School programs aim to reduce depression –
but do they work?
Spence SH, Shortt AL
The Bottom Line:
Universal school-based programs that aim to reduce the likelihood of children and adolescents developing depression have not been proven to be effective. It may be that the programs are too short or too general (i.e., designed for all students). Programs geared to children at risk for depression, or which take into account the environmental factors that lead to depression, may prove to be more effective. |
What problem is being addressed?
Children and teenagers are at significant risk of developing depression, a condition that may not get better over time. The symptoms of depression can interfere with school achievement, family and social relationships, and can lead to lifelong unhappiness. Depression prevention programs have increasingly become school based, following recommendations made by the World Health Organization’s Global School Health Initiative in 1998. Schools are viewed not only as the place to learn academic subjects but also to acquire the ability to mature emotionally and to gain social skills.
What intervention is being tested?
This review looked at studies of school-based depression prevention programs – programs aimed specifically at preventing depression, as opposed to simply promoting general well-being.
School-based depression prevention programs usually consist of teaching social skills, how to solve problems and cope with difficult situations (instead of reacting emotionally), and how to be realistically optimistic and to expect things to work out, instead of seeing failure as the likely outcome. These programs are usually directed towards all students, whether or not they are at increased personal risk of developing depression. Such programs are called “universal interventions”.
What is the real scientific evidence?
The authors examined studies to determine if they met the standards for prevention programs set by the Society for Prevention Research that would show that the programs were effective in real-life situations, rather than just test situations at universities or special clinics. (Click here for the guidelines).
The review revealed that the programs designed for use with all students, as opposed to students at risk for depression, showed no effectiveness in preventing depression. The authors concluded that universal programs should not be widely adopted.
It may be that the programs are too short to have any effect, or it may be that they fail to look at how the children’s environment influences whether or not they become depressed. Perhaps what is needed is a combination of interventions to change the environment (improve parenting skills, help depressed parents, reduce the effects of poverty on the family and community) and also help the individual children and adolescents develop ways of better coping with difficult situations.
The preceding is a summary of:
Spence SH, Shortt AL. Can we justify the widespread dissemination of universal, school-based interventions for the prevention of depression among children and adolescents? Journal of Child Psychology and Psychiatry 2007, 48(6): 526-542.
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