Examining the mental health outcomes of school-based peer-led interventions on young people: A scoping review of range and a systematic review of effectiveness

Abstract

Schools worldwide have implemented many different peer-led interventions with mixed results, but the evidence base on their effectiveness as mental health interventions remains limited. This study combines a scoping review and systematic review to map the variations of peer-led interventions in schools and to evaluate the quality of the existing evidence base. This scoping review and systematic review evaluated the existing literature across 11 academic databases. Studies were included if they reported a peer-led intervention that aimed to address a mental health or wellbeing issue using a peer from the same school setting. Data were extracted from published and unpublished reports and presented as a narrative synthesis. 54 studies met eligibility criteria for the scoping review, showing that peer-led interventions have been used to address a range of mental health and wellbeing issues globally. 11 studies met eligibility criteria for the systematic review with a total of 2,239 participants eligible for analysis (929 peer leaders; 1,310 peer recipients). Two studies out of seven that looked at peer leaders showed significant improvements in self-esteem and social stress, with one study showing an increase in guilt. Two studies out of five that looked at peer recipient outcomes showed significant improvements in self-confidence and in a quality of life measure, with one study showing an increase in learning stress and a decrease in overall mental health scores. The findings from these reviews show that despite widespread use of peer-led interventions, the evidence base for mental health outcomes is sparse. There appear to be better documented benefits of participation for those who are chosen and trained to be a peer leader, than for recipients. However, the small number of included studies means any conclusions about effectiveness are tentative.

Online peer support training to promote adolescents’ emotional support skills, mental health and agency during COVID-19: Randomised controlled trial and qualitative evaluation

“…Peer support training programmes are rarely examined in isolation. Existing studies, exclusively school-based, suggest that training brings marginal improvements to peer supporters' self-confidence [12]. However, to our knowledge, only one study evaluated outcomes directly related to adolescents' ability to help others.…”

“…Evidence indicates that having positive peer relationships in adolescence predicts greater wellbeing [10]. However, evidence from intervention studies is mixed: while some studies suggest positive outcomes for supported peers, others indicate null results (see [11,12] for systematic reviews of online and school interventions, respectively). This inconsistency may be partly due to the training young people receive to carry out the role [13].…”

Online peer support training to promote adolescents’ emotional support skills, mental health and agency during COVID-19: A pilot randomised controlled trial

“…Peer support training programmes are rarely examined in isolation. Existing studies, exclusively school-based, suggest that training brings marginal improvements to peer supporters' self-confidence (King & Fazel, 2021). However, to our knowledge, only one study evaluated outcomes directly related to adolescents' ability to help others.…”

“…Evidence indicates that having positive peer relationships in adolescence predicts greater wellbeing (Steiner et al, 2019). However, evidence from intervention studies is mixed: while some studies suggest positive outcomes for supported peers, others indicate null results (see Ali, Farrer, Gulliver, & Griffiths, 2015;King & Fazel, 2021 for systematic reviews of online and school interventions, respectively). This inconsistency may be partly due to the training young people receive to carry out the role (Gopalan, Lee, Harris, Acri, & Munson, 2017).…”

Adolescents encouraging healthy lifestyles through a peer‐led social marketing intervention: Training and key competencies learned by peer leaders

“…improving lifestyles or health led by peer leaders could provide more benefits than other types of interventions led by adults, and peer leaders could improve their health while spreading health messages. Future interventions should include young people in the dissemination and codesign of the intervention 42. Focusing on the experience, confidence and interest of peer leaders in completing their tasks related to management, communication and design, the results indicate that peer leaders' F I G U R E 2 Recommendations for the peer leader training process to encourage healthy lifestyles among adolescents improvements in these areas varied among the four countries.…”