Nov 16, 2020

Wellcome Trust review of evidence on the effectiveness of problem-solving interventions for adolescents and young adults now complete

Findings indicate interventions merit continued innovation and evaluation, and that more evidence on how they can be implemented well and at scale is needed.

CEI and our partners have completed a project as part of a major Wellcome Trust strategic programme, extending our Common Elements work. The Wellcome Trust programme has involved a number of systematic reviews on proposed ‘active ingredients’ in interventions for the treatment or prevention of depression or anxiety among 14-24-year olds. It is part of Wellcome Trust’s ambitious 5-year, £200m mental health strategy, which is critical of fragmented mental health research where allegiance to ‘branded’ complex interventions has not produced effective approaches that are scalable to low income contexts, and where too little attention is paid to young people’s lived experience.

CEI’s proposal was one of around thirty successful applications globally to partner with Wellcome Trust in this stage of the strategy. We were privileged to partner with Professor Bryce D. McLeod from Virginia Commonwealth University, Dr Kristina Metz from Johns Hopkins University, and Professor Aron Shlonsky from Monash University in undertaking the rigorous and transparent review of international evidence on the effectiveness of problem-solving interventions for adolescents and young adults.

Problem-solving interventions take young people through a series of steps to address daily stressors: identifying the problem, setting the goal, brainstorming solutions, evaluating solutions, choosing the best, creating an action plan, trying out the planned actions and reviewing. Our systematic review confirmed that such interventions:

  • can be tailored to different types of problems and individual situations,
  • are acceptable to a variety of population,
  • can be delivered in community as well as mental health settings, and
  • can be delivered in range of forms (as a standalone treatment or part of a wider programme; as a single session to multiple sessions; and with innovative online approaches too).

The review found 18 evaluations involving a control group (mainly Randomised Controlled Trials), of which six were effective. The studies we reviewed were undertaken in diverse settings: a shelter for young runaways in South Korea, US juvenile detention centres, mothers with postnatal depression in Zimbabwe, children transitioning to high school in the US, as well as in other school and mental health service settings. We held informational conversations with young people with lived experience of depression and with practitioners around the globe to centre the research. These discussions highlighted that problem-solving interventions may be particularly relevant as young people make transitions into adulthood.

In conclusion the review found that problem-solving interventions merit continued innovation and evaluation, and that more evidence on how they can be implemented well and at scale is needed.

As well as a report and presentation to Wellcome, a video aimed at 14-year olds, a lay person summary and an infographic for policymakers were all produced.