Conference Agenda

The prevention of mental health difficulties in children and adolescents is a major public health concern, as approximately one fifth of young people worldwide are affected by a mental disorder (Raccanello et al., 2023). In the European Union, youth mental health has deteriorated markedly in recent years, characterized by rising prevalence rates, early onset of mental disorders, high levels of unmet care needs, and suicide as one of the leading causes of death among adolescents (European Parliamentary Research Service [EPRS], 2023). Adolescence and early youth are considered particularly vulnerable periods in the life course, as young people face developmental, social, and contextual stressors that increase the risk of mental health problems (Solmi et al., 2021). These trends highlight the urgent need for prevention-oriented, accessible, and youth-specific mental health strategies in Europe, especially within educational and community settings (EPRS, 2023).

Schools represent a particularly suitable setting for early prevention, as they have the potential to reach all students regardless of background. However, teachers frequently report feeling insufficiently qualified to address mental health topics, which are often perceived as sensitive and complex. In addition, teachers’ motivation and perceived self-efficacy, as well as contextual factors, such as limited time resources or infrastructural constraints, constitute barriers to the implementation of school-based mental health interventions (Mason et al., 2025). Digital approaches may help alleviate some of these barriers, as digital, self-guided, and easily accessible programs can reduce both access- and implementation-related obstacles (Cilar et al., 2020). Moreover, digital interventions are often cost-effective, adaptable and allow for anonymity, which can enhance engagement in young people (Bauer et al., 2005). Indeed, school-based digital programs have demonstrated positive and promising effects in promoting youth mental health. However, many existing programs lack meaningful target-group involvement, diversity-sensitivity and long-term sustainability (Wright et al., 2023).

To address these gaps, partner institutions from Austria, Bulgaria, Poland, and Slovenia collaboratively developed the me_HeLi-D (mental health literacy and diversity) program as part of a three-year Erasmus+ project. The project aimed to provide young people (12-15 years) with an evidence-based, freely accessible digital mental health program that is tailored to their needs and preferences. A central development principle was diversity-sensitivity, encompassing dimensions, such as age, gender, cultural background, ethnicity, and neurodiversity, to ensure that students across different European contexts – and beyond – feel represented and valued.

This symposium brings together three complementary contributions that examine the development, effectiveness, and implementation feasibility of the me_HeLi-D program.

• Paper 1 addresses how the me_HeLi-D program was developed and how students perceived it.

• Paper 2 examines the effectiveness of the program in promoting aspects of mental health mental health knowledge.

• Paper 3 explores facilitators’ perspectives and recommendations following program implementation.

The first paper provides insights into the iterative and participatory development process of me_HeLi-D. Students and teachers from three partner schools in Austria, Poland, and Slovenia were actively involved at multiple stages, contributing to both content creation and program design. The paper also reports students’ perceptions of the final program, including acceptance and perceived knowledge gains. The second paper reports findings from a cluster randomized controlled trial conducted in the summer semester of 2025 in Austria, Poland, and Slovenia. Selected results regarding program efficacy and knowledge gains among students are presented. The third paper focuses on the perspectives of program facilitators involved in the trial. Semi-structured interviews with teachers, school counselors, and school psychologists explore experiences with implementation and perceived program feasibility in everyday school practice.

By integrating perspectives and lessons learned from the me_HeLi-D project on development, effectiveness, and implementation feasibility, this symposium contributes evidence-based insights to advance future school-based mental health initiatives across Europe.

Project me_HeLi-D: Mental Health Literacy and Diversity addresses the identified challenges through the development of a digital, adaptive, evidence-based, effective, target-group-specific, diversity-sensitive, and freely accessible online program for students aged 12 to 15. It combines a scientific and a participatory approach. On the one hand, its design (structure and content) is based on systematic literature reviews (Reitegger et al., 2024; Wright et al., 2023). On the other hand, it actively involves students in the co-creation of the program’s appearance, content, and activities through workshops conducted at the partner schools by teachers and researchers, thereby increasing the program’s relevance, acceptance, and effectiveness for the target group (for details, refer to Vidmar et al., 2025). The resulting me_HeLi-D program is a digital intervention designed to strengthen students’ mental health literacy across five domains: help-seeking, resilience, mindfulness, anxiety, and depression. To enhance engagement and age-appropriateness, the program is embedded in a narrative framework set in a fictional environment - the Landscape of the Mind - where students progress by completing structured learning activities. Each domain includes mandatory tasks that are required for program completion, alongside optional activities that allow for deeper exploration and further consideration of knowledge and skills. This structure supports both guided learning pathways and individual autonomy, reflecting the program’s adaptive and learner-centred design principles established during the participatory development process. This study examined students’ evaluations of the me_HeLi-D program and its perceived impact in three countries: Slovenia, Austria and Poland. The sample comprised students who had participated in the program, including 239 participants from Slovenia (Mage = 13.17 years, 58% female); 105 participants from Austria (Mage = 12.60 years, 52% female); and 57 participants from Poland (Mage = 13.86 years, 74% female). Significant differences were found between countries in participants’ evaluations of the program and its perceived impact, as well as in its perceived usefulness in daily life and willingness to recommend it. Participants from Poland consistently reported the most positive evaluations, followed by those from Slovenia, while participants from Austria reported the least positive evaluations. However, no significant differences between countries were observed in terms of future intentions to apply the acquired knowledge and skills. Overall, the findings suggest that the national context plays an important role in shaping participants' experiences of and perceptions of the program, but not their intentions to use the acquired knowledge and skills in future.

Reitegger, F., Peras, I., Wright, M. in Gasteiger-Klicpera, B. (2024). Key components and content of effective evidence-based digital prevention programs for anxiety and depression in children and adolescents: A systematic umbrella review. Adolescent Research Review, 9, 367–410. https://doi.org/10.1007/s40894-024-00237-z Vidmar, M., Veldin, M., & Peras, I. (2025). Anksioznost skozi oči mladostnikov in mladostnic: Participativni pristop k razvoju digitalnega programa za krepitev duševnega zdravja mladih. In A. Mlekuž & I. Ž. Žagar (Eds.), Raziskovanje v vzgoji in izobraževanju: Umetna inteligenca v vzgoji in izobraževanju (pp. 111–126). Pedagoški inštitut, Založba Pedagoškega inštituta. https://doi.org/10.32320/978-961-270-373-8.111-126 Wright, M., Reitegger, F., Cela, H., Papst, A. in Gasteiger-Klicpera, B. (2023). Interventions with digital tools for mental health promotion among 11–18 year olds: A systematic review and meta-analysis. Journal of Youth and Adolescence, 52(4), 754–779. https://doi.org/10.1007/s10964-023-01735-4

This paper presents findings from a multicentre controlled study conducted between April and July 2025 in Austria, Poland, and Slovenia, evaluating the effectiveness of the me_HeLi-D program in promoting mental health knowledge, psychosocial competencies, and selected mental health indicators among 12–15-year-old students. The study was conducted in a cluster-randomized controlled pre-/post-test design (N = 797; intervention group, n = 444). A set of standardized psychometric self-report instruments (e.g., MHLS, O’Connor & Casey, 2015; RCADS, Chorpita et al., 2006; GHSQ, Wilson et al., 2005) was applied for relevant mental health indicators, including mental health literacy, help-seeking, stress, anxiety, depression, mindfulness, resilience, and well-being. In parallel, a self-developed knowledge test covering the content of individual program modules was administered. Changes in outcomes were analysed using non-parametric tests and linear regression models, controlling for baseline levels and the degree of module implementation across countries (utilizing R software). The results demonstrated statistically significant changes in 17 of the 33 analysed indicators. Increases were observed in knowledge about help-seeking options, eHealth competencies, and intentions to seek help. Reductions in generalized anxiety and social phobia were found, along with a slight decrease in perceived stress. Some mindfulness subscales showed small declines, accompanied by an increase in the ability to respond non-automatically to emerging thoughts and emotions, indicating a complex pattern of change in emotional regulation. The knowledge test revealed statistically significant, though moderate, gains, particularly in modules related to mindfulness and resilience. The differences in pre- and post-measurements between countries were closely related to the level of program completion. In Slovenia (high completion level), significant increases in knowledge, an increase in the intention to seek help, and a decrease in symptoms of generalized anxiety and social phobia were observed. In Austria and Poland (lower completion levels) changes in mental health aspects and knowledge were weaker or inconsistent, confirming the importance of program completion for revealing its effects. The combined analysis of standardized instruments and knowledge tests revealed the complementary nature of the observed effects: a clear increase in knowledge gain, mental health awareness, and help-seeking intentions. These findings suggest that short-term psychoeducational interventions such as me_HeLi-D may be particularly effective in strengthening the foundations of prevention—knowledge, reflexivity, and readiness to use support—which are crucial for long-term improvements in mental well-being. This highlights the value of the program as an early intervention tool and underscore the importance of multidimensional evaluation of digital mental health interventions for adolescents.

Chorpita, B. F., Yim, L., Moffitt, C., Umemoto, L. A., & Francis, S. E. (2000). Assessment of symptoms of DSM-IV anxiety and depression in children: A revised child anxiety and depression scale. Behaviour Research and Therapy, 38(8), 835–855. https://doi.org/10.1016/S0005-7967(99)00130-8 O’Connor, M., & Casey, L. (2015). The Mental Health Literacy Scale (MHLS): A new scale-based measure of mental health literacy. Psychiatry Research, 229(1–2), 511–516. https://doi.org/10.1016/j.psychres.2015.05.064 Wilson, C. J., Deane, F. P., Ciarrochi, J. V., & Rickwood, D. (2005). Measuring help seeking intentions: Properties of the General Help Seeking Questionnaire. Canadian Journal of Counselling, 39(1), 15–28.

Implementation science shows that the efficacy of mental health programs alone is insufficient to ensure their adoption in practice; rather, successful and sustainable program uptake is shaped by multilevel factors (Bauer & Kirchner, 2020). In school-based interventions, these include characteristics of the intervention (e.g., adaptability, flexibility), the outer setting (e.g., policies, legal and contextual conditions), the inner setting (e.g. school culture, infrastructure), characteristics of the individual/facilitator (e.g., attitude towards mental health, knowledge, motivation), and implementation processes such as planning, training, role clarification (Damschroder et al., 2022; Roshan et al., 2025). Against this background, the me_HeLi-D intervention study assessed not only program effectiveness, but also implementation feasibility. This paper examines the feasibility of implementing the digital me_HeLi-D prevention program in everyday school practice from the perspective of facilitators. Qualitative data were collected through semi-structured interviews with 22 facilitators (11 teachers, eight school counselors, and three school psychologists) fromintervention schools in Austria, Poland, and Slovenia. The interviews lasted between 20 and 30 minutes (M = 24 minutes) and were conducted either in person or online. They explored facilitators’ general attitudes towards digital programs and mental health education, their experiences with me_HeLi-D, program acceptance, and perceived facilitating and hindering conditions for implementation. Interview transcripts were translated into English and analyzed using qualitative content analysis (Mayring & Fenzl, 2019). The findings align with existing implementation research while providing unique insights into the feasibility of me_HeLi-D. Across all countries, key challenges included limited time resources, technical disruptions, and varying levels of student motivation. Country-specific challenges included insufficient technical infrastructure and the length and complexity of content in Slovenia, logistical barriers related to parental consent in Poland, and the short duration of class periods in Austria. In contrast, facilitators across countries highlighted the program’s thematic relevance and its flexible integration into classroom teaching as major strengths. While most Austrian and Slovenian facilitators would recommend the program, attitudes towards future uptake were more mixed in Poland. However, facilitators across all countries indicated willingness to use an adapted version of the program (e.g., shortened or simplified content). Overall, the results suggest that digital prevention programs must be flexible, engaging, and technically reliable to foster teacher acceptance and enable sustainable implementation. Furthermore, careful planning, facilitators’ willingness to assume additional responsibilities, and ongoing technical and/or professional support appear essential. These findings underscore the importance of considering individual, intervention-related, and contextual factors when implementing school-based mental health programs.

Bauer, M. S., & Kirchner, J. (2020). Implementation science: What is it and why should I care? Psychiatry Research, 283, 112376. https://doi.org/10.1016/j.psychres.2019.112376 Damschroder, L. J., Reardon, C. M., Widerquist, M. A. O., & Lowery, J. (2022). The updated Consolidated Framework for Implementation Research based on user feedback. Implementation science, 17(1), 75. https://doi.org/10.1186/s13012-022-01245-0 Mayring, P. & Fenzl, T. (2019). Qualitative Inhaltsanalyse. In N., Baur & J., Blasius (Eds.), Handbuch Methoden der empirischen Sozialforschung (2nd ed., pp. 633-648). Springer. Roshan, R., Hamid, S., Kumar, R., Hamdani, U., Naqvi, S., Zill-e-Huma, & Adeel, U. (2025). Utilizing the CFIR framework for mapping the facilitators and barriers of implementing teachers led school mental health programs – A scoping review. Social Psychiatry and Psychiatric Epidemiology, 60, 535–548. https://doi.org/10.1007/s00127-024-02762-7