Highlights in child mental health research: March 2026

The highlights for March 2026 include:

Do school programs that build resilience improve adolescents’ mental health?

This systematic review examined resilience-based programs that aimed to improve mental health among secondary school students. It included 34 programs evaluated in randomised controlled trials and cluster randomised trials, published from 2014 to 2025. Twelve programs were found to improve depressive symptoms, anxiety symptoms, resilience, emotional symptoms or externalising challenges in the short term. There was less evidence for long-term effects. Successful implementation of such programs requires strategies to reduce student drop-out and improve engagement.

Do immersive virtual reality therapy tools help children and adolescents in mental health treatment?

This systematic review and meta-analysis examined the impact of immersive virtual reality therapy tools on child and adolescent mental health. It included nine randomised controlled trials of children and adolescents, published from 2016 to 2024. It found immersive virtual reality was associated with a small improvement in mental health compared to comparison groups. Immersive virtual reality tools were most effective when using realistic avatars; they were also highly interactive and easy to use. Evidence in this area is promising but still emerging.

Practitioners’ views on what helps improve mental health for children and adolescents in out-of-home care

This study interviewed practitioners to identify enablers to improve mental health for children and adolescents in out-of-home care. Researchers interviewed 27 practitioners in Australia between February and April 2024. Practitioners supported or identified a range of enabling factors. These included connection to community, an empowered and sustainable workforce, in-house clinical teams and collective investment in youth mental health.

How childhood domestic violence experiences relate to health service use in adulthood

This study examined the impact of childhood domestic violence experiences on adult use of health services. Researchers analysed survey data from the Australian Child Maltreatment Study on 8,503 people. Any experience of childhood domestic violence was associated with an increase in health service use, particularly primary care physicians and mental health professionals. The study emphasised that health practitioners need support to recognise and respond to childhood experiences of domestic violence.

What evidence says about the association between smartphone use and eating disorder symptoms

This systematic review examined the association between problematic smartphone use and eating disorder symptoms. It included 35 studies, published in English from 2011 to 2025. People with problematic smartphone use were found to be more likely to have eating disorder symptoms. Although there seems to be a connection between problematic smartphone use and eating disorder symptoms, there isn’t enough evidence to fully understand the relationship between these factors.

Why is this important?

• Mental health challenges are common in adolescence and often begin before adulthood. Many adolescents don’t receive timely support for their mental health challenges. Schools have the potential to reach most adolescents in need of support in a non-stigmatising way.
• Resilience is a process where a person is able to adapt and cope in the face of adversity.
• Resilience-based programs have been found to be effective in reducing mental health challenges in adolescents. However, it is currently unclear which program components work best, how long benefits last, and what helps or hinders delivery in schools.

What did they do?

• The authors conducted a systematic review of resilience-based programs for students aged 11–19 years in secondary education.
• They only included randomised controlled trials (a study that tests whether a program is effective by randomly putting people into a program or comparison group) and cluster randomised trials (where whole groups of people, such as a school, are randomly assigned to a program or a comparison group) published from 2014 to 2025 in English or Spanish.
• The authors found 34 programs that met their inclusion criteria. They explored the effectiveness of these programs and what program components were associated with greater effectiveness.

What did they find?

• Twelve resilience-based programs showed benefits for adolescent mental health compared with a comparison group. These programs showed improvements for depressive symptoms, anxiety symptoms, resilience, emotional symptoms and externalising challenges.
• Programs that used multiple components were more likely to show benefits for mental health, especially those combining social skills training, cognitive behavioural therapy and positive psychology.
• Improvements in mental health were more commonly reported at short-term follow-up (less than six months). Improvements were rarely maintained over a longer term, with only two studies finding improvements more than six months after the program ended.
• Common delivery challenges included student drop-out, low engagement and inconsistent delivery as planned, alongside limited resources and cultural fit across settings.

What does this mean for practice?

• Resilience-based programs have evidence showing they can help improve adolescents’ mental health, particularly in the short term. Ongoing support may be needed for improvements to be maintained over a longer time.
• Programs that incorporate multiple components, such as social skills training alongside other approaches, appear to be a more promising approach for improving mental health than single-component programs.
• How a program is implemented can impact how effective it can be. Schools should develop strategies to engage students, minimise drop-out from the program and support staff to deliver programs as designed.

Why is this important?

• Mental health treatment for children and adolescents often requires engaging approaches that fit their developmental stage.
• Over the last decade, there has been a surge in virtual reality devices and use across many sectors. Their use is gaining traction in mental health care.
• Immersive virtual reality involves a person using hardware, such as a headset or head-mounted display, to enter a computer-generated, interactive 3D environment where they feel as if they are physically ‘present’. This is contrasted with non-immersive virtual reality, which is usually shown on a computer screen.

What did they do?

• The authors conducted a systematic review and meta-analysis (a type of statistical analysis that combines the results of multiple studies into one summary result) of studies examining the effect of highly immersive virtual reality therapy tools on the mental health of children and adolescents (under 18 years).
• They only included randomised controlled trials that were published from 2016 to 2024 in English or German.
• Nine studies met the inclusion criteria. The authors explored the effectiveness of the virtual reality tool in these studies, as well as whether the features of the virtual reality therapy tools (such as avatars, interactivity and usability) were associated with improvements in mental health.

What did they find?

• Across the included studies, immersive virtual reality was associated with a small improvement in mental health compared with comparison groups.
• Immersive virtual reality tools that had more realistic avatars, were highly interactive and were easy to use were associated with greater improvements in mental health.

What does this mean for practice?

• Immersive virtual reality could be a promising addition to mental health therapy for children and adolescents. Evidence of its effectiveness is still emerging so it should be implemented cautiously and its use evaluated.
• If services are considering incorporating virtual reality in therapy, tools that usable, interactive and have realistic avatars may support improvements in mental health for children and adolescents.

Why is this important?

• Children and adolescents in out-of-home care (OOHC) often experience complex mental health challenges. Despite this, there isn’t a coordinated, system-wide approach in Australia to effectively meet their needs.
• Children and adolescents in OOHC rely on the OOHC system to connect them with services and other systems to meet their mental health needs. They face many barriers in having these needs met, such as limited suitable services and clinicians, long wait times and inflexible mental health services.

What did they do?

• The authors interviewed 27 OOHC practitioners (e.g. case workers, therapeutic specialists, clinical leads, executives) in Australia. They used semi-structured online interviews that were conducted between February and April 2024.
• The authors used 11 enabling factors identified in a previous literature review in the interviews. They asked practitioners to comment on these and suggest any additional enabling factors.
• These enabling factors included: being empowered to seek and engage in mental health care; nurturing and healing relationships; proactive mental health care; multi-dimensional stability; comprehensive assessment; cross-sector collaboration and shared knowledge systems; specialised clinical interventions; highly skilled and expert care teams; evidence of effective OOHC practice; integrated and systemic service structure; trauma awareness; and trauma-informed care.

What did they find?

• The practitioners supported all 11 enabling factors identified in the literature review (listed above) and identified four additional enabling factors. These are the four additional factors:
  • Connection to community: Practitioners described community connection (including cultural, identity, interest or family networks) as important for belonging and as a protective factor for mental health, particularly when transitioning out of care.
  • An empowered, sustainable workforce: Practitioners identified workforce stability and support as important for children’s wellbeing. They identified staff turnover, burnout and inconsistent expertise as barriers to a secure workforce.
  • In-house clinical teams: Practitioners reported that there are gaps in access to appropriate clinical support for children and adolescents in OOHC. They highlighted the value of embedded clinical teams within OOHC services to provide timely, context-aware support and improve continuity of care.
  • Collective investment in youth mental health: Practitioners emphasised the need for broader community understanding and empathy as well as sustained investment in the mental health of children and adolescents. They suggested that the current stigma and discomfort about childhood trauma can reduce support for needed reform and funding.

What does this mean for practice?

• The authors argue that there is a need for greater investment and advocacy by the OOHC sector to implement these enabling factors to improve the mental health of children and adolescents in care.
• Other practice considerations include:
  • Practitioners supporting children and adolescents to make community connections outside of the OOHC context as part of their mental health plan.
  • OOHC service providers embedding trauma-informed supervision, reflective practice and mechanisms to mitigate vicarious trauma into their regular practice.
  • OOHC service providers consider employing multi-disciplinary in-house clinical teams as an interim solution to address the current service gap.

Why is this important?

• Childhood experiences of family and domestic violence are associated with mental health challenges (e.g. anxiety, depression) and physical health challenges (e.g. chronic pain). However, little is known on how these experiences relate to health service use in adulthood.
• An improved understanding of how childhood domestic violence experiences shape patterns of health service use will likely help inform appropriate support and intervention approaches.

What did they do?

• The authors analysed nationally representative survey data on 8,503 people in Australia from the Australian Child Maltreatment Study.
• They categorised childhood domestic violence experiences into four types: physical violence; threats of serious harm; damage to property or pets; and intimidation or control.
• They examined the association between experiencing any domestic violence in childhood, each different type of domestic violence and health service use in adulthood in the past 12 months (e.g. hospital admission, primary care physicians, psychologists). When looking at the association between a type of domestic violence and health service use, the authors adjusted the analysis to take the influence of experiencing the other three types of domestic violence into consideration.

What did they find?

• People who experienced any type of childhood domestic violence were more likely to have used health services in the past 12 months, particularly a primary care physician (49% more likely) or a mental health professional (23% more likely), than those who didn’t experience domestic violence in childhood.
• Those who experienced intimidation and control had a greater likelihood of visiting a mental health professional (44% more likely) and ‘other’ types of health professionals (e.g. specialist physicians, allied health professionals, complementary therapists; 16% more likely) than those without this experience.
• Those who experienced damage to property or pets were more likely to visit a primary care physician (37% more likely) than those without this experience.
• Those who experienced threats of serious harm had a greater likelihood of a hospitalisation (25% more likely) than those without this experience.
• Experiences of childhood physical violence were not found to be associated with an increase of using any health services.
• Associations between experiences of childhood domestic violence and health service use were often stronger for men compared to women.

What does this mean for practice?

• Practitioners in health services should be aware that it’s likely that adults with experiences of childhood domestic violence are using their services. They can consider using a trauma-informed approach to care that includes being sensitive to the possibility that their clients may have experienced trauma. They can also be aware of the connection between trauma and health.
• Health practitioners may benefit from professional development on how to:
  • recognise and appropriately respond to adults with experience of childhood domestic violence
  • use approaches that consider the impact of domestic violence on the whole family.

Why is this important?

• Smartphones are widely used, with some people developing patterns of use that are considered ‘problematic’. Problematic smartphone use refers to a behavioural or psychological dependence on smartphones that can mirror a behavioural addiction.
• Problematic smartphone use disproportionately impacts adolescents and young people. There’s growing concern that these behaviours may be associated with poorer mental health outcomes, including eating disorder symptoms.

What did they do?

• The authors conducted a systematic review of studies that examined the association between problematic smartphone use and eating disorder symptoms.
• They included quantitative studies published in English from 2011 to 2025.
• They included 35 studies that met their inclusion criteria. The vast majority of these studies (n=32) used a cross-sectional study design. This is a type of research study that looks at a group of people at one point in time and measures exposures (e.g. smartphone use) and outcomes (e.g. eating disorder symptoms) at the same time.

What did they find?

• People who had problematic smartphone use were more likely to also have eating disorder symptoms than those with lower or no problematic smartphone use.
• Increases in levels of problematic smartphone use were weak-to-moderately associated with increases in eating disorder symptoms (i.e. as scores for problematic smartphone use increased, scores for eating disorder symptoms also increased).
• These findings were consistent across different age groups (e.g. adolescents, young adults, adults) and countries (e.g. United States, Germany, Spain).
• As many of the included studies used a cross-sectional design, this review cannot determine if problematic smartphone use leads to eating disorder symptoms (or vice versa) as both factors were measured at the same time.

What does this mean for practice?

• Practitioners should be aware that there seems to be a connection between problematic smartphone use and eating disorder symptoms. However, we don’t currently have enough evidence to determine whether one of these factors causes the other.
• When working with people who are at risk of developing an eating disorder, practitioners could consider incorporating psychoeducational approaches related to how people use smartphones and media literacy related to problematic smartphone use.