Universal digital mental health interventions for children and youth: a scoping review.

Introduction: Digital mental health interventions (DMHIs) are increasingly used to support child and youth mental health, yet the scope and characteristics of universal (Tier 1) DMHIs remain poorly defined. Methods: This scoping review synthesized peer- reviewed studies of universal DMHIs delivered to children and youth aged 0-18 years. Results: Use of online programs and hybrid delivery were prevalent. Many programs used an independent structure, while facilitation varied across self- led, facilitator-led, and both-led models. Outcomes were commonly assessed across multiple domains, including emotional, behavioural, social, and cognitive outcomes. When single domains were examined, these most often focused on emotional outcomes such as anxiety and depression. Interventions frequently employed therapeutic approaches such as cognitive behavioural therapy and psychoeducation, with content emphasizing emotion regulation, coping and problem-solving skills, and mental health literacy. Structural features varied in length and number of sessions, and many included scaffolded self-managed elements such as messaging or check-ins. Early childhood was underrepresented, with limited reporting of child outcomes for ages 0-4. Equity considerations were also limited, as many studies did not report race or ethnicity and sex and gender reporting was often binary or unspecified. Youth involvement in intervention design or consultation was uncommon. Discussion: This review provides an overview of the current landscape and identifies key gaps, including limited equity considerations, the underrepresentation of early childhood development, and minimal youth involvement. Clearer reporting of delivery structure and facilitation, stronger demographic reporting, and component-focused evaluation can support equitable, developmentally responsive scale-up. Systematic Review Registration: https://inplasy.com/inplasy-2024-9-0026/, INPLASY202490026.