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Purpose – It is important within public health goals to promote adolescents’ mental health and to reduce socioeconomic inequalities in mental health. Among adults there are indications that the socioeconomic pattern of low positive mental health (PMH) differs from the socioeconomic pattern of high PMH. Knowledge regarding the social epidemiology of PMH among young people is lacking. The purpose of this paper is to examine the socioeconomic patterning of aspects of low and high PMH among adolescents. Design/methodology/approach – The Health Behaviour in School-aged Children Methodology Development Study 2012 provided data on 3,670 adolescents aged 11-15 in two municipalities in Denmark. Socioeconomic differences in aspects of low and high PMH (self-esteem, social competence and self-efficacy) were investigated by calculating sex-specific prevalence of PMH in socioeconomic groups measured by parents’ occupational social class. Using multi-level logistic regression analyses, odds ratios for low and high PMH compared to moderate PMH were estimated. Findings – In age-adjusted analyses there seemed to be a graded relationship with increasing odds for low PMH with decreasing socioeconomic position, but no indication of a socioeconomic patterning of high PMH. The prevalence of high self-esteem and high self-efficacy was higher among boys than girls. High social competence and high self-efficacy increased with age. Research limitations/implications – Public health research has primarily focused on risk factors and mental health problems. Research highlighting more detailed aspects of PMH is needed. Originality/value – The socioeconomic pattern of high PMH may be different from the socioeconomic pattern of low PMH.

PurposeThe paper's purpose is to participate in a debate about the role of randomised controlled trials in evaluation of preventive interventions for children.Design/methodology/approachThe paper is a response to critiques on Stewart‐Brown et al. published in the Journal of Children's Services, Vol. 6 No. 4, pp. 228–35.FindingsRandomised controlled trials are likely to be at their best in the evaluation of interventions that do not require the active engagement and personal development of participants. The latter may depend on a series of interventions and events that potentiate each other over time. Randomised controlled trials are likely to be least valuable in evaluating universal level interventions that aim to change population norms. Because of the challenges involved in conducting RCTs in this setting they cannot be relied upon to give accurate estimates of programme effect and therefore do not deserve the privileged position that has been accorded them in the hierarchy of evidence.Originality/valueThis paper develops the argument that the privileged position of RCTs in the evidence hierarchy of preventive services for children is undeserved.

Purpose – Randomised controlled trials (RCTs) have been offered a privileged position in terms of the evidence base for preventive interventions for children, but practical and theoretical issues challenge this research methodology. This paper aims to address this issue. Design/methodology/approach – This paper analyses practical and methodological issues of using RCTs within children's preventive services and presents the results of a qualitative study using data collected from parents who were asked to take part in an RCT of a preventive intervention. Findings – Well recognised issues include the impossibility of blinding participants, the problem of identifying a pre‐eminent outcome measure for complex interventions, and problems with limiting access to equivalent interventions in real world settings. A further theoretical problem is the exclusion from RCTs of families who are most ready to change, resulting in a reduced level of intervention effectiveness. Qualitative evidence from one recent RCT suggests that this problem could be operating in some prevention trials. Increasing sample sizes can overcome some of these problems, but the cost of the necessarily huge trials becomes disproportionate to the intervention? Originality/value – Given the limitations on RCTs in preventive settings, the paper argues their privileged position in terms of research evidence maybe undeserved.

Background: There is a growing policy imperative to promote positive mental health as well as preventing the development of mental health problems in children. This paper summarises the results of published systematic reviews evaluating interventions to promote mental health and prevent mental illness in children.\ud Method: A search was undertaken of ten electronic databases using a combination of medical subject headings (MeSH) and free text searches. Systematic reviews covering mental health promotion or mental illness prevention interventions aimed at infants, children or young people up to age 19 were included. Reviews of drug and alcohol prevention programmes or programmes to prevent childhood abuse and neglect were excluded because these have been the subject of recent good quality reviews of reviews. Critical appraisal of all studies was undertaken using a standardised appraisal tool for systematic reviews. Where possible effect sizes and 95% confidence intervals are reported. A narrative summary has been provided.\ud Results: A total of 27 systematic reviews were included and grouped pragmatically under the following headings: parenting interventions; programmes for the prevention of anxiety and depression, programmes to promote self esteem, violence and aggression prevention programmes, school-based programmes, and general reviews. Included studies targeted a range of risk and protective factors, and a range of populations (including both parents and children). While, many lacked methodological rigour, overall, the evidence is strongly suggestive of the effectiveness of a range of interventions in promoting positive mental well-being, and reducing key risk factors for mental illness in children.\ud Conclusion: A variety of programmes have been shown to be effective in promoting children’s mental health, albeit with modest effect sizes. Based on this evidence, arguments are advanced for the preferential provision of early preventive programmes.

The aim of this article is to summarise the available evidence from systematic reviews about the effectiveness of interventions to prevent or treat child physical abuse and neglect. A computerised search was undertaken of major electronic databases up to December 2005 using key search terms. Only systematic reviews were included in which the primary studies evaluated the effectiveness of targeted or indicated interventions for child physical abuse or neglect. A total of 31 systematic reviews were identified and 15 met all the inclusion criteria. They covered a range of interventions/services, including home visiting, parenting programmes, multi‐component interventions, intensive family preservation services, family‐focused casework and multi‐systemic family therapy. There was limited evidence of the effectiveness of services in improving objective measures of abuse and neglect, due in part to methodological issues involved in their measurement, but good evidence of modest benefits in improving a range of outcomes that are associated with physical abuse and neglect, including parental and family functioning and child development. The results also showed some interventions (eg. media‐based and perinatal coaching) to be ineffective with high‐risk families. The evidence provided by these reviews has clear implications for children's services in the UK and other western developed countries.

This paper reviews current evidence of the significance of interpersonal relationships ‐ at community, workplace, school and family levels ‐ in influencing mental health and well‐being. It argues that the parent‐child relationship is of pre‐eminent importance both because of its direct effect on future mental health and because it sets the scene for future relationships. It also argues that, because of the reciprocal nature of the relationships, the mental health of society can be improved by improving the mental health of any of its individual members. From this it follows that to focus mental health promotion programmes entirely on the most vulnerable limits the potential for improvement, because working with people who are not mentally ill will increase their ability to support those who are. Universal mental health promotion programmes should therefore have relationships ‐ and parent‐child relationships in particular ‐ at their heart, aiming to improve everyone's capacity to relate supportively and respectfully to others.

Reviews previous studies of the universal approach to mental health promotion, and disease prevention programmes or interventions in schools. Over 8,000 publications were identified initially and 425 studies obtained for further review. The inclusion criteria were met by 17 (mostly US) studies investigating 16 interventions. Positive evidence of effectiveness was obtained for programmes that adopted a whole‐school approach, were implemented continuously for more than a year, and were aimed at the promotion of mental health as opposed to the prevention of mental illness. Provides evidence that universal school mental health promotion programmes can be effective and suggests that long‐term interventions promoting the positive mental health of all pupils and involving changes to the school climate are likely to be more successful than brief class‐based mental illness prevention programmes.