What is the evidence for social support programs and youth depression?
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What is the evidence for social support programs and youth depression?

Last updated: April 2025 (includes research published from 1980 to March 2025)  

This review summarises research evidence for youth depression prevention and treatment programs that include a social support element, as well as insights from young people, family, carers and supporters, and youth mental health practitioners. It is aimed at professionals who support the mental health of young people in clinical, education and community services. It is designed to support shared decision-making with young people, and with family, carers and supporters, as part of responsive and person-centred care. It may also help with policy and program funding and implementation decisions.  

“For young people, it's important not to underestimate the potential power of social support in promoting mental health.” — Young person, 22

What is this review about?

This review focuses on social support and youth depression. Social support is broadly defined as emotional and physical assistance provided to others  (1). For young people, social support is often provided by parents and family, but it can also be provided by friends and others. It can include things like empathy, helpful information, financial assistance, housing, and more. For more information about social support and youth mental health see Orygen factsheet: Social support and youth mental health.

There is strong evidence that social support is an important protective factor against depression for young people (2). However, less is known about what types of programs involving a social support component might be beneficial for preventing or treating depression in young people.  This evidence summary aims to address this gap. 

Research Snapshot

This research review provides a summary of the findings from 29 controlled trials involving 10,771 young people (3-31).  

Overall, the research shows that programs with a social support element designed to prevent or treat youth depression: 

  • are generally safe;  

  • may be better than no intervention for addressing symptoms of depression;  

  • may be as effective as other interventions for depression, depending on the young person’s level of need and characteristics of the program.  

In this review, other interventions include evidence-based treatments such as cognitive behavioural therapy, referral to usual care or services in the community, and psychoeducation. 

Because the research was designed and conducted in different ways, it is not possible to be completely confident in these findings. Right now, it is still unclear:  

  • which programs with a social support element are more likely to work, or not work, for youth depression; 

  • how much they improve depression; and  

  • how much the social support component of programs contributes to their effectiveness.  

When we spoke to young people and family, supporters and carers, they told us that:  

  • programs need to be culturally responsive and tailored to the individual needs of young people, depending on their life circumstances as well as the severity of their symptoms; 

  • workforces need to be mindful of who is represented in the research evidence, and how depression is measured – and that this might not align with everyone’s experiences of depression, especially culturally and linguistically diverse and First Nations young people.  

More details about the included research studies, the perspectives of young people and carers, and implications for practice and policy can be found in the sections below. A table summarising key information about the studies included in this review can be found in the ‘Results in detail’ section.  

This research review included any study where the program being tested aimed to strengthen social support for young people to prevent or treat depression. Programs varied in how they addressed social support, with many focusing on building general social and communication skills through group activities or online interaction, while fewer of these programs specifically aimed to strengthen relationships and social networks. Some studies of interpersonal therapy focused more on improving family relationships and social environments. For more information about social support and youth mental health, see Orygen factsheet: Social support and youth mental health.  

Delivery of programs varied, with about half delivered in-person (16 studies), and others delivered online (nine studies), and through hybrid formats (four studies). Digital programs included smartphone apps, websites, videoconferencing and text messaging. Program facilitators included clinicians, researchers, teachers, youth workers, peers, and others who received training about program delivery. Programs also varied in whether they used psychological theories or approaches, with cognitive behavioural therapy and behavioural activation being common in prevention programs, while interpersonal therapy appeared across both prevention and treatment studies. Some programs used more general therapeutic approaches like positive psychology, while others did not use any formal therapeutic framework.  

 

This research included young people aged 11.7 to 25.2 years. On average, across the studies there were more female participants (56%) than male (29%). About one-third of the research reported on non-binary and trans participants. Across those studies, the proportion of non-binary and trans participants ranged from 1–37% of the study samples. Two studies focused on LGBTQA+ young people. One-third of studies reported having ‘minority’ ethnicity participants and five studies reported migrant participants. One study had a focus on young people with migration experiences. Seven studies reported low income or socioeconomic status. Only three studies – all from the US – reported a small proportion (0–4%) of First Nations participants. Of the 29 included studies, only three involved caregivers, parents or guardians as well as young people. Overall, there was some diversity in the experiences of young people who took part in this research, but limited representation of First Nations communities.  

Of the 29 included studies, only two studies were conducted in Australia. Most were conducted in the US (nine studies) or China (seven studies), three studies were conducted in Canada, and one study each from Lebanon, Germany, Malaysia, South Korea, Kenya, Ireland and Iran. More research is needed in Australian settings to explore feasibility and cultural appropriateness, although similarities between Australia, the US, UK and Canada make it easier to generalise from these contexts.    

Programs were often delivered through secondary schools and universities, as well as community, clinical and, less often, targeted settings such as correctional facilities. Diversity in settings suggests that interventions targeting social support may be appropriate across a range of contexts, depending on the characteristics of the program.  

All the studies measured depression by symptom severity, using a range of tools (e.g. Patient Health Questionnaire (PHQ), Center for Epidemiological Studies-Depression Scale). Many studies also measured changes in perceived social support, sometimes separating social support from family, friends and significant other. All the research included in this review was quantitative, meaning that outcomes were measured using numerical data – for example, the PHQ measures depression symptom scores on a scale of 0–27.   

 

Based on the current research, programs with a social support element appear to be safe. Most studies found either a positive impact of programs or that they were no different to a comparison program or nothing. There was one study that found young people who accessed a psychoeducation website without interactive discussion boards showed greater improvements in depression symptoms than those who accessed the website with discussion boards (3). One study also reported a young person sharing “troubling” posts on a self-help web platform, although this was not described as an adverse event (4). These two studies were the only evidence that social support interventions may be potentially harmful in some situations. However these were single studies, which both had concerns for risk of bias – meaning that the results may not be very reliable. 

About one-third (10 of 29) of studies evaluated a universal prevention program, which engaged general populations of young people regardless of lived experience or risk of depression. One-third (10 of 29) studies were of indicated prevention programs, involving young people experiencing distress or depression symptoms. Eight studies were of selective prevention programs, involving groups of young people who are known to be at heightened risk of depression due to social determinants e.g. LGBTIQA+ young people. There were two treatment studies where young people met criteria for a diagnosis of depression.  

From these studies, it is not possible to confidently say whether programs with a social support element are more likely or not to be beneficial for addressing youth depression. This is partly because of how studies were designed and conducted. It is also partly because studies showed a mix of positive and non-significant results. This doesn’t mean that interventions with a social support element are not effective, only that they are not more effective than other programs.  

The features of programs with a social support component that make them more promising for addressing depression in young people are an important finding from this review. The following sections provide a summary of the evidence for different program types. 

Evidence for universal Prevention programs

Studies of universal prevention programs (10 studies, total 6954 participants) were mostly delivered in educational settings including secondary school and university, using a mix of in-person, hybrid, and online formats (4–13). Based on this research, it appears that universal prevention programs with an explicit focus on strengthening relationships and building interpersonal and communication skills may be the most promising. In addition – in line with previous research – the evidence suggests that a whole-school approach to mental health and wellbeing is most useful. For instance, the largest study to find positive results evaluated a school-based intervention (MindOut) focused on social awareness and relationship management as part of a whole-school approach to wellbeing, engaging students, staff, parents and the community (6).  

evidence for Selective prevention programs

Studies of selective prevention programs (eight studies, total 1878 participants) focused on specific populations, including LGBTQA+ young people, young parents, and young people with recent non-suicidal self-injury, as well as specific settings, including correctional or reform facilities, foster care, secondary schools with majority marginalised students, and mental health clinics (14–21). Two studies found longer-term benefits (4–6 months later) (14,20), one of which had not found positive results in the shorter-term (20). Based on these studies, there is some evidence to suggest that those tailored to specific populations and delivered by specialist providers may be most promising for improving both depression and social support outcomes. For instance, the largest study to find positive results evaluated a six-month, home-based parenting model for young caregivers, which was delivered by trained child and parenting service providers and designed to improve parenting behaviours and promote family social support using motivational interviewing techniques (SafeCare) (14). 

Evidence for indicated prevention programs

Studies of indicated prevention programs (nine studies, total 1068 participants) included young people with symptoms of depression or distress and were delivered in educational and clinical settings, with many using digital platforms (e.g. smartphone app, website, email, text message, videoconferencing) (3,22–29). While more than half found benefits for reducing symptoms of depression, only two studies examined longer-term outcomes and found that positive impacts were not maintained within 6–12 months later (22,25). Delivery format may be a key factor, with interventions that were entirely self-directed showing fewer positive outcomes. Notably, some digital platforms showed potential for worsening depression symptoms and perceived social support, although these were single studies with concerns for how the research was designed and participant dropout rates (3,27). Overall, however, the current research highlights the need for careful consideration when developing and choosing indicated prevention programs with social support elements.  

Evidence for treatment programs

Only two studies included young people with symptoms that met criteria for diagnosis of depression (30,31). Both studies evaluated interpersonal psychotherapy (IPT), which focuses on addressing symptoms by improving interpersonal relationships (32). In one study, changes in family social support – but not friend social support – predicted depression at follow-up (31). Based only on these results, it is not possible to confidently say whether interventions with a social support element are beneficial as a treatment for youth depression, due to the limited number of studies. However, there is strong evidence in favour of IPT for the treatment of depression in adolescents and adults from other published reviews, which suggests that this may be an appropriate approach for some young people whose symptoms meet criteria for diagnosis (33,34). 

Young people’s reflections on the research

We spoke with Orygen’s National Youth Advisory Council – around 15 young people aged 18-25 years – to understand their perspectives on the research. For young people, the research confirmed the importance of social support in supporting mental health and wellbeing. Young people spoke about the long-term benefits of establishing authentic social support, which might be through strengthening existing relationships with family and friends, or with young people in their community who have genuine shared interests (either locally or online). They suggested that while this may be difficult to measure in the long-term, it is important for supporting wellbeing into adulthood.  

Young people highlighted that social support has a broad definition, with some elements being basic human rights (i.e. practical element such as housing), while others are less tangible and more difficult to measure (i.e. emotional support elements such as care and affirmation). Young people considered these different elements as different targets that should be carefully selected and aligned to a young person’s needs depending on their experience of mental ill-health and their life circumstances. They suggested that programs that are beneficial for one cohort, may not be beneficial for others, and that interventions should be tailored, culturally specific, and considerate of the young person’s developmental context.  

Young people pointed out that research evidence can be biased, and in this case First Nations young people were underrepresented in the results, although there was representation from lots of countries around the world. They also spoke about quantitative research being developed from White Western ways of thinking and highlighted that the tools used to measure depression might not always be culturally appropriate. Young people wanted workforces to hold this in mind when considering the research evidence.  

“As a young person, I think being prescribed social support could be a really effective way to promote connection and overall mental wellbeing.” — Young person, 22

Family, carer and SUPPORTER reflections on the research

We spoke with family peer workers at Orygen’s specialist and primary youth mental health services to understand their perspectives on the research. This group includes family, carers and supporters of young people who have experienced mental ill-health and illness.  

When presented with the research evidence, family reflected that they would feel relief if social support interventions were offered to the young person in their life. Family highlighted the importance of tailoring interventions to the individual young person, their needs, and their stage of ill-health. They suggested that interventions should be culturally informed, considering community and family understandings of depression and mental health more broadly. They also indicated that social support interventions may be more effective in prevention, early intervention, and primary care, and that careful consideration would need to be given for social support programs provided in tertiary care and during times of crisis. Careful consideration of family context and relationships must be given when involving family alongside young people in programs. Family saw positive social support as a long-term goal, where other interventions (e.g. medical interventions) may be needed to first achieve short-term goals. Ultimately, family saw benefit in interventions having a social support element, as this often will have positive outcomes for the family unit as well. 

“As a parent, I've seen how important social support is for young people's mental health - helping them feel less alone, more able to cope, and reassured that things can get better because they're not facing it on their own.” — Parent

What do these findings mean for youth mental health practitioners?

The current research suggests that programs targeting or involving social support are generally safe for young people and may be effective for alleviating symptoms of depression. From the perspective of young people and family, carers and supporters, programs with a social support component were seen as valuable for the prevention and treatment of depression, but the needs and contexts of young people should always be considered when deciding whether a program is appropriate.   

The findings from this review highlight several key considerations for youth mental health practitioners:  

  • Shared decision-making: As with any decision about care, work together with young people as much as possible to choose which intervention or program might be appropriate. 

  • Stage of mental illness: For young people with more complex needs, it may be most appropriate to engage in programs that are delivered by a trained mental healthcare provider. 

  • Human rights and broader social inclusion (e.g. housing, physical safety): Although the research found in this review mostly focused on programs designed to strengthen social relationships and skills, social support can also include things like housing and financial support. Addressing these fundamental determinants of health and wellbeing provides a stable foundation for therapeutic work. 

  • Cultural context: Not all youth mental health programs have been developed using a culturally responsive lens. When considering whether to implement or refer to a program with a social support component, ask questions about how a program was developed, who designed and delivers the program, and whether the needs of LGBTIQA+, culturally and linguistically diverse, or First Nations communities have been actively considered and integrated in the design.  

For more tips on facilitating social support with young experiencing mental ill-health, see Orygen factsheet: Social support and youth mental health.

“As clinicians we always need to centre our work around the needs and preferences of the young person. If a young person is struggling with housing, finances or other social stressors, then it is our responsibility to make sure these are adequately addressed and that the young person has the access to the right support at the time.” — Caroline, senior youth mental health clinician

 WORKING WITH FIRST NATIONS YOUNG PEOPLE

Although this research review did not find any programs designed specifically for Aboriginal and Torres Strait Islander young people, there are resources and programs available, which have been designed by and for First Nations communities to support mental health and wellbeing. These often have a strong focus on healing through social support from trusted people, in line with the National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing. The framework includes a principle on recognising the centrality of Aboriginal and Torres Strait Islander family and kinship, as well as the broader concepts of family and the bonds of reciprocal affection, responsibility and sharing. 

Key resources for working with Aboriginal and Torres Strait Islander young people:

  • 13YARN is a national service providing telephone access to Aboriginal or Torres Strait Islander Crisis Supporters 24 hours/7 days. 

  • WellMob provides social, emotional and cultural wellbeing online resources for Aboriginal and Torres Strait Islander People, including workforces. 

  • Improving the social and emotional wellbeing of Aboriginal and Torres Strait Islander children – developed by the Healing Foundation and Emerging Minds, includes an online course and fact sheets for mental health professionals.  

  • Yarn Safe is a youth led national Aboriginal and Torres Strait Islander mental health campaign that provides resources for young people, including a fact sheet about healthy relationships.  

  • Social and Emotional Wellbeing (SEWB) framework provides an evidence-based model for understanding Aboriginal and Torres Strait Islander mental health and wellbeing, including specific domains related to connection to land, culture, ancestry, family, and community. The model shows that social support is vital for the wellbeing of First Nations young people and provides a framework for designing culturally responsive mental health and wellbeing programs with and for Aboriginal and Torres Strait Islander communities.  

Although none of the studies we reviewed included recommendations for policy, several national Australian strategies and initiatives emphasise the importance of social support for the mental health and wellbeing of young people. 

  • Stronger Places, Stronger People – a federal government initiative designed to address disadvantage and create better futures for children and families in several regional communities across Australia, through evidence-based, locally-tailored solutions delivered in partnership with local people.   

For more information about social support, youth depression, prevention and treatment:  

  • Orygen depression resources – designed for youth mental health professionals, includes clinical practice guides and manuals, online learning modules, evidence summaries and more. 

  • Orygen school resources – includes an evidence summary and implementation toolkit about school-based universal and targeted depression prevention programs.  

  • Beneficial program or positive results: Where a study found an improvement in depression symptoms for young people who were assigned to take part in a program with a social support component, compared to young people who were assigned to a control group.
  • Control group: A comparison group used for testing whether a program of interest is associated with a significant improvement in depression. Control groups in this review could be no intervention, an attention control, another treatment for depression, or the same treatment without the social support component.
  • Controlled trial: a research study that includes a control group as well as an intervention group who are assigned to take part in the program of interest.
  • Universal prevention: study recruited whole populations, regardless of risk or experience of mental ill-health, e.g., recruiting whole of school or whole classroom or whole of community.
  • Selective prevention: study recruited participants with any established risk factor - broadly conceptualised - for a mental health condition, e.g., ethnic minority, parent with mental ill-health.
  • Indicated prevention: study recruited participants with elevated symptoms or distress, e.g., all participants must score above a certain level on a symptom measure such as the Patient Health Questionnaire.
  • Treatment: study recruited participants with symptoms that meet criteria for a diagnosis according to DSM/ICD criteria.

This review conducted a systematic search of academic literature and used knowledge translation principles to consider evidence from lived experience and practice wisdom alongside the research evidence. Data from controlled trials was found using the Evidence Finder and by searching databases (EMBASE, PsycINFO, Medline) for research published from 1980 to the current date of this review. Included studies focus on preventing or treating depression in young people age 12 – 25 years. Studies were only included if the intervention aimed to target or improve perceived and/or actual social support for young people or included an outcome measure related to social support.

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Authors:

  • Isabel Zbukvic, Senior Research Fellow, Knowledge Translation, Orygen, Centre for Youth Mental Health, University of Melbourne
  • Alan Bailey, Research Fellow, Orygen, Centre for Youth Mental Health, University of Melbourne
  • Caroline Crlenjak, Workforce Development and Partnerships Lead, Knowledge Translation, Orygen
  • Katherine Mok, Research Fellow, Orygen, Centre for Youth Mental Health, University of Melbourne
  • Zoe Nikakis, Project Officer, Knowledge Translation, Orygen
  • Katie Barton, young person
  • David Baker, Research Fellow, Policy Translation, Orygen
  • A/Prof Kate Filia, co-head Social and Functional Recover, Orygen, Centre for Youth Mental Health, University of Melbourne
  • Caroline Gao, Co-Head of Data Science & Analytical Methods (DSAM), Biostatistician for Health Services and Outcomes Research, Orygen, Centre for Youth Mental Health, University of Melbourne

 

Authors gratefully acknowledge the contributions of the following people, whose expertise was instrumental in shaping this work:

  • Orygen National Youth Advisory Council
  • Orygen Youth Participation Team
  • Orygen’s specialist and primary youth mental health services family peer work program teams
  • Orygen First Nations Team
  • Amelia Ascuitto, youth advisor
  • Matt Cram, Head of Communications and Media, Orygen
  • A/Prof Magenta Simmons, Head Youth and Family Involvement Research, Orygen & Centre for Youth Mental Health, University of Melbourne