Letter to the Editor: Integrating context-specific and universal strategies: reflections on Birrell et al.'s universal school-based mental health interventions.

This letter responds to Birrell et al.'s (Child and Adolescent Mental Health, 30, 92) article on universal school-based mental health interventions, emphasizing the importance of refining universal approaches rather than discarding them. The letter discusses critical aspects of program adaptation to cultural contexts, the role of meaningful co-design with students and staff, and the integration of targeted strategies in concert with universal approaches. It also highlights the potential of digital health technologies, emphasizing equitable access and personalization to diverse populations. Additionally, the letter calls for a broader evaluation of intervention impacts beyond symptom reduction, including stigma reduction, school climate, and help-seeking behaviors. Drawing from recent evidence, the letter advocates for integrated models that combine universal and targeted strategies, offering practical recommendations for future research and policy.