difficulties in secondary school age children over the past decade. Need for psychological support exceeds available provision and is exacerbated by staffing shortages. Schools are key settings for mental health and wellbeing (MHWB) support. This umbrella review synthesises evidence on school-based MHWB interventions in secondary schools, aiming to map and evaluate outcomes and intervention approaches on a tiered framework. MethodsFollowing PRISMA guidelines, a systematic search of reviews on school-based MHWB interventions was conducted. Data were extracted on intervention type, delivery mode, and outcomes. Reviews including broader age ranges (4-25 years) were considered, with a specific focus on adolescents.ResultsAfter screening 478 studies, 33 reviews published between 2014 and 2024 were included, covering programmes for adolescents aged 12-18 years. Social and emotional learning (SEL) programmes were most effective when implemented as whole-school approaches. Targeted interventions produced the largest gains for high-risk students, while universal programmes were more common in younger age groups. Preventive interventions delivered by specialists showed stronger effects, whereas universal programmes were more effective when delivered by school staff. Findings support a stepped-care model aligning MHWB support to student need. However, despite policy recommendations, implementation remains inconsistent.ConclusionsEffective MHWB provision in schools requires culturally responsive, developmentally appropriate, and scalable approaches. A tiered framework matching support to student need is recommended. Future research should explore digital delivery, scalability, and sustainability of school-based MHWB initiatives.