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Public health interventions improve mental health in young people in LMICs: systematic reviewPublic health interventions improve mental health in young people in LMICs

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Key Takeaway
Consider public health interventions with digital components for young people in LMICs, but note limited long-term data.

This systematic review synthesized 30 studies (26 on major depressive disorder, 4 on schizophrenia) evaluating public health interventions for young people aged 15-29 in low- and middle-income countries. Interventions were often based on existing frameworks like CBT and behavioral activation, and included digital health components such as electronic therapy and messaging services. Comparators were baseline and/or usual care.

Key findings: 25 of 30 studies reported statistically significant improvements in mental health outcomes, assessed using validated tools like the Beck Depression Inventory-II and the 12-item Discrimination and Stigma scale. Secondary outcomes related to mental health literacy also showed improvement. However, pooled effect sizes were not reported, and follow-up durations were short (≤6 months).

Limitations include the lack of reported effect sizes, adverse events, and long-term follow-up. The review did not specify funding or conflicts of interest. The authors note potential for these interventions to improve mental health literacy and outcomes in resource-limited settings, but caution that the evidence is limited by short follow-up and absence of quantitative synthesis.

Mental health struggles are tough anywhere, but for young people in low- and middle-income countries, help can be hard to find. A new review of 30 studies suggests that public health interventions, like therapy-based programs and digital tools, can make a real difference.

The review looked at 26 studies on depression and 4 on schizophrenia, involving young people aged 15 to 29. It found that 25 of the studies reported significant improvements in mental health outcomes. The interventions included cognitive behavioral therapy, behavior activation, and digital health options like computerized therapy and messaging services.

These findings are promising, but there are important caveats. The studies had short follow-up periods of six months or less, so we don't know if the benefits last. Also, the review didn't report on side effects or how well people tolerated the treatments. More research is needed to confirm these results over time and in different settings.

What this means for you:
Public health and digital interventions can help young people in low-income countries with depression and schizophrenia.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJun 2026
View Original Abstract ↓
BackgroundYoung people aged 15–29 experience a substantial mental health burden, with major depressive disorder (MDD) and schizophrenia accounting for as much as half of this burden. Young people living in low- or middle-income countries (LMICs) face challenges to improving their mental health. A substantial treatment gap exists, driven by resource constraints and workforce shortages. Addressing mental health and mental health literacy through public health interventions has the potential to reduce the burden of mental disorders in this population, while meeting the needs of resource-limited settings. Understanding how best to design public health interventions to address both mental health and mental health literacy is key to effectively using resources and maximising benefits.MethodsElectronic database searches (MEDLINE, Embase, CENTRAL, PsycINFO) were supplemented with non-English database searches (Global Index Medicus, African Journals Online), searches of conference proceedings and other grey literature sources. Eligible studies were conducted in resource-limited settings and reported characteristics of public health interventions. ≥80% of the study population was required to be aged 15–29 years, with MDD and/or schizophrenia.Results5,339 records were identified in database searches; 30 studies (26 on MDD and 4 on schizophrenia) were included. Most studies (25 of 30) presented a behaviour therapy intervention, often based on an existing framework (e.g., CBT, behaviour activation). 10 studies incorporated digital health in their programme design, including electronic/computerised versions of behaviour therapy interventions and messaging services to allow participants to contact facilitators for support. Intervention outcomes were assessed using pre-existing validated tools such as Beck Depression Inventory-II (BDI-II) and the 12-item Discrimination and Stigma scale (DISC-12), often adapted to the local context. Mental health literacy outcomes included social support, self-efficacy and cognitive re-appraisal. 25 studies reported statistically significant improvements in mental health outcomes following intervention, compared to baseline and/or usual care. Outcomes were generally assessed over short follow-up durations of ≤6 months.ConclusionThese findings demonstrate the potential for public health interventions, enabled by digital health, to improve mental health literacy and outcomes in LMICs. Other considerations for programme design included adaptation of pre-existing intervention frameworks and use of validated tools to evaluate outcomes.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD42024579598
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