Child mental health is reportedly declining across many Western societies, with increasing levels of anxiety, depression, and loneliness detected. Some countries, such as the United Kingdom and Denmark, have introduced nationwide school-based mindfulness programs to explore whether such interventions can improve student mental health.
In Denmark, the government established the Danish Center for Mindfulness at Aarhus University to train schoolteachers to deliver mindfulness-based training to elementary school students across the country. The program was modeled after the United Kingdom’s Mindfulness in Schools Project.
Juul et al. [Social Science and Medicine] conducted a nationwide cluster-randomized trial to evaluate the effectiveness of the Danish elementary school mindfulness-based curriculum on child mental health in both the general student population and among students identified as at risk.
The Center for Mindfulness invited Danish elementary schools to voluntarily participate in the program. Schools opting in sent teachers to the Center for training. The training instructors were experienced Mindfulness-Based Stress Reduction (MBSR) teachers and received additional training through the United Kingdom’s Mindfulness in Schools Project.
Schoolteacher training involved completion of an MBSR course, a 4-day residential training, and three 2-day seminars. The school-based program consisted of a 10-week intervention delivered in ten 60-minute classroom sessions to students in grades 4 through 9. Due to the COVID pandemic, all sessions were conducted online. Students attending schools in the program were compared to students in schools on a waiting list that offered their normal curriculum.
Students were assessed at baseline, post-intervention, and 3 months after the intervention using a variety of self-report measures. The primary outcome was the Total Difficulties Score from the Strengths and Difficulties Questionnaire (SDQ). Secondary outcome measures included SDQ subscales assessing emotional, conduct, and peer relationship problems, hyperactivity/inattention, and prosocial behavior. Students scoring above the 80th percentile on the baseline total difficulties score were classified as “at risk.”
Of the 1,669 students who completed baseline assessments, 351 were identified as at risk. Attrition was high given over 44% of students failed to complete post-intervention assessments. Students from control schools were significantly more likely to provide data at post-intervention periods.
The results showed that among-at-risk students, both study groups had a small improvement on the total difficulties measure, but without a statistically significant difference between groups. At-risk students who received the intervention performed worse than their control counterparts on measures of hyperactivity/inattention (Cohen’s d = 0.34) and on a self-rated visual analog health scale (d = 0.26). At the 3-month follow-up, boys in the intervention group reported significantly increased hyperactivity/inattention (d = 0.89), while girls showed no such effect (d = -0.07).
In the general student population, there was no evidence of improvement on the primary outcome immediately following the intervention. At the 3-month follow-up, both intervention and control groups showed modest improvements in the Total Difficulties Score, again without significant differences between them.
The study shows that a universal school-based mindfulness curriculum does not appear to improve mental health outcomes either for the general student population or for at-risk students. Moreover, the intervention may perhaps worsen some outcomes such as hyperactivity/ inattention among at-risk children, especially boys.
The study is limited by the social and institutional complications posed by the COVID pandemic and online format as well as the lack of fidelity checks to determine if teachers correctly implemented the curriculum as intended.
Reference:
Juul, L., Frydenberg, M., Bonde, E. H., Beck, M. S., Goetzsche, K., Nielsen, H. B., & Fjorback, L. O. (2025). Mindfulness in the school curriculum? A nationwide cluster-randomized trial of the effectiveness of implementing a mindfulness-based intervention for 9–16-year-olds students in Danish elementary schools. Social Science & Medicine.
Link to study
