Many marginalised and disadvantaged children and young people (CYP), including those with adverse experiences, are at increased risk of poor mental health. This study aims to inform efforts to reduce inequalities, and the authors mapped the evidence of targeted digital mental health technologies (DMHTs) for “at-risk” CYP.
Systematic searches were conducted in January 2025 across PsycINFO, CINAHL, MEDLINE, Scopus and the Cochrane Library, with supplementary searches in Google Scholar, key reference lists and selected journals. Records were screened against predefined criteria, moving from titles and abstracts to full text. Peer-reviewed English-language studies were included if they described the development or evaluation of technology-supported mental health interventions for marginalised or disadvantaged CYP, as defined by the United Nations. Data were extracted and synthesised descriptively. The protocol was registered on the Open Science Framework and informed by consultations with CYP, carers, practitioners and topic experts.
Of 8,831 records, 125 studies (1997–2024, 52% USA) describing 116 DMHTs met the inclusion criteria. Interventions targeted CYP with neurodivergent or physical health conditions, ethnic minority or LGBTQIA2S+ communities, care-experienced or justice-involved CYP and CYP affected by low-income or migration. One-third of the interventions involved CYP in the design phase (34%), and fewer than half were accessible at the time of review (41%). Technology was primarily used to treat, manage or support internalising problems (58%), commonly delivered through telehealth/video calls (34%) or self-guided resources (40%). While evidence of acceptability and impact was substantial, limited data addressed cost-efficiency or safety.
The findings suggest that targeted DMHTs show promise for supporting the mental health of marginalised and disadvantaged CYP. However, greater attention to co-production, accessibility, safety, sustainability and implementation is needed to maximise their contribution to reducing mental health inequalities.
