Evaluated Interventions Targeting the Mental Health and Psychosocial Wellbeing of Children and Adolescents: A Scoping Review Focused on Low- and Middle-Income Countries in East Asia and the Pacific.

Abstract

Child and adolescent mental health in low- and middle-income countries is a growing focus of global health policy, yet the evidence for effective intervention remains unclear. We undertook a scoping review of LMICs in the East Asia and Pacific region. We searched four databases between 2010 and 2021 for evaluated interventions targeting child and adolescent mental health. We mapped intervention studies by location, evaluation method, and target of intervention: mental health promotion, prevention, or response. We included 69 unique studies from 12 countries: 32 RCTs, 31 before-after studies, and 6 post-intervention evaluations. There were several promising intervention studies, although these had methodological limitations. Three studies addressed mental health promotion, 46 addressed prevention, and 23 addressed response. There was a disproportionate focus on "individual capacity" prevention and "clinical management" response. There were few studies in mental health promotion (through communities, policies, or legislation), prevention beyond the individual (via parents, peers, or schools), or in longer-term response. Most (62) of these interventions were undertaken in China and four South-East Asian nations. There were few studies in smaller, less wealthy nations, and only three in Pacific nations. Effective progress in global child and adolescent mental health will require greater attention and investment in these programmatic gaps and geographic areas.