Mental health literacy interventions addressing elementary school students – a global systematic review

AbstractBackground: Childhood (ages 6–12) is a critical period for the onset and early identification of mental disorders and for cultivating Mental Health Literacy (MHL). Limited or inaccurate knowledge of mental disorders, positive mental health and stress, high stigma, and poor help-seeking behaviours and attitudes in this age group may contribute to delayed or inappropriate referral, care, and poorer mental health outcomes short- and long-term. Programs exist to bolster social, emotional, and resilience-based outcomes, but very few focus specifically on the MHL pillars above. No prior systematic review has collated and evaluated elementary-school MHL interventions.Methods: We searched EMBASE, MEDLINE, PsycINFO, CINAHL, and ERIC between 2022 and 2025. Quantitative studies of school-based interventions addressing any MHL pillar (knowledge, positive mental health, stigma reduction, help-seeking efficacy) in students aged 6–12 were eligible. Risk of bias was assessed with design-specific tools and a proprietary MHL-specific checklist. Ten studies (n=60–751; mostly grades 5–6 students) met criteria.Results: Intervention studies that measured knowledge reported significant short-term gains, with some demonstrating relatively sustained gains. Favourable stigma reduction and help-seeking outcomes were less consistent. Age-, grade-, and sex-related subgroup patterns were observed in a very small number of studies. No intervention addressed all four MHL pillars or explicitly promoted positive mental health. Only two studies had low overall risk of bias. Methodological heterogeneity precludes meta-analysis.