The Impact of Place-Based Approaches Addressing Mental Health and Substance Use Among Adolescents: A Systematic Review of the Literature

Abstract

Objectives: We systematically appraised peer reviewed evidence assessing the impact of “place-based approaches” (PBAs) – those requiring multi-sectoral action within localities to address complex health challenges – on mental health outcomes among adolescents. Methods: We searched six databases from inception to May 2023. We defined PBAs as at least two sectors (e.g., local government, health) working collaboratively within a locality. Studies reporting mental health and substance-use among young people (aged 10–24) were included. Two authors independently assessed study quality using MMAT. Heterogeneity in PBAs, study design and outcomes prevented meta-analysis; results were narratively synthesised. Results: Thirty-three publications presented data from 22 PBA evaluations; 6 evaluations assessed mental health or wellbeing, 16 appraised substance use. Higher quality evaluations found no impact on mental health outcomes (n = 4), and some evidence for delayed initiation (n = 4) and reduced point-in-time use (n = 10) of alcohol. Evidence for impact on binge-drinking and drug use was mixed. Conclusion: Based on very few published studies of mixed quality, PBAs have not improved mental health or wellbeing among adolescents. More evidence exists to suggest PBAs can improve certain alcohol use outcomes in young people.