Mental Health in Adolescents with a Migration Background in 29 European Countries: The Buffering Role of Social Capital

Study design: The social wellbeing of newly-arrived adolescent migrants in reception education in Flanders (socNAMs)

AIMS

socNAMs provides a comprehensive and comparative dataset for researchers to identify how students' recent migration and their school setting relates to their social wellbeing, particularly regarding their feelings of loneliness. Results: This study design article delineates a quantitative cross-sectional research study (socNAMs) which successfully developed three questionnaires that were administered with unique and hard to reach populations, newly-arrived adolescent migrants (NAMs) and school staff offering reception education in Flanders, Belgium.

METHODS

At the individual level, socNAMs collected information on: (1) socio-demographic variables of NAMs; (2) migration and family context; (3) social relationships; (4) school experiences; (5) self-perceived wellbeing (physical and social); and (6) experiences with discrimination. The questionnaire developed for NAMs is available in 16 languages. To gain a further understanding of the impact of the school environment on NAMs, socNAMs collected contextual information primarily concerning school social capital by including data collected from teachers and reception-class coordinators. The final sample included 1379 NAMs, 50 teachers and 26 reception-class coordinators, from 35 schools offering reception education.

CONCLUSIONS

In this article, we present the rationale for this study, the methodology of sampling and recruitment, the development and content of the questionnaires, some preliminary descriptive results and the strengths and limitations of the study. Future empirical studies will address the research aims outlined in this protocol paper. In addition, we highlight the opportunities that the dataset provides for advancing research regarding the social wellbeing of NAMs in varying school and national contexts.

Factors associated with repeat emergency department visits for mental health care in adolescents: A scoping review

OBJECTIVES

The aim of this review was to identify factors associated with multiple visits to emergency department (ED) services for mental health care in adolescents.

METHODS

Electronic databases (MEDLINE, PsycINFO, Embase, CINAHL, Web of Science and ProQuest Dissertations & Thesis Global) were searched for evidence that presented an association between risk factors or correlates of multiple visits to the emergency departmental for mental health care by 10-24 year olds. High impact use was defined as at least one return ED visit for mental health care. Primary studies of any quantitative design were included, with no exclusions based on language or country and all possible risk factors were considered. Data were extracted and synthesised using quantitative methods; frequencies of positive, negative and null associations were summarised for categories of potential risk factors.

RESULTS

Sixty-five studies were included in the review. Most studies were from North America and reported a wide range of measures of high impact ED use, the most common being a binary indicator of multiple ED visits. Sex/gender and age were the most frequently reported risk factors. Measure of previous or concurrent access to mental health care was consistently positively associated with high impact use. Having private health insurance, compared with public or no insurance, was generally negatively associated with high impact use. Proxy measures of socioeconomic position (SEP) showed associations between lower SEP and more high impact use in a small number of studies. No other factors were consistently or uniformly associated with high impact use.

CONCLUSIONS

The review identified a substantial evidence base but due to the variability in study design and measurement of both risk factors and outcomes, no consistent risk factors emerged. More research is needed, particularly outside North America, using robust methods and high quality routinely collected data.

Impact of Digital Media, School Problems, and Lifestyle Factors on Youth Psychosomatic Health: A Cross-Sectional Survey

BACKGROUND

Post-pandemic psychosomatic complaints in children and adolescents have been underreported. This study investigated psychosomatic complaints in children and adolescents in Northern Italy in 2023, with the aim of identifying changes in predictors and vulnerable subgroups.

METHODS

Cross-sectional data representative of scholars from a northern Italian province were analyzed using the Health Behavior in School-aged Children (HBSC) checklist. The sum scores, count data, and dichotomized data were examined, and predictor effects were expressed using a linear regression model for the sum scores.

RESULTS

Data from 4525 participants (aged 7-19 years, 50.5% girls) were analyzed. Psychosomatic symptoms remained unchanged after the pandemic. Significant gender differences were noted, especially in older age groups, with girls reporting more complaints. Factors such as children's health, digital media use, and school problems significantly influence psychosomatic outcomes. While migration background negatively affected girls' psychosomatic well-being, boys showed improvement through sports.

CONCLUSION

The psychosomatic well-being of children and adolescents did not improve after the pandemic. These findings indicate the need for targeted interventions, improved health literacy, and ongoing monitoring to support the mental well-being of this vulnerable population. Reducing screen time remains a critical strategy for enhancing youth well-being.

Intercultural effectiveness in GPs' communication and clinical assessment: An experimental study

OBJECTIVE

This study aimed to investigate potential disparities in general practitioners' overall communication and clinical assessments based on patient ethnicity, while examining the influence of intercultural effectiveness.

METHODS

Employing a 2 × 2 experimental study design, online video recorded consultations with simulated patients were conducted and analyzed using OSCEs. Each GP (N = 100) completed a consultation with both an ethnic majority and an ethnic minority patient. Additionally, a follow-up survey was administered to gather supplementary data. Paired sample t-tests explored ethnic disparities, correlation and regression analyses determined associations with intercultural attitudes, traits and capabilities.

RESULTS

No statistically significant differences in GPs' communication or clinical assessment were found based on patients' ethnic background. Positive associations were observed between all aspects of intercultural effectiveness and GPs' consultation behavior. Intercultural traits emerged as a strong and robust predictor of clinical assessment of ethnic minority patients.

CONCLUSION

Intercultural traits, such as ethnocultural empathy, may play a critical role in GPs' clinical assessment skills during intercultural consultations.

PRACTICE IMPLICATIONS

Findings provide valuable insights into the determinants of intercultural effectiveness in healthcare, fostering promising targets for interventions and training programs aiming to ensure higher-quality and more equitable care delivery.

Emotional and relational problems of adolescents with and without a migrant background in Europe: a systematic review

Mental health of migrant adolescents is a topic that has been widely studied in the past decades. Emotional and behavioural problems are amongst the most explored areas; however, little attention has been paid to the relational sphere, which represents another key aspect of mental health and is paramount during adolescence. This systematic review analysed the available evidence on emotional and relational problems comparing adolescents with and without a migrant background in Europe between 2010 and 2021. The search was conducted in four databases using a common search strategy composed of terms addressing adolescence, migrant population, and emotional and relational problems. Three rounds of screening produced 36 eligible studies. Factors affecting both types of problems were identified and categorised using thematic synthesis, dividing them into factors affecting both types of problems jointly or separately and analysing them according to three systemic levels affecting the adolescents' lives (intrapersonal, interpersonal and external). Critical analysis of the results pointed to mixed findings, with a mild tendency in migrant-background adolescents to portray more emotional problems than their native peers and a stronger tendency for relational problems in the same direction. Several limitations were identified and, along with the conclusions, point to suggestions for future research focusing on studying relational problems as a key component of mental health and its link to emotional problems. Further suggestions entail designing studies that target adolescents with different migrant-background profiles and cultural origins to establish differences between them and identify additional factors affecting emotional and relational problems during the pre-migration and transit phases of the migratory journey to help prevent the onset of these problems.

The Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS) - A psychometric evaluation of adolescents in Sweden during the COVID-19 pandemic

The Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS) is effective in assessing positive aspects of mental health. Despite its advantages, little is known about group differences in the interpretation of SWEMWBS items across age groups, especially during the adolescence period. Hence, this study examined the psychometric properties of the SWEMWBS through Confirmatory Factor Analysis (CFA), Rasch analysis and network analysis of Swedish adolescents during the COVID-19 pandemic. A total of 5548 participants from the south of Sweden (i.e., Jönköping County) took part in this cross-sectional study through an online platform between September 2020 and October 2020. The CFA, Rasch (including differential item functioning, DIF) analysis and network analysis were used to examine the psychometric properties and measurement invariance of the SWEMWBS. The SWEMWBS had a unidimensional structure with robust psychometric properties. The CFA demonstrated measurement invariance across gender, school year and country of birth, which was also confirmed by Rasch DIF. Furthermore, considerable associations between the items of the SWEMWBS, general health and COVID-19 impact items were observed in network analysis. The SWEMWBS showed robust psychometric properties capable of assessing positive aspects of mental health and well-being among adolescents.

School students' burdens and resources after 2 years of COVID-19 in Austria: a qualitative study using content analysis

Introduction

The mental health of young people has been severely affected by the COVID-19 pandemic and the measures associated with it. Mental health symptoms increased across various domains during the pandemic and subjective wellbeing decreased.

Methods

This study examined the burdens and resources of Austrian school students (M = 16.63 years old) in the third year of the pandemic and compared them descriptively with the burdens and resources identified in a comparative study in 2021. A cross-sectional online survey with open-ended questions from April to May 2022 provided data that was analyzed using qualitative content analysis. A sub-sample of N = 214 was selected from the larger sample. This sub-sample is representative for the Austrian population aged 15-19 in terms of gender and migrant background.

Results

Analysis of the open-ended questions showed that concerns about the pandemic and the burdens of the measures were no longer on young people's minds at the time of the survey in 2022. On the other hand, stress at school was increasing and the opening of schools and the resumption of face-to-face teaching were challenging for respondents. While resuming social contacts and leisure activities was mentioned as a resource by many respondents, some also expressed a desire for more time off and a retreat into coping strategies such as sleeping more or avoiding problems.

Discussion

Our findings suggest that there is a need for low-threshold support from teachers and parents to help students catch up on missed lessons and to empathize with the mas they make the transition back to "old normal".

Socioeconomic Status, Protective Factors, and Mental Health Problems in Transition from Adolescence to Emerging Adulthood: Results of the Longitudinal BELLA Study

Lower familial socioeconomic status (SES) is associated with more mental health problems in adolescence. The aim of this study was to identify factors that may protect adolescents from families with lower SES from developing mental health problems in emerging adulthood. Data of the population-based longitudinal BELLA study included n = 426 participants aged 13 to 17 years at t0 (2009-2012) and 18 to 24 years at t1 (2014-2017). Hierarchical multiple linear regressions with interaction terms were conducted, examining three selected protective factors (self-efficacy, family climate, and social support). Self-efficacy had a small protective effect for adolescents from families with lower SES for mental health problems in emerging adulthood. However, social support had a small protective effect for adolescents from families with higher SES. No moderating effect was found for family climate. Instead, better family climate in adolescents predicted fewer mental health problems in emerging adulthood with a small effect regardless the SES in adolescence. Results indicate the need for prevention measures for adolescents from families with lower SES for becoming mentally healthy emerging adults.

Community indicators for mental health in Europe: a scoping review

Background

Community indicators may predict and influence individuals` mental health, and support or impede mental health management. However, there is no consensus on which indicators should be included in predictions, prognostic algorithms, or management strategies for community-based mental health promotion and prevention approaches. Therefore, this scoping review provides an overview of relevant community-level indicators for mental health in the general as well as risk populations in a European context.

Methods

We conducted a scoping review in the following electronic databases: PubMed, Embase, and PsycInfo. Eligible studies focused on context factors such as either the physical or social environment, reporting at least one mental health outcome and referring to a European population. Publications between 2012 and March 8, 2022 are considered.

Results

In total, the search yielded 12,200 identified records. After the removal of duplicates, 10,059 records were screened against the eligibility criteria. In total, 169 studies were included in the final analysis. Out of these included studies, 6% focused on pan-European datasets and 94% on a specific European country. Populations were either general or high-risk populations (56 vs. 44%, respectively) with depressive disorder as the main reported outcome (49%), followed by general mental health (33%) and anxiety (23%). Study designs were cross-sectional studies (59%), longitudinal (27%), and others (14%). The final set of indicators consisted of 53 indicators, which were grouped conceptually into 13 superordinate categories of community indicators. These were divided into the domains of the physical and social environment. The most commonly measured and reported categories of community indicators associated with mental health outcomes were social networks (n = 87), attitudinal factors toward vulnerable groups (n = 76), and the characteristics of the built environment (n = 56).

Conclusion

This review provides an evidence base of existing and novel community-level indicators that are associated with mental health. Community factors related to the physical and social environment should be routinely recorded and considered as influencing factors or potentially underestimated confounders. The relevance should be analyzed and included in clinical outcomes, data, monitoring and surveillance as they may reveal new trends and targets for public mental health interventions.

The Behavioral and Mental Health Benefits of Speaking the Heritage Language within Immigrant Families: The Moderating Role of Family Relations

Understanding the development of behavioral and mental health issues among adolescents, particularly those from immigrant families, is a key area of concern. Many prior studies have focused on the role of societal (country-of-destination) language skills, but we know less about the role played by the use of the heritage language in families. We examined this latter relationship with a focus on changes in heritage language use and internalizing and externalizing problems, and how family relations moderate this relationship. We used the first two waves (2010/2011 and 2011/2012) of the Children of Immigrants Longitudinal Survey in Four European Countries (CILS4EU) data collected from Germany (n = 1614; M_age = 14.8 years, 50% female), the Netherlands (n = 1203; M_age = 14.7 years, 54% female), Sweden (n = 1794; M_age = 14.2 years, 53% female), and England (n = 1359; M_age = 14.6 years, 50% female). Our results suggest that increased use of heritage language is associated with fewer externalizing problems only in families with greater family cohesion and parental warmth (in Germany and the U.K.) and with fewer internalizing problems only in families with higher parental monitoring (in the Netherlands and Sweden). Good family relations are thus an important precondition for increased heritage language use to lead to improved behavioral and mental health for children of immigrants.

Impact of Cultural and Linguistic Maintenance on Mental Health Outcomes in Migrant Adolescents: Protocol for a Scoping Review

BACKGROUND

There is no consensus on how the disruption or maintenance of heritage culture and language affect mental health outcomes in adolescents with a migrant (also known as "immigrant" or "international migrant") background. Even though previous literature reviews have investigated the association between acculturation and mental health in migrants, none have explicitly focused on adolescents.

OBJECTIVE

The aim of the scoping review described in this protocol is to understand (1) the focus, scope, and nature of quantitative empirical research investigating heritage cultural maintenance, including linguistic maintenance, and mental health outcomes in adolescents with a migrant background worldwide and (2) the potential effects of cultural and linguistic maintenance or disruption on migrant adolescent mental health outcomes.

METHODS

A total of 11 key electronic health, medical, social science, and language databases (APA PsycArticles Full Text; Embase Classic+Embase; Ovid MEDLINE All and Epub Ahead of Print, In-Process, In-Data-Review and Other Non-Indexed Citations and Daily; Ovid MEDLINE All; APA PsycInfo; University of Melbourne full-text journals; Science Citation Index Expanded; Social Sciences Citation Index; Arts & Humanities Citation Index; Scopus; Linguistics and Language Behavior Abstracts) were searched. Databases were searched without time restrictions from the beginning of their coverage. Publication date, location, and quantitative study design (except for literature reviews) were not restricted; however, the search was only conducted in English. Data from included studies will be extracted using a template with predefined data items, and results will be summarized in a structured, narrative summary.

RESULTS

A search was conducted on April 20, 2021, returning 2569 results. We are currently at the final stages of screening titles and abstracts of our search results, which will be followed by a full-text review and the data extraction of included studies. We expect to submit the full review for publication by the end of 2023.

CONCLUSIONS

The scoping review aims to provide a better understanding of existing research on the association between cultural (including linguistic) maintenance and mental health in migrant adolescents. It will help identify gaps in the existing literature and develop hypotheses that could inform future research, eventually facilitating the development of targeted prevention initiatives and improving migrant adolescents' well-being.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/40143.

Who Stays, Who Moves on and the Host Population: A Picture of Adolescents' Perceived Well-Being and Risk Behaviours

The study aims to evaluate the health profile of first- and second-generation Romanian immigrants living in Italy compared to their adolescent peers in the country of origin (Romania) and the host population (Italian-borns). Analyses were performed on the 2013/2014 Health Behaviour in School-aged Children (HBSC) survey data. Romanian natives showed lower levels of health complaints and higher life satisfaction than Romanian migrants, who were similar to the host population, especially the second-generation ones. A comparable prevalence of being bullied was registered among Romanians, both native and immigrant, with significantly lower levels among Italian natives. Bullying others showed the second-generation migrants share a similar prevalence with the host population. The prevalence of liking school a lot was three times higher among the Romanian natives than among their peers living in Italy. Thanks to the HBSC data, this study is the first to examine the health of adolescent migrants from both the perspective of the host country and the population of origin. The results highlight the need for a more nuanced approach to studying immigrant populations, taking into account both the host country's perspective and the health patterns of the population of origin.

How Much Should We Trust Others? The Relationship Between Trust Beliefs in Others and Psychosocial Adjustment

Introduction: This study compared the Trust Promotes Adjustment (TPA) approach with the Centralist Approach to Trust (CAT) regarding the relationship between trust beliefs in others and psychosocial adjustment. The TPA predicted linear, whereas the CAT predicted quadratic, relationships between the two. The predictions were tested by analyses for the curvilinearity of data gathered by Teunisse et al. (2020). Method: Six hundred and fifty-one adults (M age = 24.9 years, SD = 10.4 years) completed standardized scales of trust beliefs in others, agreeableness, and social intelligence. Results: In support of TPA, trust beliefs in others were linearly associated with social awareness. In support of CAT, quadratic relations were found between trust beliefs in others and both agreeableness and social skills. Individuals with very low or very high trust beliefs showed lower agreeableness and social skills than those with the midrange of trust beliefs or the linear relationship between the variables. Individuals showed optimal psychosocial adjustment when trust beliefs were between 1.5 standard deviations above and below the mean. Discussion: These findings challenge the traditional TPA, which asserts that increasing trust in others corresponds to increasing psychosocial adjustment. The findings support the CAT hypothesis that too little or too much trust in others is associated with psychosocial maladjustment with implications for psychopathology.

Trust Beliefs in Significant Others, Interpersonal Stress, and Internalizing Psychopathology of Adolescents with Psychiatric Disorders

This study examined relations between trust beliefs in significant others (TBSO), interpersonal stress, and internalizing psychopathology for adolescents with psychiatric disorders. Two hundred and thirty-four adolescents from an acute inpatient unit (154 females, M_age = 14.72 years, SD = 1.39 years) completed standardized scales/interviews that assessed TBSO (mother, father, teacher, peers and TBSO as a total score), interpersonal stress, and internalizing psychopathology. It was found that adolescents' TBSO and trust beliefs in each significant other were negatively associated with interpersonal stress and internalizing psychopathology. The findings confirmed that the relation between the adolescents' interpersonal stress and internalizing psychopathology was moderated by TBSO, trust beliefs in mother, and trust beliefs in peers. The findings supported the conclusion that holding elevated TBSO (particularly trust beliefs in mother and peers) by adolescents with psychiatric disorders promotes their psychosocial adjustment including their resilience to the effects of interpersonal stress on internalizing psychopathology.

Patterns of students' well-being in early adolescence: A latent class and two-wave latent transition analysis

Adolescence is a developmental stage with high risks in terms of psychological challenges and adjustments related to subjective well-being. Thus far, the findings reported a general decrease in school-related well-being over time. We considered well-being a multidimensional and latent construct that included both feeling good and functioning well at the individual level, and focused on the interplay between hedonic and eudemonic factors. Data of N = 377 high school students in Switzerland were used by conducting an online longitudinal study with two waves. Baseline data was gathered in autumn 2019 and the subsequent time point occurred 1 year later (2020; grades seven and eight). By applying a person-oriented analytical approach via latent class and latent transition analyses, we were able to identify and compare longitudinally three distinct well-being patterns and the respective trajectories. Regarding the distribution of the well-being patterns for both waves, significant changes over time were identified: particularly from wave 1 to wave 2, where there was an increase for the low and high well-being patterns, yet a decrease for the middle pattern. Comparing the stability of the respective patterns over time, the high well-being level showed the highest stability of all identified patterns. Multinomial logistic regression of covariates to the identified latent status membership established for both waves showed low but significant effects of socio-demographic variables. At wave 1, having a migration background was associated with a significant increase of being in a low versus high well-being level pattern. At wave 2, being female was associated with a significant increase of being in a low versus high and in a middle versus high well-being pattern.

Subjective Well-Being Among Unaccompanied Refugee Youth: Longitudinal Associations With Discrimination and Ethnic Identity Crisis

Unaccompanied refugee youth (URY), who as children fled their countries to seek asylum in a foreign country without the company of an adult legal caretaker are described as being in a vulnerable situation. Many of them struggle with mental reactions to traumatic events experienced pre-migration, and to the daily hassles they face after being granted asylum and residence. Despite continuous high levels of mental health problems URY demonstrate remarkable agency and social mobility in the years after being granted asylum in their destination countries. A sense of subjective well-being (SWB) may enable resilient outcomes in people exposed to past or ongoing adversities. To fill the gap in the research literature about positive psychological outcomes among URY, the overall aim of this study was to explore the longitudinal associations between SWB and two taxing acculturation hassles: perceived discrimination and ethnic identity crisis. Three annual waves of self-report questionnaire data were collected from a population-based sample of URY; n = 581, M_age = 20.01(SD = 2.40), M_{length of stay} = 4.63 (SD = 4.40), 82 % male, mainly from Afghanistan, Somalia, Iraq, and Sri Lanka. The longitudinal associations between SWB, perceived discrimination and ethnic identity crisis across time were analyzed using auto-regressive cross-lagged modeling. The results revealed that perceived discrimination, but not ethnic identity crisis, negatively predicted subsequent levels of SWB. More importantly, high levels of SWB at one timepoint predicted decreases in both discrimination and ethnic identity crisis at subsequent timepoints. Further, increases in SWB from one timepoint to the next was associated with significant co-occurring decreases in both discrimination and ethnic identity crisis, and vice versa. Despite the negative effect of perceived discrimination on SWB, promoting SWB in URY can protect them from future hazards of acculturation hassles in complex ways. We underscore the need for more research on SWB among URY and other refugee youth. We further discuss the potential of SWB to foster resilient outcomes in young refugees and suggest that interventions to strengthen SWB among them should consider their transnational and multicultural realities and experiences.

Family Related Variables' Influences on Adolescents' Health Based on Health Behaviour in School-Aged Children Database, an AI-Assisted Scoping Review, and Narrative Synthesis

Objects

Health Behaviours in School-aged Children (HBSC) is an international survey programme aiming to investigate adolescents' health behaviours, subjective perception of health status, wellbeing, and the related contextual information. Our scoping review aimed to synthesise the evidence from HBSC about the relationship between family environmental contributors and adolescents' health-related outcomes.

Methods

We searched previous studies from six electronic databases. Two researchers identified the qualified publications independently by abstract and full-text screening with the assistance of an NLP-based AI instrument, ASReview. Publications were included if they were based on HBSC data and investigated the effects of family environment on adolescents' health outcomes. Researches addressed family-related factors as mediators or moderators were also included.

Results

A total of 241 articles were included. Family environmental contributors could be mapped into six categories: (1) Demographic backgrounds (N = 177); (2) General family's psycho-socio functions (N = 44); (3) Parenting behaviours (N = 100); (4) Parental health behaviours (N = 7); (5) Family activities (N = 24); and (6) Siblings (N = 7). Except for 75 papers that assessed family variables as moderators (N = 70) and mediators (N = 7), the others suggested family environment was an independent variable. Only five studies employed the data-driven approach.

Conclusion

Our results suggest most research studies focussed on the influences of family demographic backgrounds on adolescents' health. The researches related to parental health behaviours and siblings are most inadequate. Besides, we recommend further research studies to focus on the mediator/moderator roles of the family, for exploring the deep mechanism of the family's impacts. Also, it would be valuable to consider data-driven analysis more in the future, as HBSC has mass variables and data.

School Students’ Concerns and Support after One Year of COVID-19 in Austria: A Qualitative Study Using Content Analysis

Adolescents suffer severely from the psychological consequences of the COVID-19 pandemic. Using qualitative content analysis, this study examined open-ended responses to a survey on the mental health of school students in Austria in February 2021. A representative sample (n = 214) was drawn from a total survey sample of 3052 adolescents aged 14–20. The analysis revealed several areas of concern, including school-related concerns, concerns about restrictions, self-related concerns, and interpersonal problems. School-related concerns associated with distance learning were mentioned most frequently. Compared with research conducted at the beginning of the pandemic, it appeared that concerns about educational and professional futures increased. The analysis also indicated young people’s most important sources of support, such as social contacts, recreational activities, attitudes and abilities, distraction, and escape. Of concern is the proportion of young people citing maladaptive coping strategies and the reluctance to seek professional support. Ideas for practice-oriented measures were developed from the study results, such as embedding youth-led peer interventions in traditional mental health services.

Mind the Gate: General Practitioner's Attitudes Towards Depressed Patients with Diverse Migration Backgrounds

This study aims to examine (a) whether there are differences in general practitioners' (GPs) attitudes towards native Belgian patients, patients of foreign descent and asylum seeking patients who all express symptoms of major depression, and (b) whether these differences depend on GPs' experience with cultural competency training and interethnic contact. Using a video vignette study among 404 Flemish (Belgium) GPs, we find evidence of a provider bias. While GPs regard a patient of foreign descent as less trustworthy and less able to adhere to medical recommendations than a native Belgian patient, they also hold more pessimistic views on a potential recovery of an asylum seeking patient. In addition, we find that cultural competency training might alter GPs' attitudes of asylum seeking patients in a positive way. Summarized, our research highlights the need to target stereotypes among GPs for interventions designed to reduce migration-based disparities in healthcare use and health status.

Effectiveness of Promotive and Preventive Psychosocial Interventions on Improving the Mental Health of Finnish-Born and Immigrant Adolescents

Background: Schools are considered natural environments in which to enhance students’ social–emotional skills and mental health in general, but they can be especially important for students with refugee and immigrant backgrounds. The current study tested the effectiveness of two school-based interventions in enhancing the mental health and wellbeing of adolescents of native, refugee, and immigrant backgrounds. It further analyzed the role of age, gender, daily stressors, and discrimination in affecting the interventions’ effectiveness. Methods: A three-arm cluster RCT with parallel assignment was applied among the 16 schools. Schools were randomized to three conditions of two active interventions and a waiting-list control condition. Students (n = 1974) filled in an online questionnaire at baseline before the interventions, after the interventions, and at follow-up an average of 9 months after the interventions. The effectiveness criteria were internalizing and externalizing problems, resilience, and prosocial behavior. Results: Interventions were generally not effective in decreasing mental health problems and increasing psychosocial resources. The expected positive intervention effects were dependent on students’ age and gender and exposure to socioeconomic daily stressors. Conclusion: Interventions enhancing teacher awareness and peer relationships at school should be carefully tailored according to the strengths and vulnerabilities of participating students, especially their daily stress exposure, but also age and gender.

The Impact of Migration Status on Adolescents’ Mental Health during COVID-19

The purpose of this study was to compare mental health in adolescents with and without migration background after a semester of remote schooling and almost a year of social distancing in Austria. An online survey, supported by the Austrian Federal Ministry of Education, Science and Research, was conducted from 3rd February to 28th February 2021 measuring well-being (WHO-5), depression (PHQ-9), anxiety (GAD-7), sleep quality (ISI), stress (PSS-10), and disordered eating (EAT-8). A matched-pairs analysis with and without migration background was conducted and was checked with whole sample analysis. From a total of 3052 participants, N = 508 had a migration background (first or second generation) and N = 479 could be matched according to age, gender, region, and education with adolescents without migration background. Matched-pairs analyses showed that migration background is associated with poorer mental health concerning well-being, depression, anxiety, and insomnia scores (all p-values < 0.05). Prevalence of depressive symptoms (64.5% vs. 56.5%), anxiety symptoms (53.5% vs. 46.0%), as well as insomnia (31.9% vs. 21.0%) is higher in adolescents with migration background (all p-values ≤ 0.02). Comparison of the whole sample (N = 3052) confirmed these results. Results suggest that migration status is a risk factor for mental health problems among adolescents during the COVID-19 pandemic and highlight the need to implement easily accessible culture- and language-specific health promotion and prevention strategies.

The Impact of Social Capital on Mental Health: Evidence from the China Family Panel Survey

The influence of social capital on mental health is a controversial topic. As some studies have pointed out, cognitive social capital significantly affects mental health but structural social capital does not. Using data from the China Family Panel Survey, this study measured social capital from social help, social trust, social networks, and social participation, and took regional average level of social capital as the instrumental variables, and applied a two-stage least squares regression. We found that the mental health of residents who trust and help each other is significantly higher than that of residents without trust and mutual help. When residents' efforts to maintain social networks increase, their mental health significantly improves. These results are robust. Furthermore, the impact of social capital on mental health was heterogeneous in terms of urbanicity, gender, age, and area. These results are helpful for making policies for promoting residents' mental health.

Trajectories of Perceived Discrimination among Chinese Rural-to-Urban Migrant Early Adolescents: Predictors and Outcomes

Perceived discrimination is associated with poorer psychological adjustment and greater problem behaviors among rural-to-urban migrant adolescents. Yet, the predictors and the consequences of distinct changing patterns of perceived discrimination are less clear. The current study sought to identify distinct patterns of perceived discrimination trajectories and examine the developmental implications of these patterns among 385 Chinese rural-to-urban migrant early adolescents (M_age = 10.49, SD_age = 0.69; 62% boys). Four distinct patterns of perceived discrimination trajectories, i.e., Low-stable (79.59%), Decreasing (9.08%), High-stable (6.11%), and Increasing (5.22%), were identified. Predictors including resilience, family support, peer support, and demographic characteristics (i.e., gender and school types) contributed to differences in pattern membership. Moreover, the Low-stable pattern exhibited more favorable distal outcomes (i.e., lower levels of social anxiety and loneliness and higher levels of self-esteem) than the other three patterns; the Decreasing group had lower levels of loneliness than the High-stable group. The findings extend the understanding of the predictors and consequences of perceived discrimination among rural-to-urban migrant early adolescents from a developmental perspective.

Mental Health of Apprentices during the COVID-19 Pandemic in Austria and the Effect of Gender, Migration Background, and Work Situation

This study assessed the mental health of apprentices during the COVID-19 pandemic in Austria and the effect of gender, migration background, work situation, and work sector. An online survey via REDCap was performed with a sample of 1442 apprentices (female: 53.5%, male: 45.4%, diverse: 1.1%, migration background: 28.4%) from 29 March to 18 May 2021. Indicators of mental health were depression (PHQ-9), anxiety (GAD-7), well-being (WHO-5), disordered eating (EAT-8), and insomnia (ISI-7). There was a high prevalence of clinically relevant depression (cut-offs ≥11 for adolescents, ≥10 for adults: 48.3%), anxiety (cut-offs ≥11 for adolescents, ≥10 for adults: 35.4%), insomnia (cut-off ≥15: 27%), and disordered eating (cut-offs ≥2 for men, ≥3 for women: 50.6%). Linear models revealed that apprentices with female and diverse gender, migration background, and unemployed status showed the poorest scores on all mental health measures (all p-values < 0.05) except disordered eating. These findings emphasize the need for intersectional strategies to reduce and prevent adverse mental health consequences of the COVID-19 pandemic for apprentices.