School-based digital mental health interventions: A scoping review.

INTRODUCTION Globally, the mental health of children and adolescents is a public health concern. Schools are a primary access point for youth mental health support, yet traditional delivery models remain constrained by limited resources, shortage of specialised professionals, and high counsellor caseloads. Digital mental health interventions may help address these gaps by offering scalable, accessible, and less-stigmatising support.

Aim

This review aimed to map and characterise school-based digital mental health interventions for children and adolescents by examining intervention characteristics, implementation, and intervention outcomes.

Methods

A comprehensive search of peer-reviewed studies (2008-2025) was conducted across PsycNet, ERIC, and PubMed, using the PRISMA-ScR Checklist. Eligible studies evaluated a digital mental health intervention delivered in a school setting among K-12 students and reported at least one implementation and/or mental health outcome.

Results

Across 40 studies, most were conducted in high-income countries and used randomised designs. Web-based, structured cognitive behavioural therapy (CBT) modules in classroom settings predominated. Intervention delivery ranged from teacher-led to self-directed use, with some hybrid clinician-supported models. Findings were heterogeneous for internalising symptoms (e.g., depression and anxiety), with evidence of benefit in some CBT-oriented interventions but mixed effects in universal programmes. In contrast, mental health literacy, stigma, and well-being outcomes showed more consistent positive effects. Engagement and implementation quality appeared closely linked to effectiveness.

Conclusion

School-based digital mental health interventions can improve mental health literacy and stigma-related outcomes when grounded in CBT. Future research should prioritise standardised outcome measurement (e.g., fidelity, adoption), theory-to-component linkages, co-design elements, and hybrid effectiveness-implementation, particularly in low-and middle-income settings.