We have engaged in work that aligns with the call from Birrell et al. (Child and Adolescent Mental Health, 2024), particularly in terms of thinking about co-design with young people to develop new outcomes and targets of universal school-based interventions. We engaged young people in a Cochrane systematic review and co-designed the outcomes for this review. What emerged was the need for research led by young people to develop and evaluate innovative universal school-based interventions that focus on creating environments that build and support young people’s ability to cope by expressing and managing emotions. Whole-of-school approaches that ensure compassionate and caring responses can support the development of coping skills to manage distress, mental illness, self-harm and suicidal ideation.