Rationale 

More than half of mental health problems start at an early age and many of these persist throughout adult life (Kessler et al., 2005).  Worldwide data shows an increase in the prevalence of mental health issues in childhood and adolescence (de la Barra, 2009) and the percentage of those afflicted reaching nearly 20% (WHO, 2016).  More than half of mental health problems start at Childhood and adolescence, and many of these persist throughout adult life (Kessler et al., 2005). For this reason, it’s very important to promote mental health at these stages.

Currently, many of the children and youth affected are not receiving an optimal response to address these needs (Green et al., 2013; Mills et al., 2006; Weist & Murray, 2008), as the multidimensional nature of the problem cannot be tackled only at the individual level. Accordingly, schools and communities offer an optimal context to intervene as children and adolescents grow and develop through social interaction. Schools and communities can make the most of its environment to foster child and youth development and to promote good mental health (Weist & Murray, 2008).  Therefore, social and cognitive development is enacted through social interactions in a particular cultural and social context (Bronfenbrenner, 1979; Vygotsky, 1978). Our interest relies on exploring in which ways dialogue and interaction may play a relevant role in effective mental health interventions carried out in schools and communities in the world.

Research question

The research questions that have guided this systematic review are:

-        Do mental health interventions in schools and communities have positive effects on children and adolescents with and without mental health problems?

-        How do interactions occur among different agents in mental health interventions targeting children and adolescents?

Objective 

The objective of this study has been to provide a systematic review of evidence for positive effects of interaction-based interventions in schools and communities in children’s and adolescents’ mental health. For this, an exhaustive search was carried out in the databases of Web of Knowledge, SCOPUS, ERIC and PsycINFO in order to identify interventions in which dialogue and interaction between peers, teachers, families or other community members and professionals have a relevant role. At the same time, the effects on students with and without mental health problems have been explored.

For this study we have conducted a systematic review (Gough et al., 2013) taken into account the recommendations made by PRISMA (Moher et al., 2009) and we used a checklist for the assessment of the primary studies provided (Lockwood et al., 2015), in order to ensure transparency, validity, replicability . For the review, empirical articles published in international scientific journals in the areas of psychology, education, and mental health and focused on interventions among children and youth between 2007 and 2017 were searched and screened. To that effect, the following databases were analyzed: Web of Knowledge, SCOPUS, ERIC, and PsycINFO. The articles were searched using the following keywords: “school-based”, “community-based”, “dialogue”, “mental health”, “well-being”, “emotional development”, “interventions”, “program”, “interaction”, and “prevention”. The exploration was completed with searches that employed synonyms or derivatives of the keywords. The keywords were also combined to refine the search. The publications containing the search criteria in the title, in the keywords and in the abstract were include. The first part of the search yielded a total of 384 articles from indexed journals: 183 published in the WOS database, 12 in Scopus, 33 in ERIC and 156 in PsycINFO. All these articles were entered into the Mendeley software for its screening and review. Basic information such as the title, year, authoring, and abstracts were obtained and introduced in a spreadsheet for a first screening. Abstracts of the 301 articles were reviewed according to the inclusion and exclusion criteria. As a result, 17 articles initially met the inclusion criteria and were eligible for the review. The articles were downloaded for an in-depth review. The three researchers examined the articles independently and extracted the most relevant information that was included in a spreadsheet. This first review and discussion of the studies of the 11 articles lead to the elimination of a further six articles that did not adequately fit the inclusion criteria. Thus, a total of 11 articles were finally selected for analysis. For the analysis, the researchers developed an analytical grid to systematize the most relevant information for the purpose of the review: study characteristics, interactions fostered during the intervention, positive effects and information for assessment of the risk of bias.

This systematic review of 11 studies has focused on mental health interventions in which interaction plays an important role. Supportive interactions carried out in the framework of mental health interventions involve various contexts, agents and systems, including teachers, parents, mental-health professionals, and members of the community. There is evidence of a positive effect on the mental health of children and adolescents, both in decreasing internalizing and externalizing symptoms and in promoting personal well-being. More specifically in this study, nine of the studies show the effects of preventive interventions aim to reduce future problems and to promote mental health among children and adolescents without mental health problems. Only two studies target children who had already contacted the school-based mental health service (Fazel, 2015) and adolescents who presented depressive symptoms (Connell & Dishion, 2008). Factors that foster mental health as social support or engagement also increase with interventions programs that include interaction as the main feature. The literature analyzed sheds light on the importance of preventive interventions where different agents work together towards the common goal of promoting children’s and adolescents’ mental health (Atkins et al., 2015; Kia-Keating et al., 2017). However, more research is needed into the specific impact of interaction on the mental health of children and adolescents, as well as analysing the type of interactions that have the most beneficial effect. Further empirical studies would contribute to unveil the potential of dialogue and interaction for the benefit of developing a positive mental health.

Atkins, M. S., Shernoff, E. S., Frazier, S. L., Schoenwald, S. K., Cappella, E., Marinez-Lora, A., ... & Bhaumik, D. (2015). Redesigning community mental health services for urban children: Supporting schooling to promote mental health. Journal of consulting and clinical psychology, 83(5), 839. Bronfenbrenner, U. (1979). The ecology of human development. Harvard university press. Connell, A. M., & Dishion, T. J. (2008). Reducing Depression Among At-Risk Early Adolescents: Three-Year Effects of a Family-Centered Intervention Embedded Within Schools. Journal of Family Psychology, 22(4), 574–585. https://doi.org/10.1037/0893-3200.22.3.574 de la Barra M, F. (2009). Epidemiología de trastornos psiquiátricos en niños y adolescentes: Estudios de prevalencia. Revista Chilena de Neuro-Psiquiatría, 47(4), 303–314. https://doi.org/10.4067/S0717-92272009000400007 Fazel, M. (2015). A moment of change: Facilitating refugee children’s mental health in UK schools. International Journal of Educational Development, 41, 255–261. https://doi.org/10.1016/j.ijedudev.2014.12.006 Gough, D., & Elbourne, D. (2002). Systematic Research Synthesis to Inform Policy, Practice and Democratic Debate. Social Policy and Society, 1(03), 225–236. https://doi.org/10.1017/S147474640200307X Green, J. G., McLaughlin, K. A., Alegría, M., Costello, E. J., Gruber, M. J., Hoagwood, K., ... & Kessler, R. C. (2013). School mental health resources and adolescent mental health service use. Journal of the American Academy of Child & Adolescent Psychiatry, 52(5), 501-510. Kessler, S., Ashenden, D. J., Connell, R. W., & Dowsett, G. W. (1985). Gender Relations in Secondary Schooling. Sociology of Education, 58(1), 34. https://doi.org/10.2307/2112539 Kia-Keating, M., Santacrose, D. E., Liu, S. R., & Adams, J. (2017). Using community-based participatory research and human-centered design to address violence-related health disparities among Latino/a youth. Family and Community Health, 40(2), 160–169. https://doi.org/10.1097/FCH.0000000000000145 Mills, C., Stephan, S. H., Moore, E., Weist, M. D., Daly, B. P., & Edwards, M. (2006). The President’s New Freedom Commission: Capitalizing on Opportunities to Advance School-Based Mental Health Services. Clinical Child and Family Psychology Review, 9(3–4), 149–161. https://doi.org/10.1007/s10567-006-0003-3 Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & Group, T. P. (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Medicine, 6(7), e1000097. https://doi.org/10.1371/journal.pmed.1000097 Vygotsky, L. S. (1978). Mind in society: The development of higher mental process. Cambridge, MA: Harvard University Press. Weist, M. D., & Murray, M. (2008). Advancing School Mental Health Promotion Globally. Advances in School Mental Health Promotion, 1(sup1), 2–12. https://doi.org/10.1080/1754730X.2008.9715740 WHO. (2016). “WHO | Child and Adolescent Mental Health.” WHO. World Health Organization. http://www.who.int/mental_health/maternal-child/child_adolescent/en/