1 Mental Health Research Center, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran

2 Department of Biostatistics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran


INTRODUCTION: Various programs are implemented internationally to promote the mental and social
health of the students in schools. This study systematically reviewed and categorized all resources,
indicators, and criteria for evaluating mental and social programs of schools.
MATERIALS AND METHODS: This systematic review was conducted by collecting data
from the PubMed, Google Scholar, Scopus, ProQuest, and Web of Science databases
using the keywords of “evaluation, mental health program, social health program, behavioral
and emotional program.” In the initial review, 4295 studies were found, which reduced to 75 after
removing the repetitions and evaluating the studies’ quality. The articles were selected using the
PRISMA chart.
RESULTS: The findings resulted in three main categories of structure, process, and
outcome; 16 subcategories; and 166 codes. The category of structure included the subcategories of
human resources, physical space, facilities, training, needed committees and teams, financing, and
implementing mental and social programs. The subcategories of process category were functional
indicators, guidelines and protocols, communication, documentation, planning/coordination, time
management, and monitoring. The subcategories of behavioral‑therapeutic, satisfaction, and
educational outcomes were associated with the outcome category.
CONCLUSION: Application of the structure, process, and outcome indicators, derived from the
findings of this study, will greatly improve evaluation of the international mental health programs in


  1. DurlakJA, WeissbergRP, DymnickiAB, TaylorRD, SchellingerKB.
    The impact of enhancing students’ social and emotional learning:
    A meta‑analysis of school‑based universal interventions. Child
    Dev 2011;82:405‑32.
    2. Kieling C, Baker‑Henningham H, Belfer M, Conti G, Ertem I,
    Omigbodun O, et al. Child and adolescent mental health
    worldwide: Evidence for action. Lancet 2011;378:1515‑25.
    3. Scott KM, Von Korff M, Angermeyer MC, Benjet C, Bruffaerts R,
    de Girolamo G, et al. Association of childhood adversities and
    early‑onset mental disorders with adult‑onset chronic physical
    conditions. Arch Gen Psychiatry 2011;68:838‑44.
    4. Patel V, Flisher AJ, Hetrick S, McGorry P. Mental health of young
    people: A global public‑health challenge. Lancet 2007;369:1302‑13.
    5. Fergusson DM, Woodward LJ. Mental health, educational, and
    social role outcomes of adolescents with depression. Arch Gen
    Psychiatry 2002;59:225‑31.
  2. 6. Kang‑Yi CD, Mandell DS, Hadley T. School‑based mental health
    program evaluation: Children’s school outcomes and acute mental
    health service use. J Sch Health 2013;83:463‑72.
    7. Sturgeon S. Promoting mental health as an essential aspect of
    health promotion. Health Promot Int 2006;21 Suppl 1:36‑41.
    8. Garber J, Frankel SA, Herrington CG. Developmental demands
    of cognitive behavioral therapy for depression in children and
    adolescents: Cognitive, social, and emotional processes. Annu
    Rev Clin Psychol 2016;12:181‑216.
    9. World Health Organization. Mental Health Programmes in
    Schools. Geneva: World Health Organization; 1994. Available
    PSF_93.3_Rev. 1.pdf.Last Access: 2019 June 24.
    10. Collaborative for Academics, and Emotional Learning. Available
    from: Access: 2019 June 24.
    11. Dix KL, ShearerJ, Slee PT, Butcher C. KidsMatter for Students with
    A Disability: Evaluation Report. Ministerial Advisory Committee:
    Australia; 2010.
    12. Humphrey N, Kalambouka A, Bolton J, Lendrum A,
    Wigelsworth M, Lennie C, et al. Primary Social and Emotional
    Aspects of Learning (SEAL). Department for Children, Schools
    and Families:London; 2008.
    13. Hatry HP. Performance Measurement: Getting Results.
    Washigton D.C: The Urban Institute; 2006.
    14. Albright A, Michael K, Massey C, Sale R, Kirk A, Egan T. An
    evaluation of an interdisciplinary rural school mental health
    programme in Appalachia. Adv Sch Mental Health Promot
    15. Singh J. Critical appraisal skills programme. Journal of
    Pharmacology and Pharmacotherapeutics 2013;4:76‑7.
    16. Nabors LA, Reynolds MW. Program evaluation activities:
    Outcomes related to treatment for adolescents receiving
    school‑based mental health services. Children’s Services. Soc
    Policy Res Pract 2000;3:175‑89.
    17. Barry MM, Clarke AM, Jenkins R, Patel V. A systematic review
    of the effectiveness of mental health promotion interventions for
    young people in low and middle income countries. BMC Public
    Health 2013;13:835.
    18. Amador A. Boston Public Schools OSESS Behavioral Health
    Services And Sch Based Mental Health Collaborative have
    Developed the Standards for School‑Based Mental Health
    Services. USA; 2012.
    19. Allen S. School‑Based Mental Health Services and Supports:
    Needs Assessment and Recommendations. USA; 2007.
    20. Hendren R. Mental health programs in schools. In: World
    Health Organization, editor. Division of Mental Health.
    Switzerland: Geneva; 1994.
    21. Beavon DJ, Spence N, White J. Aboriginal well‑being: Canada’s
    Continuing Challenge. Toronto: Thompson Educational
    Publication; 2007. p. xii, 234.
    22. Cowen EL, Izzo LD, Miles H, Telschow EF, Trost MA, Zax M.
    A preventive mental health program in the school setting:
    Description and evaluation. J Psychol 1963;56:307‑56.
    23. Dix KL, Slee PT, Lawson MJ, Keeves JP. Implementation quality
    of whole‑school mental health promotion and students’ academic
    performance. Child Adolesc Ment Health 2012;17:45‑51.
    24. Mishara BL, Ystgaard M. Effectiveness of a mental health
    promotion program to improve coping skills in young children:
    Zippy’s friends. Early Child Res Q 2006;21:110‑23.
    25. Weist M, Lever N, Stephan S, Youngstrom E, Moore E, Harrison B,
    et al. Formative evaluation of a framework for high quality,
    evidence‑based services in school mental health. Sch Mental
    Health 2009;1:196‑211.
    26. SleePT, Murray‑HarveyR, DixKL, SkrzypiecG, Askell‑WilliamsH,
    Lawson MJ, et al. KidsMatter Early Childhood Evaluation Report.
    Australia: Shannon Research Press; 2012.
    27. Hallam S. An evaluation of the Social and Emotional Aspects
    of Learning (SEAL) programme: Promoting positive behaviour,
    effective learning and well-being in primary school children.
    Oxford Rev Educ 2009;35:313‑30.
    28. Shek DT, Yu L, Ho VY. Subjective outcome evaluation and factors
    related to perceived effectiveness of the project P.A.T.H.S. In Hong
    Kong. ScientificWorldJournal 2012;2012:490290.
    29. Torres A. School‑Based Mental Health Care Program Evaluation.
    California State University: San Bernardino; 2018.
    30. Bruns EJ, Walrath C, Glass‑Siegel M, Weist MD. School‑based
    mental health services in Baltimore: Association with school climate
    and special education referrals. Behav Modif 2004;28:491‑512.
    31. Price OA, Lear JG. School Mental Health Services for the
    21st Century: Lessons from the District of Columbia School Mental
    Health Program. Washington: Center for Health and Health Care
    in Schools; 2008.
    32. Swick D, Powers JD. Increasing access to care by delivering mental
    health services in schools: The school‑based support program. Sch
    Community J 2018;28:129‑44.
    33. Lyon AR, Borntrager C, Nakamura B, Higa‑McMillan C. From
    distal to proximal: Routine educational data monitoring in
    school‑based mental health. Adv Sch Ment Health Promot
    34. Adams‑Langley S, Evert H. Place2Be in the inner city:
    A schoolbased mental health service in the United Kingdom. Int
    J Sch Based Fam Couns 2013;5:1‑14.
    35. Kline H. Evaluating the effectiveness and utilization of
    school‑based mental health programs. Sophia, the St. Catherine
    University repository; 2012. Availbale from: https://sophia.
    36. Eberhart NK, Burnam MA, Berry SH, Collins RL, Ebener PA,
    Ramchand R, et al. Evaluation of California’s statewide mental
    health prevention and early intervention programs: Summary of
    key year 2 findings. Rand Health Q 2015;5:15.
    37. Eberhart NK, Cerully JL, Shearer AL, Berry SH, Burnam MA,
    Ebener PA. Evaluation Approaches for Mental Health Prevention
    and Early Intervention Programs. California: RAND; 2017.
    38. Hargrave D. School‑Based Mental Health Practices in Utah:
    A Descriptive Study. Utah State University: USA; 2015.
    39. Stewart D. Implementing mental health promotion in schools:
    A process evaluation. Int J Mental Health Promot 2008;10:32‑41.
    40. Dray J, Bowman J, Campbell E, Freund M, Wolfenden L,
    HodderRK, et al. Systematic review of universal resilience‑focused
    interventions targeting child and adolescent mental health
    in the school setting. J Am Acad Child Adolesc Psychiatry
    41. Brener ND, Weist M, Adelman H, Taylor L, Vernon‑Smiley M.
    Mental health and social services: Results from the school health
    policies and programs study 2006. J Sch Health 2007;77:486‑99.
    42. Eberhart NK, Burnam MA, Berry SH, Collins RL, Ebener PA,
    Ramchand R, et al. Evaluation of California’s Statewide Mental
    Health Prevention and Early Intervention Programs: Summary
    of Key Year 2 Findings. Rand health quarterly 2015;5 (1):15.
    43. Claire Blewitt BMF‑T, Andrea Nolan., Social and Emotional
    Learning Associated With Universal Curriculum‑Based
    Interventions in Early Childhood Education and Care Centers.
    JAMA Netw Open 2018;1 (8):e185727.
    44. Slee PT, Murray‑Harvey R, Dix KL, Van Deur PA. Quality
    Assurance for KidsMatter Primary: A Scoping Paper. Australia:
    the National Depression Initiative; 2011.
    45. Domitrovich CE, Bradshaw CP, Poduska JM, Hoagwood K,
    Buckley JA, Olin S, et al. Maximizing the implementation quality of
    evidence‑based preventive interventions in schools: A Conceptual
    framework. Adv Sch Ment Health Promot 2008;1:6‑28.
    46. Shek DT, Sun RC, Kan VW. Full implementation of the secondary
    1 program of project P.A.T.H.S.: Observations based on the
    co‑walker scheme. ScientificWorldJournal 2009;9:982‑91.
    47. Askell‑Williams H, Dix KL, Lawson MJ, Slee PT. Quality of implementation of a school mental health initiative and changes
    over time in students’ social and emotional competencies. Sch Eff
    Sch Improv 2013;24:357‑81.
    48. Nabors LA, Leff SS, Power TJ. Quality improvement activities
    and expanded school mental health services. Behav Modif
    49. Weist MD, Nabors LA, Myers CP, Armbruster P. Evaluation of
    expanded school mental health programs. Community Ment
    Health J 2000;36:395‑411.
    50. Armbruster P. The administration of school‑based mental health
    services. Child Adolesc Psychiatr Clin N Am 2002;11:23‑41.
    51. Nabors LA, Weist MD, Tashman NA, Myers CP. Quality
    assurance and school-based mental health services. Psychol Sch
    52. Nabors LA, Weist MD, Reynolds MW. Overcoming challenges
    in outcome evaluations of school mental health programs. J Sch
    Health 2000;70:206‑9.
    53. Seiler L, Millhauser B, Finkel A, Fuchs D, Bogart H, Manning I,
    et al. The Big Shot. United States: Warner Bros, Pictures; 1942.
    54. Frohman D, Frohman C, Croisset Fd, Leblanc M, Lyceum Theatre.
    45th Street), Theater Playbills and Programs Collection (Library
    of Congress). New York: Arsène Lupin; 1909.
    55. Brent DA, Howell M. Data based program evaluation in a project
    involving mental health consultation to schools. J Am Acad Child
    Psychiatry 1983;22:447‑53.
    56. Lyon AR, Bruns EJ. From evidence to impact: Joining our best
    school mental health practices with our best implementation
    strategies. Sch Mental Health 2019;11:106‑14.
    57. White H, LaFleur J, Houle K, Hyry-Dermith P, Blake SM.
    Evaluation of a school-based transition program designed to
    facilitate school reentry following a mental health crisis or
    psychiatric hospitalization. Psychol Sch 2017;54:868‑82.
    58. O’Reilly A, Barry J, Neary ML, Lane S, O’Keeffe L. An evaluation
    of participation in a schools‑based youth mental health peer
    education training programme. Adv Sch Mental Health Promot
    59. Montañez E, Berger‑Jenkins E, Rodriguez J, McCord M, Meyer D.
    Turn 2 us: Outcomes of an urban elementary school – Based
    mental health promotion and prevention program serving ethnic
    minority youths. Child Sch 2015;37:100‑07.
    60. Guzmán J, Kessler RC, Squicciarini AM, George M, Baer L,
    Canenguez KM, et al. Evidence for the effectiveness of a national
    school‑based mental health program in Chile. J Am Acad Child
    Adolesc Psychiatry 2015;54:799‑8070.
    61. Grassetti SN, Williamson AA, Herres J, Kobak R, Layne CM,
    Kaplow JB, et al. Evaluating referral, screening, and assessment
    procedures for middle school trauma/grief‑focused treatment
    groups. Sch Psychol Q 2018;33:10‑20.
    62. Adi Y, Killoran A, Janmohamed K, Stewart‑Brown S. Systematic
    Review of the Effectiveness of Interventions to Promote
    Mental Wellbeing in Children in Primary Education. Database
    of Abstracts of Reviews of Effects (DARE): Quality‑assessed
    Reviews; 2007.
    63. Banerjee R, Weare, K, Farr W. Working with ‘social and emotional
    aspects of learning’ (SEAL): Associations with school ethos,
    pupils’ social experiences, attendance, and attainment. Br Educ
    Res J 2014;4:718‑42.
    64. Byrne M, Barry M, NicGabhainn S, Newell J. The development
    and evaluation of a mental health promotion programme for
    post‑primary schools in Ireland. The Health Promoting School.
    International Advances in Theory, Evaluation and Practice.
    Copenhagen: Danish University of Education Press; 2005.
    p. 389‑415.
    65. Durlak JA, DuPre EP. Implementation matters: A review of
    research on the influence of implementation on program outcomes
    and the factors affecting implementation. Am J Community
    Psychol 2008;41:327‑50.
    66. Barry MM, Clarke A, Hussein Y, Morreale S, Field C. What Works
    In Enhancing Social And Emotional Skills Development During
    childhood and adolescence? A Review of The evidence on the
    Effectiveness of School‑Based and Out‑of‑School Programmes
    in the UK; 2015.
    67. Sklad M, Diekstra R, Ritter MD, Ben J, Gravesteijn C. Effectiveness
    of school-based universal social, emotional, and behavioral
    programs: Do they enhance students’ development in the area
    of skill, behavior, and adjustment? Psychol Sch 2012;49:892‑909.
    68. Salerno JP. Effectiveness of universal school‑based mental
    health awareness programs among youth in the United States:
    A systematic review. J Sch Health 2016;86:922‑31.
    69. Blewitt C, Fuller‑Tyszkiewicz M, Nolan A, Bergmeier H,
    Vicary D, Huang T, et al. Social and emotional learning
    associated with universal curriculum‑based interventions in early
    childhood education and care centers: A systematic review and
    meta‑analysis. JAMA Netw Open 2018;1:e185727.
    70. Wigelsworth M, Humphrey N, Lendrum A. A national evaluation
    of the impact of the secondary social and emotional aspects of
    learning (SEAL) programme. Educ Psychol 2012;32:213‑38.
    71. Zins JE, Bloodworth MR, Weissberg RP, Walberg HJ. The scientific
    base linking social and emotional learning to school success.
    J Educ Psychol Consult 2007;17:191‑210.
    72. Bywater T, Sharples J. Effective evidence‑based interventions for
    emotional well‑being: Lessons for policy and practice. Res Pap
    Educ 2012;27:389‑408.
    73. Wong AS, Li‑Tsang CW, Siu AM. Effect of a social emotional
    learning programme for primary school students. Hong Kong J
    Occup Ther 2014;24:56‑63.
    74. Guide C. Effective social and emotional learning programs.
    Preschool and Elementary School. 9th Ed. Collaborative for
    Academic, Social, and Emotional Learning: Chicago; 2013.
    75. Acosta OM, Tashman NA. Providing mental health services
    to youth where they are: School and community based
    approaches. In: Ghuman HS WM, Sarles RM, editors. Establishing
    Successful School Mental Health Programs: Guidelines and
    Recommendations. Routledge: Great Britain; 2013. p. 57.
    76. Zins JE. Building Academic Success on Social and Emotional
    Learning: What Does the Research Say? Reading and Writing
    Quarterly. 2007;23 (2): 197‑202.
    77. Jones S, Brush K, Bailey R, Brion‑Meisels G, McIntyre J, Hkhan J.
    Navigating SEL from the Inside Out. Looking Inside and Across 25
    Leading SEL Programs: A Practical Resource for Schools and OST
    Providers. Cambridge: Harvard Graduate School of Education;
    78. Björklund K, Liski A, Samposalo H, Lindblom J, Hella J,
    Huhtinen H, et al. “Together at school” – A school‑based
    intervention program to promote socio‑emotional skills and
    mental health in children: Study protocol for a cluster randomized
    controlled trial. BMC Public Health 2014;14:1042.
    79. Wrabel SL, Hamilton LS, Whitaker AA, Grant S. Investing in
    Evidence Based Social and Emotional Learning. U.S.: Rand
    Corporation; 2018.
    80. Weare K. Promoting mental, emotional and social health: A whole
    school approach. London: Routledge; 2013.
    81. Payton J, Weissberg RP, Durlak JA, Dymnicki AB, Taylor RD,
    Schellinger KB, et al. The Positive Impact of Social and Emotional
    Learning for Kindergarten to Eighth‑Grade Students: Findings
    from Three Scientific Reviews. Technical Report. Collaborative
    for Academic, Social, and Emotional Learning (NJ1); 2008.
    82. Citizens’ Committee for Children of New York IC. A Prescription
    for Expanding School‑Based Mental Health Services In New York
    City Public Elementary Schools. USA: Citizens’ Committee for
    Children of New York; 2013.
    83. Bywater T, Sharples J. Effective evidence‑based interventions for
    emotional well‑being: Lessons for policy and practice. Res Pap
    Educ 2012;27:389‑408.
  3. 84. Maldonado‑Durán JM, Garcia JM, Lartigue T, Karacostas V. Infant
    mental health, new evidence. Salud Mental 2002;25:59‑67.
    85. Langberg JM, Becker SP, Epstein JN, Vaughn AJ, Girio‑Herrera E.
    Predictors of response and mechanisms of change in an
    organizational skills intervention for students with ADHD. J Child
    Fam Stud 2013;22 (6):1‑22.
    86. Fazel M. Psychological and psychosocial interventions for refugee
    children resettled in high‑income countries. Epidemiol Psychiatr
    Sci 2018;27:117‑23.
    87. Fazel M, Hoagwood K, Stephan S, Ford T. Mental health
    interventions in schools 1: Mental health interventions in schools
    in high‑income countries. Lancet Psychiatry 2014;1:377‑87.
    88. Walsh AS. Interdisciplinary Collaboration for Youth Mental
    Health: A National Study.USA: Scholar Commons University of
    South Florida (USF); 2013.
    89. Palinkas LA, Fuentes D, Finno M, Garcia AR, Holloway IW,
    Chamberlain P, et al. Inter‑organizational collaboration in the
    implementation of evidence‑based practices among public
    agencies serving abused and neglected youth. Adm Policy Ment
    Health 2014;41:74‑85.
    90. Cooper JL. The federal case for school‑based mental health
    services and supports. J Am Acad Child Adolesc Psychiatry
    91. Livingston JD, Tugwell A, Korf‑Uzan K, Cianfrone M, Coniglio C.
    Evaluation of a campaign to improve awareness and attitudes
    of young people towards mental health issues. Soc Psychiatry
    Psychiatr Epidemiol 2013;48:965‑73.
    92. Ball SJ, Youdell D. Hidden Privatisation in Public Education.
    London, England: Education International; 2007.
    93. Stormont M, Reinke W, Herman K. Teachers’ knowledge of
    evidence‑based interventions and available school resources for
    children with emotional and behavioral problems. J Behav Educ
    94. Kohen DE, Brooks‑Gunn J, McCormick M, Graber JA.
    Concordance of maternal and teacher ratings of school and
    behavior problems in children of varying birth weights. J Dev
    Behav Pediatr 1997;18:295‑303.
    95. Dickinson E, Joyce J, Davies WH, Rhinelander PH, Walters WS,
    Michelangelo B, et al. Americans in Rome Music by Fellows of the
    American Academy in Rome. New Rochelle, N.Y.: Bridge; 2008.
    96. Nardi DA. Depression in school‑aged children: Assessment
    and early intervention. J Psychosoc Nurs Ment Health Serv
    97. Payne AA. Do predictors of the implementation quality of
    school‑based prevention programs differ by program type? Prev
    Sci 2009;10:151‑67.