Is the Thoughts and Health programme feasible in the context of Swedish schools?

Carl Wikberg, Pia Augustsson, Marcus Marcus Praetorius Björk, W Edward Craighead, Eiríkur Örn Arnarson, Gudny Sveinsdottir, Ina Marteinsdottir, Josefine L Lilja

Keywords: Mental health, public health, prevention, adolescence, collaboration, depression.

Background:

Clinical depression significantly increases among adolescents, impairing relationships and causing cognitive and emotional difficulties. An Icelandic preventive program "Thoughts and Health" program has showed preventive effect of depression and dysthymia for up to 12 months. This program is now being tested in Sweden to help eighth-grade students “at risk” to avoid depression and maintain mental health.

Research questions:

Can the "Thoughts and Health" program, effective in Iceland, be implemented in Sweden, and what effects on preventing depression among at-risk eighth-grade students does the program have.

Method:

A quasi-experimental controlled design using qualitative and quantitative methods involved adolescents from five Swedish communities. They were screened for depression, and eligible "at risk" individuals were assessed by a Primary Care Psychologist. Adolescents without prior depression were offered the 12-week "Thoughts and Health" course or a control group (standard school health care). The study evaluated the program's impact on clinical depression at the end, 6-, 12-, and 18-months post-course. Outcome variables included depression onset, school attendance, grades, adolescent experiences, and psychologist evaluations, analyzed via group-based statistics and systematic text condensation.

Results:

Our primary findings indicate that the "Thought and Health" program can be implemented successfully in Swedish schools in collaboration with primary care. It shows promise in preventing depression among at-risk adolescents. Screening involved 887 adolescents aged 14. Eligible "at-risk" individuals were evaluated by a Primary Care Psychologist. 24 participants completed the 12-week course. Initial data suggest potential decreases in depression onset compared to controls. These results aim to validate the program's effectiveness, informing primary depression prevention strategies with significant public health implications.

Conclusions:

The program "Thoughts and Health" has potential in preventing depression among at-risk adolescents when supported by primary care collaboration in Swedish schools. These results could significantly impact public health strategies, promoting youth mental well-being and early depression prevention.

Points for discussion:

Adaptations made to the program to suit the Swedish school environment and how these adaptations might have impacted its effectiveness.

What are the key challenges in implementing mental health programs like "Thoughts and Health" in school settings, and how were these challenges addressed in the study?

What are the implications of the study’s findings for the long-term sustainability and broader implementation of preventive mental health programs in schools?

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