School-based prevention of depression: a 2-year follow-up of a randomized controlled trial of the beyondblue schools research initiative.
OBJECTIVE
To investigate the effectiveness of a universal intervention designed to reduce depressive symptoms experienced by adolescents at high school. The results from annual assessments during the 3-year intervention and a 2-year follow-up are reported.


METHODS
Twenty-five pairs of secondary schools matched on socio-economic status were randomly assigned to either an intervention or a comparison group (n = 5,633 year 8 students, mean age = 13.1 years, SD = .5). The intervention used a comprehensive classroom curriculum program, enhancements to school climate, improvements in care pathways, and community forums. A range of measures completed by students and teachers was used to assess changes in depressive symptoms, risk and protective factors relevant to depression, and the quality of the school environment.


RESULTS
Changes in the levels of depressive symptoms and in the levels of risk and protective factors experienced by students in the two groups did not differ significantly over the 5 years of the study. Statistically significant differences in the ratings of school climate across this time were found only for teacher-rated assessments.


CONCLUSIONS
There was little evidence that a multicomponent universal intervention delivered over a 3-year period reduced levels of depressive symptoms among participating students. Implementing universal interventions to improve student mental health is difficult in school settings that commonly have a crowded agenda of educational and health-related programs. Successful implementation will require programs which are perceived by teachers and students as relevant to educational and learning goals, and which can be effectively delivered in conjunction with other school programs.
Sawyer
Michael G
MG
Discipline of Paediatrics, University of Adelaide, South Australia, Australia. michael.sawyer@adelaide.edu.au
Harchak
Taylor F
TF
Spence
Susan H
SH
Bond
Lyndal
L
Graetz
Brian
B
Kay
Debra
D
Patton
George
G
Sheffield
Jeanie
J
D000223:Adaptation, Psychological; D000293:Adolescent; D003866:Depressive Disorder / Q000517:prevention & control* / Q000523:psychology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D011314:Preventive Health Services / Q000379:methods*; D015397:Program Evaluation / Q000379:methods* / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012307:Risk Factors; D012572:School Health Services; D017678:Sex Distribution; D012931:Social Environment; D012938:Social Perception; D012944:Social Support