Implementation of digital mental health interventions for children and adolescents: A systematic review.

Background: Young people are adversely affected by the lack of access to mental health support. Digital interventions have demonstrated efficacy in randomised trials and pose one possible solution to increase access to mental health care. Yet, purposeful implementation efforts seldom occur, and effective interventions are rarely evaluated in real-world contexts. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided this systematic literature review. Relevant databases were systematically searched for studies reporting on disseminated digital mental health interventions for child and adolescent anxiety and/or depression that reported implementation outcome data. Reference lists of included studies and articles citing the included studies were also searched. Intervention and implementation outcome data was extracted. Results: Nine peer-reviewed articles, pertaining to seven different digital interventions, were identified as meeting inclusion criteria. There was significant heterogeneity in methods and dissemination efforts. The use of implementation science was inconsistent across studies, and the use of implementation frameworks and models was minimal. Digital interventions were effective for and adopted by community users, though dropout rates were high. Results indicate that young people and parents find digital mental health interventions to be acceptable and beneficial. Conclusions: This review highlights the inconsistencies in the application of implementation science for scaling up digital interventions for children and adolescents. However, results of included scale-up efforts support the notion of community dissemination of child and adolescent digital interventions. Future research should focus on planning and testing implementation strategies for the dissemination of such interventions.The review protocol was registered with PROSPERO (Registration ID CRD42024552703).