Secondary school teachers' roles and experiences in supporting students with depression, anxiety, early psychosis, and suicide risk: A scoping review

Mental ill health commonly emerges during adolescence, with depression and anxiety highly prevalent, early psychosis first appearing during this period, and suicide a leading cause of death among young people. These conditions disrupt students' engagement, attendance, and academic functioning, contributing to school disengagement, reduced completion rates, and longer-term social, vocational, and mental health consequences. Secondary school teachers, through regular contact with students in classroom settings, are well positioned to observe changes in behaviour and functioning over time. However, their roles and experiences across these conditions are not well understood. This scoping review examined evidence on teachers' roles and experiences in relation to depression, anxiety, early psychosis, and suicide risk. Thirteen electronic databases were searched for studies published between 2000 and 2024, yielding 34 studies. Data from qualitative, quantitative, and mixed-methods research were integrated using thematic synthesis. Six core teacher roles were identified: recognition, referral, student support, collaboration, identification and response to suicide risk, and classroom-based mental health promotion and education. Four recurrent experiences were identified: emotional burden, perceived responsibility, unmet training needs, and exposure to student suicide. These roles were carried out under conditions of uncertainty, limited training, and variable system-level support. Recognition appeared to be more consistent for depression and anxiety than for early psychosis, with variability and uncertainty also evident in identifying and responding to suicide risk. Teachers are positioned to contribute to early identification and support; however, their contribution is shaped by variation in recognition and response across conditions, professional role boundaries, and the availability of systemic supports.