Low-intensity psychological interventions for adolescent mental health in community and education settings: what can we learn from routinely collected data?

A nationwide initiative in England has expanded mental health provision for adolescents by training a new workforce to provide low-intensity interventions in education and community settings. However, only two small-scale, pre-pandemic studies have evaluated the effectiveness and clinical application of this provision. Accordingly, little is known about what is being provided, for whom, and whether current provisions lead to real-world improvements in outcomes. We aimed to address these gaps and offer recommendations to improve future implementation and evaluation.
Using routinely collected data, we examined service provisions in one geographical area, comprising nine service sites and 1071 adolescent service users between 2021 and 2024. Eligible adolescents were aged 11-18 years (M=13.82, SD=1.85), and consisted of 70.4% females, 29.5% males, 0.1% individuals with an other-unspecified sex. Ten types of low-intensity interventions were offered, with the most common being individual low-intensity CBT (47.1%), group-delivered parent-led CBT (14.7%), and individual behavioural activation (11.5%). Significant pre-post improvements, with medium-to-large effect sizes, were observed across all measures of depression and anxiety (Cohen's d=0.48 to 0.64), and goal attainment (d=-1.96).
Low-intensity interventions reached more females than males. A range of interventions were offered, predominantly targeted at anxiety. These interventions were effective in reducing distress and helping adolescents progress towards their idiosyncratic goals. However, we encountered several challenges pertaining to using routinely collected data, including limited recording of demographic characteristics, missingness, and lack of longer-term follow-up data.