Aligning interventions with the University Mental Health Charter: a stratified review of reviews of mental health and wellbeing interventions for higher education students

This stratified review of reviews evaluates the alignment of mental health and wellbeing interventions for higher education students within the University Mental Health Charter's domains. A narrative synthesis of 341 studies was conducted, extracted from 265 reviews. Interventions were stratified by the Mental Health Charter's domains—Live, Learn, and Support—and analysed for their impact on mental health outcomes. The “Live” domain, particularly proactive interventions and mentally healthy environments, had the highest number of studies, predominantly conducted via Randomised Controlled Trials. The “Learn” domain largely comprised quasi-experimental studies, while the “Support” domain featured pre-post designs without control groups. Interventions were primarily conducted in person and were universal, targeting undergraduate students, with North America being the most frequent research location. For the most frequent mental health outcomes (anxiety, depression, and stress), interventions showed mixed effectiveness across all domains, with no significant association between the type of intervention and its impact. Most studies were rated as having medium evidence strength, with less than 10 % classified as strong evidence. The findings highlight a critical need for diversified research focusing on underrepresented areas within the Mental Health Charter, such as academic progression and partnerships with external care providers. Additionally, there is a call for standardised outcome measures to enhance the robustness of future meta-analyses and the overall evidence quality. Addressing these gaps will support the effective implementation of a whole-university approach to student mental health.