Postnatal depression (PND) is the most prevalent mental health disorder during the postpartum period. Evidence suggests that clinical practice guidelines (CPGs) can improve the mental well-being of women affected by PND. This study aimed to identify the CPGs available globally for the management of PND and to summarize their recommendations. A comprehensive search was performed across five electronic databases (MEDLINE, PsycINFO, CINAHL, TRIP, and Epistemonikos) and four guideline-specific websites (GIN, SIGN, NICE, and WHO) to identify the English language CPGs published between 2012 and 2023. The general characteristics of the CPGs, as well as the reported pharmacological and non-pharmacological recommendations, were extracted. The AGREE-II instrument was used to assess the methodological quality. Nineteen CPGs were included in the review, with only one from a low and middle-income country (Lebanon). Cognitive-behavioral therapy (CBT) was the most frequently recommended psychological therapy. Pharmacological interventions were included by 17 CPGs, predominantly Selective Serotonin Reuptake Inhibitors (SSRIs). Only three CPGs incorporated Patient and Public Involvement and Engagement (PPIE) in the form of an advisory group. Seven CPGs matched the criteria for adequate methodological quality by achieving an overall score of ≥70%. The findings highlight limited methodological quality and underrepresentation of LMICs, which may lead to disparities in the management of PND and undermine equitable mental health care.

Given the large mental health treatment gap in low- and middle-income countries (LMICs), particularly in post-conflict settings like Sierra Leone, and the limited healthcare infrastructure, understanding the wider benefits of evidence-based mental health interventions within households is critical. This study explored potential mental health spillover effects – the phenomenon of beneficial effects among nonparticipants – among cohabitating caregivers and partners of youth who participated in an evidence-based mental health intervention in Sierra Leone. We recruited a sub-sample of cohabitating caregivers and partners (N = 20) of youth intervention participants; caregivers had enrolled in a larger study investigating indirect benefits of the evidence-based intervention in Sierra Leone (MH117359). Qualitative interviews were conducted at two time points to explore the following: (a) potential mental health spillover effects and (b) through which mechanisms spillover may have occurred. Two trained coders reviewed transcripts and analyzed qualitative data, assisted by MaxQDA. Qualitative findings suggested that spillover effects likely occurred and supported three potential mechanisms: decreased caregiving burden, behavior changes among Youth Readiness Intervention participants and improved interpersonal relationships. Mental health spillover effects may occur following youth intervention participation in a post-conflict LMIC. Investing in evidence-based services may offer indirect benefits that extend beyond those directly receiving services.

Studies show that mental health promotion is an effective strategy that can reduce the burden of mental health disorders and improve overall well-being in both children and adults. In addition to promoting high levels of mental well-being and preventing the onset of mental illness, these mental health promotion programmes, including mental illness prevention interventions, help increase levels of mental health literacy in community members. While there is evidence showing the effectiveness of mental health promotion, much of what is known about this field is informed by studies conducted in high-income countries. There is a need to gather evidence about the effectiveness of such interventions in low- and middle-income countries (LMICs) where mental health services are often inadequate. In this systematic review, we synthesised the available published primary evidence from sub-Saharan Africa (SSA) on the types and effectiveness of mental health promotion programmes for young people. We performed a search of selected global databases (PubMed, PsycINFO, ScienceDirect and Google Scholar) and regional databases (Sabinet African Journals). We included observational, mixed methods, trials, pilots and quantitative original papers published from 2013 to 2023. We used the Mixed Methods Appraisal Tool (MMAT) to evaluate the quality of methods in selected studies, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA-2020) for reporting the evidence gathered. We identified 15 types of youth mental health promotion and illness prevention interventions. Among those identified, we found that school-based interventions enhanced mental health literacy, mental health-seeking behaviours and self-assurance and confidence among young people. Family-based interventions also showed a potential to improve relationships between young people and their caregivers. Future studies should explore how to further strengthen school- and family-based interventions that promote mental health among young people.

This study assessed whether a music therapy program improved mental health and school attendance among girls in the Democratic Republic of Congo (DRC) following economic and conflict-related insecurity. It included 483 girls aged 10–14 who participated in the Healing in Harmony (HiH) program, implemented by World Vision and Make Music Matter in Kasai-Central province. Participants completed surveys before and after the program, and up to two follow-up interviews assessing depression, anxiety, self-esteem, and school attendance. Before the program, 36.0% (95% CI 31.7%–40.3%) and 60.5% (95% CI 56.1%–64.8%) screened positive for depression and anxiety, respectively. After participation, the risk of screening positive declined by 75% for depression (RR = 0.27, 95% CI 0.22–0.32) and by about half for anxiety (RR = 0.46, 95% CI 0.41–0.53), with improvements sustained up to 17 months. Self-esteem scores increased by 3.93 points (95% CI 3.22–4.64, p<0.001). School absenteeism decreased from 10% (95% CI 7.2%–12.6%) to 5.4% (RR = 0.54, 95% CI 0.40–0.73). Participation in HiH was associated with sustained improvements in mental health and school attendance. These findings support integrating psychosocial care into humanitarian responses to improve both mental health and educational outcomes for crisis-affected children.

Mental health promotion in schools has gained greater salience in high-income countries, especially since the COVID-19 pandemic. However, less is known about its conceptualisation and implementation in less developed countries such as Indonesia. This research aimed to describe what school communities in Surabaya, Indonesia, understand about their role and actions in promoting mental health. This exploratory study employed Focus Group Discussions with diverse members of junior high school communities, including students. Using the Health Policy Triangle as the theoretical framework, transcripts were thematically analysed using a deductive approach. Forty-six participants took part, from national to municipality levels. Three themes were found. First, participants considered that socialisation difficulties contributed to poor student mental health and engagement in learning. Second, while schools reported familiarity with a range of actions, from promotion to preventive and curative interventions, their primary focus was around ensuring access to services for students with mental health problems. Third, contextual barriers and enablers were identified impacting schools’ mental healthpromoting actions. The inter-related aspects of context, content, process, and actors were found to shape implementation. These findings highlight the multi-component expertise and resources of school communities, which, if better embraced, could enhance their capabilities to promote mental health in schools.

Although the needs of conflict-affected children are well-documented, research on the post-conflict period is limited, particularly in Syria, where the fall of the Assad regime has created a rapidly evolving environment for internally displaced children. This study explores how key informants perceive the mental health needs, daily stressors and coping strategies of internally displaced children during the post-regime period. Online semi-structured interviews were conducted with 10 staff members from a non-governmental organization working in psychosocial support in the Syria camps. Data were analyzed using thematic analysis. Five major themes emerged: (1) stressors in the current camp environment, (2) challenges related to return, (3) observed emotional and behavioral difficulties, (4) children’s psychological resources and (5) needs and gaps in support services. Findings highlight the inseparability of children’s mental health from basic needs, the role of place-based attachments in return processes and the importance of a holistic approach that considers context-specific stressors and resources in this unique period.

This study aimed to determine the prevalence and associated factors of depressive symptoms among adolescents in Can Tho City, Vietnam. A cross-sectional study was conducted with 1,054 students aged 15–18 years, recruited from eight high schools using one-off anonymous questionnaires. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale Revised – Vietnamese version. The Self-esteem Scale of Vietnamese Adolescents, the Crandell Cognitions Inventory-Short form scale, the School Connectedness Scale and the Educational Stress Scale for Adolescents were used to assess self-esteem, cognitive distortion, school connectedness and educational stress, respectively. Univariate analyses explored the relationships between sociodemographic variables and depressive symptoms. Pearson correlations were calculated for the associations between variables. Multiple regression was used to adjust for the factors that contributed to depressive symptoms in adolescents. The findings revealed that 37.4% of adolescents in Can Tho City, Vietnam, experienced depressive symptoms. Factors influencing depression in adolescents include cognitive distortions, academic pressure, exposure to interpersonal violence, consumption of alcohol and smoking, family history of depression, family incarceration and experiences of digital sexual violence. These results underscore the urgent need for a multilevel and multidimensional intervention strategy involving parents, educators, mental health professionals and policymakers to promote early identification, provide support and enhance mental health literacy among adolescents.

Mental health interventions, such as Youth Readiness Intervention (YRI), offer an opportunity for improving the mental health of war-affected youth in fragile and conflict-affected regions. The YRI has demonstrated effectiveness in improving mental health outcomes, yet prior analyses have not examined the economic impact of the YRI integrated within with an entrepreneurship (ENTR) program. A costing analysis was conducted using standard activity-based costing methodology to estimate implementation costs. Next, economic benefits (productivity, healthcare offsets and local returns) were estimated, using participant-reported and secondary data. Total benefits were compared with total costs to calculate the return on investment (ROI), taking into consideration varying unemployment rates as a result of the intervention. Results show that the YRI + ENTR implementation cost is $117,289.00 ($305.44 per participant) and the ENTR-alone implementation is $67,279.10 ($177.05 per participant). The ROI for the YRI + ENTR varies from $1.01 to $1.95. The ROI for the ENTR alone varies from $2.53 to $6.92. In one of the ROI pathways – that is, healthcare savings – we find that the YRI + ENTR results in an 8.5-fold larger healthcare saving compared to the ENTR alone. This is one of the first studies to examine the broader economic returns of the YRI and ENTR program and are important to consider in future implementation due to the broad nature of economic benefits.