School and workplace mental health — multi-tier design and RTW (MEQ)

(i) Multi-tier school model. Tier 1 universal: whole-school climate, social-emotional learning, classroom behaviour systems, mental health literacy. Tier 2 selective: small-group or targeted supports for elevated risk. Tier 3 indicated: individual clinical care pathways, specialist CAMHS, safety planning, educational adjustments. SEL meta-analysis supports universal skills and academic gains when implemented well.[2]

(ii) SEYLE. European school cluster RCT of suicide prevention. Youth Aware of Mental Health (YAM) reduced suicide attempts and severe suicidal ideation at 12 months versus control. QPR gatekeeper training and professional screening arms were not superior to control on those primary outcomes in the main analysis — do not claim all arms worked equally.[1]

(iii) Workplace risks and framework. Risks linked to common mental disorders include high job strain (high demand, low control), low social support, effort-reward imbalance, organisational injustice, job insecurity, long hours, and bullying.[3] Mentally healthy workplace frameworks emphasise designing work to reduce harm, organisational culture supporting help-seeking, early intervention, recovery-oriented RTW, and stigma reduction — not annual resilience days alone.[4][6]

(iv) RTW. Combine adequate clinical treatment of depression with work-focused components: graded hours, modified duties, coordination with employer/occupational health, problem-solving around work barriers, and frequent review. Work-directed and multicomponent strategies are central in RTW evidence syntheses; clinical care alone often underperforms for work outcomes.[5]

(v) Red flags. Active suicidal intent/plan, inability to keep safe, psychosis, mania, severe agitation, child safeguarding emergencies — same-day crisis pathways. Programmes, EAP, and workshops are not emergency care.[1]