Objective To support the development of a Flemish policy plan for mental health promotion (MHP), a rapid umbrella review was conducted to identify effective interventions for MHP and the primary prevention of mental health problems across the life course. Methods A search was conducted in Scopus, PubMed, ProQuest (Psychology and Social Sciences), and the Cochrane Database of Systematic Reviews for systematic and umbrella reviews published between October 2021 and March 2024. In total, 204 reviews were included. Broad patterns in the evidence were synthesized by life stage (the first 1000 days; children and adolescents; adults; older adults; across life stages). Results Sufficient evidence is available to support the scale-up of some interventions. School-based social and emotional learning (SEL) programs have a well-established evidence base. CBT-based and mindfulness-based approaches show reliable small-to-moderate effects on mental health outcomes across populations. Physical activity interventions contribute positively to mental health across age groups, settings, and vulnerable populations, although effect sizes are generally small. Workplace interventions combining organizational interventions with individual support are promising. During the perinatal period, CBT-based, mind-body, physical activity, support-based and parenting interventions show positive effects on mental health outcomes. Guided digital interventions are promising, although effects are generally smaller than those of face-to-face interventions. Evidence for older adults and disadvantaged populations remains limited. Conclusion This umbrella review provides evidence to support the development of a Flemish policy plan for mental health promotion. Such a plan should combine universal and targeted approaches, with particular attention to vulnerable groups.
Background Financial strain is associated with poor mental health, but debt repayment problems remain underexamined as correlates of self-harm and suicidal thoughts and behaviours among students. We examined associations between debt repayment problems, difficulties meeting ongoing expenses, and past-year self-harm and suicidal thoughts and behaviours among Norwegian students in higher education. Methods We analysed cross-sectional data from 49,198 participants in the 2026 Students’ Health and Wellbeing Study. Financial indicators were assessed using four-level frequency measures. Outcomes were past-year thoughts of self-harm, non-suicidal self-harm, suicidal ideation without attempt, and suicide attempt. Prevalence ratios (PRs) with 95% confidence intervals (CIs) were estimated using modified Poisson regression with robust standard errors, adjusting for sociodemographic factors. Sensitivity analyses additionally adjusted for psychological distress and mutual financial indicators. Results Both indicators showed graded associations with all outcomes. Compared with no difficulties, debt repayment problems most of the time were associated with suicide attempt (PR 8.57, 95% CI 5.10 to 14.40) and suicidal ideation without attempt (PR 3.48, 95% CI 3.01 to 4.03). Corresponding estimates for difficulties meeting ongoing expenses were 7.16 (95% CI 4.55 to 11.28) and 3.33 (95% CI 3.00 to 3.71). Associations were attenuated but generally persisted at the highest exposure levels after additional adjustment. Conclusions Debt repayment problems and difficulties meeting ongoing expenses were associated with higher prevalence of self-harm and suicidal thoughts and behaviours. Financial strain may be an important marker of elevated vulnerability in student welfare and prevention-oriented support.
Background Women who did not meet their breastfeeding goals often experience breastfeeding grief (BG) and may be likely to have postpartum depression. Postpartum depression is nearly twice as common in African American women as in Non-Hispanic White women. No research exists on BG and its role in postpartum depression. This study examined African American women’s experiences of BG and its possible contributions to postpartum depressive symptoms. Methods Convergent parallel mixed methods design. A purposive sample of 14 African American women with children aged 6 months-2 years with BG participated in individual semi-structured interviews about their experiences of BG and completed an online survey including the Edinburgh Postnatal Depression Scale (EPDS). Qualitative and quantitative data were analyzed using reflexive thematic analysis and descriptive statistics, respectively. Both data were integrated using joint display of data and side-by-side comparison. Results Participants’ mean age was 29.6 years. Four meaning-based themes about BG were generated: Yearning to fulfill maternal responsibilities, Disconnect between idealized plans and lived realities, Navigating the disconnect, and The disconnect is preventable. From quantitative results, all participants reported history of postpartum depressive symptoms, and they all reported that experiencing BG contributed to their postpartum depressive symptoms. Half of participants also had EPDS scores ≥11. Findings suggest that BG may contribute to postpartum depressive symptoms in African American women without prior diagnosis of depression. Conclusions Qualitative and quantitative findings from this novel exploratory study revealed an overlap that African American women with BG may experience postpartum depressive symptoms.
Background The mental health of young people has deteriorated markedly in recent decades, with rising rates of anxiety, depression, school difficulties, self-harm, and suicidality. Strong evidence shows that parent and family interventions can modify key determinants of youth mental health. However, these interventions remain underutilised in policy and service systems. Method We conducted a narrative review, integrating expert commentary from members of the Parenting & Family Research Alliance (PAFRA). Our goal was to identify modifiable parent and family determinants contributing to rising youth mental health problems and to examine evidence-based interventions and policy strategies that could address these with potential for population-level impact. Results Key modifiable risk and protective factors for youth mental health include social, environmental, and developmental factors. Contemporary challenges (e.g., climate change, technological risks) add considerable stress to young people, with implications for parenting. Bidirectional interactions between youth and parent factors shape mental health outcomes, with contemporary parenting challenges heightening risk. Interventions that educate parents about key risk and protective factors and strengthen emotional communication, stress regulation, and supportive parent-adolescent relationships can enhance resilience and buffer families during rapid social, environmental and economic change. Conclusions Many of the identified drivers of youth mental health decline can be targeted through parenting interventions that provide psycho-education and build parents’ ability to support their young person’s mental health. Scaling evidence-based parent and family interventions, alongside supportive policy and community infrastructures, represents a substantial opportunity to improve youth mental health at a population level.
Background Higher education students experience high levels of depression, anxiety, and stress, which can negatively impact their mental well-being and academic performance. Tai Chi has shown potential benefits in improving mental health, but its effects on university students remain inconclusive. This systematic review and meta-analysis aimed to assess the effects of Tai Chi on ameliorating mental health of higher education students. Methods We searched multiple databases and trial registries to identify randomized controlled trials which evaluated Tai Chi interventions in higher education students with elevated symptoms of depression, anxiety, or stress. Review Manager software was used for meta-analyses and subgroup analyses. The risk of bias was evaluated using Cochrane Risk of Bias 2.0, and the quality of evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results Ten trials with 598 participants were included in this review. Meta-analysis showed that Tai Chi may reduced depression symptoms compared to no intervention or usual care (SMD= -1.63, 95% CI [-2.21, -1.05], P < 0.00001, I2=82%, 8 studies). For anxiety, a reduction was also observed (SMD = -1.28, 95% CI [-2.36, -0.19], P = 0.002, I² = 76%, 2 studies). However, the GRADE assessment demonstrated the evidence quality of both depression and anxiety was very low due to high risk of bias and significant heterogeneity. Conclusion Tai Chi may reduce depression and anxiety symptoms in higher education students. However, more high-quality studies are needed to establish its effectiveness.
Objective Social prescribing is a pathway that connects individuals to non-clinical services. It supports and addresses social needs, such as those related to loneliness, housing instability and mental health. Social Prescribing Europe (SP-EU), a European Union funded project, seeks to co-create an adaptation of the social prescribing pathway based on the needs of the following target groups: LGBTIQ+ people, refugees and first-generation immigrants, older people living alone. This adapted social prescribing pathway will be tested in a pragmatic randomised controlled trial (RCT) in ten hubs, covering eight countries, across Europe.The aim of this process evaluation is to explore the implementation of the SP-EU RCT social prescribing pathway, and the experiences of the link workers, general practitioners, intervention staff, and patients from the groups listed above in both the intervention and control groups. Methods We will adopt a convergent parallel mixed methods approach. Data will be reported using appropriate reporting guidelines. Both quantitative and qualitative data will be collected, analysed and integrated to examine levels of convergence, divergence, or complementarity. Discussion Overall, the findings from this process evaluation will contribute to the interpretation of the main SP-EU trial results. More generally, it will add to our understanding of how social prescribing pathways may be used to engage people in vulnerable situations in activities that have the potential to increase health and wellbeing across a European context. The results will feed into a research policy document on social health care intervention RCTs in primary care across Europe.
Background University students face high rates of psychological distress, yet access to timely mental health support is often limited. This study evaluated Sharper Minds online modules, a set of seven self-paced digital modules designed to improve students’ mental health literacy (MHL), self-care, and health behaviours, framed within a peer support approach. Design Undergraduate students (N = 145, 73.8% women) completed the foundational module to improve MHL and provide information on the supports available on campus, plus up to six optional modules across health and self-care domains (physical activity, sleep, nutrition, mood regulation, using music listening for managing study-related emotions, and social connection; median = 6 modules completed, range = 1–7 modules in total). A single-group, uncontrolled pre-post design assessed changes in MHL, self-care knowledge and use, peer-support confidence, academic motivation, and psychological distress. Results Scores improved across all outcomes from pre- to post-intervention, with medium to large within-group effects for help-seeking knowledge, self-care knowledge, and self-care use. Academic motivation increased modestly, while psychological distress decreased, with the proportion screening above the clinical threshold decreasing from 63.9% to 53.5%, although more than half of participants still screened above the threshold. Most participants (n = 128) reported supporting at least one peer, and over half of those who recommended professional help to a peer reported that the peer subsequently sought professional support. Conclusion These preliminary findings are consistent with the potential of brief, student-centred online modules to support mental health knowledge, skills, and behaviours, warranting controlled evaluation, including their role alongside counselling services.
Objective This paper describes the study protocol for the HADAS Program, a multidimensional psychoeducational intervention aimed at preventing eating disorders (ED) in adolescent female athletes by involving the entire "sports triangle": athletes, coaches, and families. Methods A cluster randomized controlled trial with a longitudinal design will be conducted in aesthetic sports clubs. Randomization will be executed at the club level. A sample of 236 female athletes (aged 12–16), their coaches, and family members will be randomized into an experimental group (EG) or a control group (CG). The EG will receive a multi-component program consisting of five psychoeducational sessions for athletes, four for coaches, and two for families, supported by specific workbooks. Primary outcomes include ED risk (EAT-26) and body dissatisfaction (BSQ-34), while secondary outcomes encompass psychological well-being, competitive anxiety, perfectionism, media literacy, coaching leadership styles, and family communication dynamics. Assessments will be conducted at baseline (T0), immediate post-intervention (T1), and at 6-month (T2) and 12-month (T3) follow-ups. Longitudinal data will be analyzed using robust linear mixed models (rLMM) to account for the nested structure of the data within clubs and to perform intention-to-treat analyses. Conclusion The HADAS Program protocol proposes a comprehensive, multi-level framework for ED prevention in sports, aiming to address both individual and contextual risk factors within the athlete's immediate environment. Trial registration The study was prospectively registered on ClinicalTrials.gov. Identifier: NCT07750301
Access to child and adolescent mental health (CAMH) services in Nepal remains extremely limited. Most CAMH efforts focus on treatment-oriented, resource-intensive interventions that are difficult to scale. School-based mental health promotion and illness prevention offer a promising alternative, yet evidence from Nepal remains scarce. This formative study explored stakeholder perspectives to inform the development of a universal, school-based mental health promotion and illness prevention intervention. Objective To explore adolescents’, parents’, and teachers’ views on priority content, delivery approaches, and suitable delivery agents for a school-based prevention program for mental health problems. Methods The study was conducted in six community schools in Kanepokhari Rural Municipality, Nepal. Semi-structured interviews were conducted with teachers (n = 6) and parents (n = 4), alongside seven focus group discussions with adolescents (n = 47) and parents (n = 19). Framework analysis was used for data analysis. Results Participants identified bullying, menstruation-related stigma, sexual and reproductive health, substance use, and parent–child communication as priority intervention content. They recommended interactive delivery methods, sessions during school hours, and parental involvement. Preferences varied regarding group composition and facilitator selection, with many favoring trained external facilitators. Perceived benefits included improved emotional expression, strengthened family relationships, and enhanced psychosocial wellbeing. Conclusion Findings highlight the importance of contextually tailored, school-based mental health promotion and illness prevention intervention in Nepal, emphasizing relevant content, engaging methods, and meaningful parental participation to support adolescent wellbeing.
Background and objective: Irish Travellers are an ethnic minority group, native to the island of Ireland, who experience disproportionately high levels of suicide and poor mental health as a result of decades of material deprivation, discrimination, and the loss of their culture and nomadic lifestyle. This research study examined the perspectives of Travellers on the factors and strategies needed to achieve optimal mental wellbeing and prevent suicide in their community. Methods: A community-based participatory research approach was adopted. Seventeen Traveller peer researchers conducted thirteen workshops and five individual interviews nationwide with 87 adult members of their community (17% males, age range 18-73). Convenience sampling and participatory data analysis, involving the peer researchers, were employed. Results: The findings point to the importance of promoting Traveller culture and identity, addressing the detrimental effect of discrimination and the right to equal opportunities and life choices. Community-based initiatives were also deemed essential by Travellers to promote their mental health and reduce suicide. The value of addressing the social and structural determinants of Traveller’s mental health emerged as a fundamental approach. Conclusion: The study findings call for whole-of-government approaches and intersectoral strategies that have a strong foundation in Traveller culture, include empowering and strengths-based approaches and the provision of mental health promotion and community support based on a peer-led model of delivery. The key actions identified by Travellers support a greater focus on culturally grounded co produced mental health promotion and prevention strategies that complement mainstream treatment and recovery approaches.
Background Digital media use among children, adolescents, and young adults has shifted from general screen exposure toward passive, visually oriented, and algorithmically curated engagement. Passive scrolling and short-form video consumption on platforms such as TikTok, Instagram Reels, and YouTube Shorts have raised concerns regarding mental health and cognitive outcomes. However, current evidence remains heterogeneous, and causal relationships are not yet well established. Objective This scoping review aimed to map empirical evidence on the associations between passive scrolling, short-form video consumption, and closely related passive, problematic, or platform-specific digital engagement patterns and mental health-related outcomes among children, adolescents, and young adults. Methods This scoping review was guided by the methodological framework of Arksey and O’Malley and Levac et al., and informed by PRISMA-ScR and JBI guidance. Four databases, PubMed, Scopus, CINAHL, and Web of Science, were searched for peer-reviewed empirical studies published in English between 2021 and 2026. Eligible studies examined passive scrolling, short-form video consumption, or closely related passive, problematic, or platform-specific digital engagement patterns and reported mental health-related or cognitive outcomes. Data were synthesized descriptively and thematically. Meta-analysis was not conducted because of heterogeneity in populations, exposures, platforms, outcomes, instruments, and study designs. Results Eighteen empirical studies met the inclusion criteria. The included studies covered diverse populations, including children, adolescents, university students, and young adults. Most studies used cross-sectional designs, with fewer longitudinal, experimental, diary, or parental perception studies. Passive scrolling, short-form video consumption, problematic social media use, and smartphone addiction were reported in association with anxiety, depressive symptoms, psychological distress, sleep disturbance, inattention, loneliness, emotion regulation difficulties, body image concerns, self-harm-related outcomes, stigma, and digital well-being. However, findings were mixed, and longitudinal evidence did not consistently support long-term associations. Conclusions The current evidence suggests that passive scrolling, short-form video consumption, and related digital engagement patterns may be associated with several mental health-related and cognitive outcomes among children, adolescents, and young adults. However, the evidence remains heterogeneous and largely correlational, limiting causal interpretation. Future research should use longitudinal designs, ecological momentary assessment, objective digital trace data, and platform-specific measures to clarify mechanisms, moderators, and protective factors.
Objective:Financial challenges are common during emerging adulthood (ages 18-29) and may have implications for mental health and social relationships. Research with adults more generally indicates that debt and financial distress are associated with a range of poor health and social outcomes. However, most research has not addressed emerging adulthood, an important developmental period. Additionally, research with emerging adults has focused on debt burden rather than the broader concept of financial well-being which reflects a more holistic assessment of capabilities, future opportunities, and security. We examined financial well-being as a predictor of subsequent changes in mental health and loneliness among emerging adults. Methods:A community sample of emerging adults (N=2,157) completed surveys in 2021-22 (mean age=25) and 2022-23 (mean age=26) measuring financial well-being, depression symptoms, anxiety symptoms, and loneliness. We used longitudinal multivariable linear regression models to examine financial well-being and perceived debt burden, both independently and simultaneously, as predictors of change in outcomes one year later. Results:Lower financial well-being was prospectively associated with greater depression symptoms, anxiety symptoms, and loneliness. Debt burden had no independent prospective association with any of the three mental health outcomes. Conclusion:Broader measures of financial well-being may be more relevant than debt burden or understanding mental health outcomes. Assessing financial well-being may help identify individuals at risk for psychological distress. In addition to upstream efforts to reduce drivers of debt and poor financial well-being, there is a need for greater attention to links between economic circumstances and outcomes during this critical developmental period.
Objective Early parent–infant interactions, particularly warm, responsive, and mutually enjoyable engagement, are important factors promoting the mental health and wellbeing of young children. Playful interactions are not only related to motor and cognitive development but also work as a relational process central to child socio-emotional development and resilience. This study evaluates the efficacy of a newly developed universal intervention “The Playful Learning in Infancy Program” (PLIP) compared to Care As Usual (CAU) in the primary care context of the Danish Home-visiting Program. PLIP aims to promote playful parent-infant interactions during the first year of life. Methods PLIP is delivered by 28 health visitors from two Danish municipalities. Approximately 2,128 parents will be invited to participate in the control group, and 2,526 parents will be invited to participate in the intervention group. The study uses a quasi-experimental cohort study design with data obtained at five timepoints comparing a control group receiving CAU and the intervention group receiving PLIP in addition to CAU. The primary outcome is frequency of parent-infant playful interactions. Secondary outcomes include parental attitudes towards play and infant socioemotional development. The project is registered at ClinicalTrials.gov with ID no. NCT06352229, April 3rd, 2024. Conclusion The study evaluates the efficacy of a newly developed intervention, PLIP, in promoting parent-infant playful interactions and how it relates to early socioemotional development of the child. This knowledge may guide future interventions aiming to promote child mental health through play-based interventions.
Objective Nigeria has one of the largest internally displaced populations in West Africa. Quantitative studies have documented mental health symptoms among internally displaced persons (IDPs), but less is known about the lived psychosocial realities and displacement-related factors shaping mental health in North Central Nigeria. This study explored trauma exposure, support, coping, socioeconomic conditions, and gender-based violence (GBV) and protection concerns among IDPs in Wassa and Durumi camps, Abuja. Methods A qualitative phenomenological design was used. Eighteen in-depth interviews and eight focus group discussions were conducted in Hausa with adolescents, adults, camp leaders, and religious leaders, then transcribed, translated into English, and analysed thematically using Braun and Clarke’s framework with NVivo 14. Bronfenbrenner’s Ecological Systems Theory guided interpretation. Results Five themes emerged: psychological distress and mental health perceptions, support ecosystem, coping mechanisms, socioeconomic impact, and GBV and protection concerns. Participants described violence exposure, excessive thinking, social withdrawal, disrupted schooling, livelihood loss, food and water insecurity, weak formal services, and reliance on family, peers, faith groups, and informal savings networks. GBV accounts were mostly indirect and were interpreted as participant-reported accounts and community perceptions, not verified legal claims. Conclusion Findings highlight modifiable social, economic, service, and protection conditions shaping IDP mental health across ecological levels. Prevention should strengthen trauma-informed mental health and psychosocial support, family, peer, and community networks, education access, livelihood opportunities, GBV prevention and confidential referral pathways, and policy responses that embed IDP well-being within humanitarian systems.
Objective Despite evidence that emergency physicians (EPs) have high rates of mental health difficulties and stress, research is limited. This study evaluated the frequency of mental health symptoms, stress, and treatment utilization and characteristics that distinguish higher rates. Then, the impact of different types of stress on past year mental health difficulties was investigated. Methods U.S. emergency departments with residency programs or within large hospitals / healthcare systems (n = 514) were invited to participate, with 252 attending EPs across 31 states participating (79% white; 56.3% Male; Mage = 44.01, SD=9.75). Mental health and treatment were compared by gender, years of experience, and workload. Then, elastic net and logistic regression analyses were used to examine the association of eleven stress types with past year mental health difficulties. Results Moderate-to-high past month stress was reported by 84.9% and current burnout reported by 53.6%, with 44.5% reporting past year mental health difficulties and 13.1% reporting past year suicidal ideation. Females were more likely than males to report several concerns (e.g., depression, anxiety, burnout, stress). Across the entire sample, occupational burnout and COVID-19-related stress were associated with greater odds of past year mental health difficulties in both statistical models. Model-specific effects also emerged: past-month perceived stress frequency was associated with higher risk only in the elastic net model, whereas past-year bereavement-related stress was associated with lower risk in the logistic regression model. Conclusion EPs are experiencing mental health concerns at alarming rates. This underscores the need for interventions that reduce stress and address treatment barriers.
Objective Up to half of India’s college-going emerging adult (18-25-year-old) population experience psychological distress but few seek mental health support. To improve service access and adoption in this population, our study explores language used to communicate mental health concerns, identifies availability and accessibility barriers, and explores digital mental health delivery as a potential solution. Methods An exploratory-descriptive qualitative design guided 20 focus group discussions with 106 participants in two underserved states in India. Thematic analysis identified 275 initial codes, through line-by-line, inductive coding grounded in participants’ language. These were later distilled into 63 distinct first-level codes, 12 categories, and four final themes. Results Findings suggest that emerging adults balance everyday stress through self-regulation and often trivialize their mental health concerns due to fear of stigma and labeling, contributing to barriers in service access. Findings also indicate that emerging adults perceive digital mental health services to be an accessible, low-risk option, but prefer hybrid models that could include in-person sessions after trust in confidentiality and privacy are established within the therapeutic relationship. Additionally, the findings further suggest that hybrid services should be tailored for this population, and should reflect their colloquial language, hesitancy toward help-seeking, and everyday stressors. Conclusion Mental health service uptake among emerging adults in underserved regions can be improved through flexible, user-driven, and context-dependent hybrid care models that combine digital and in-person support. Foregrounding everyday language and its role in stigma and help-seeking, our study points to new directions for designing more responsive mental health interventions.
Background Young people in sub-Saharan Africa face severe mental health issues, including high prevalence rates of mental health disorders, limited access to mental health care, widespread stigma associated with mental illness and poor help-seeking behaviour. Mental health literacy among young people in sub-Saharan Africa is critically low. This review aims to evaluate the effectiveness of the mental health literacy interventions implemented for young people in sub-Saharan Africa. Method This review used the PRISMA guidelines. Searches were carried out across three databases which included Medline, PsycINFO and Embase for published articles up to September 2025. The eligibility criteria utilised the SPIDER framework. The Risk of Bias in Non-randomized Studies - of Interventions tool (ROBINS-I) tool and Mixed Methods Appraisal Tool (MMAT) were used to assess the quality of the studies. A narrative approach was used to synthesise this review. Results Eleven studies were included. All reported improvement in at least one outcome domain: knowledge improved in all 11 studies, attitudes in 6, stigma in 5, and help-seeking behaviour in 3. Interventions were mainly school-based or multi-component and included psychoeducation, life-skills training, peer or teacher education, radio programmes, and community-linked models. Reporting on accessibility, cost, and workforce requirements was limited. Conclusion This review has shown the effectiveness and nature of the mental health literacy interventions targeted at young people in sub-Saharan Africa. Future research should evaluate the long-term effectiveness of existing mental health literacy interventions.
