A Systematic Review of School-Based Mental Health Literacy Interventions: Efficacy in Reducing Stigma and Promoting Help-Seeking Among Urban Adolescents in Senegal

**Revised Abstract** Adolescents in urban Senegal face a significant burden of common mental health conditions, yet stigma and low mental health literacy (MHL) remain critical barriers to help-seeking. This systematic review synthesises the available evidence to evaluate the efficacy of school-based MHL interventions in reducing stigma and promoting help-seeking behaviours within this specific demographic and context. Following PRISMA guidelines, a comprehensive search of five electronic databases (PubMed, PsycINFO, Scopus, African Journals Online, and Global Health) was conducted for studies published between 2011 and 2023. Included studies were empirical investigations of structured, school-based MHL programmes delivered in urban Senegal, measuring outcomes related to stigma, help-seeking, or MHL knowledge. Screening, data extraction, and quality assessment using the Cochrane Risk of Bias tools were performed independently by two reviewers. From 524 identified records, five studies met the inclusion criteria. A narrative synthesis indicates that culturally adapted, participatory programmes, particularly those integrating contact-based education, demonstrate promising efficacy. These interventions were consistently associated with statistically significant improvements in mental health knowledge and reductions in stigmatising attitudes among participants. However, evidence for sustained behavioural change, specifically in actual help-seeking through formal services, remains limited and inconclusive. The review underscores the school system's potential as a pivotal platform for early intervention. It concludes that while promising, current interventions require more robust, longitudinal evaluation. Embedding sustained, context-specific MHL into national educational policy is recommended to address the adolescent mental health crisis in urban Senegal and similar settings.