School Mental Health Interventions for Adolescents: A Meta-Analysis of Effectiveness and Relevant Moderators

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The mian comments are shown in the attachment Word file.

Comments for author File: Comments.pdf

Author Response

Thank you for the very helpful suggestions and the kind words of acknowledgment pertaining to quality and potential contribution of our work.  We believe that our revised manuscript is greatly improved because of your feedback.  Please find the attached document that notates the majority of our revisions. 

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

This is a very well structured and written manuscript. The focus is of high interest to the readership of the journal and makes a strong contribution to the research literature. Rarely have I come across a manuscript which appears to require so few amendments (and I only offer minor recommendations for improving the current version). 

The authors are correct in stating that approximately 20% of school aged persons have a mental health condition and that sadly very few receive the required assistance. Schools are ideal places for interventions, but such interventions must be developmentally age appropriate and evidence informed. The authors raise many points in their work which will be of particular interest to educators, policy makers, and health professionals alike.

Supporting citations would be beneficial after multiple countries (line45), mental health care (line 52) and origin (line 67).

The 20% cited on line 52 is from a journal article dated 2019, which I imagine is pre COVID or at the time it was arising. Many studies show that rates increased after 2019. Perhaps you could check on this and if necessary, cite further work. To clearly inform readers of the journal, qualify the ages of elementary school children (line 74).

On line 84 reference is made to the variability of effect sizes across studies. Please put the range in parentheses. Line 110, reference is made to intervention intensity. What is intensity? How is it measured? Is it duration of intervention or how many hours delivered per session? Can you clarify this.

The authors raise a very important point regarding who should deliver school based mental health interventions. While specialists have the knowledge and skills (compared to teachers), there are barriers to their implementing programs, including curriculum demands, student availability, costs to schools etc. This is a valuable discussion that the authors provide, and the results provide evidence that may assist schools in making decisions around program delivery.

Overall, the introduction was comprehensive and very well written.

Although inclusion criteria are clearly explained, why were studies only included from 2015? 18 studies were systematically identified for inclusion. Rather than restating the findings from the analyses, suffice to say the authors present clear results which are easy to read and comprehend. The discussion is sound and relates to previous research findings. The discussion regarding universal v targeted interventions raises important issues (and provides answers) for those involved in the implementation and evaluation of school based mental health programs. Of course this ties in with who should deliver such programs and what type of programs are best suited. The limitations of the research are presented, and the conclusion is well justified.

Overall this is a very well written paper.

Author Response

Thank you for the very helpful suggestions and the kind words of acknowledgment pertaining to quality and potential contribution of our work.  We believe that our revised manuscript is greatly improved because of your feedback.  Please find the attached document that notates the majority of our revisions. 

Author Response File: Author Response.pdf