Symptom Profiles and Mental Health Services Received Among Referred Adolescents

Burden, impact, and needs of caregivers of children living with mental health or neurodevelopmental conditions in low-income and middle-income countries: a scoping review

This scoping review synthesises previous research on caregivers' experiences and perspectives of caring for a child with a mental health or neurodevelopmental condition while living in low-income and middle-income countries (LMICs). 35 studies done across 15 LMICs were included in this Series paper. Most studies were done in the Africa region. Child and adolescent mental health and neurodevelopmental conditions were perceived by caregivers to have both biomedical and traditional or spiritual causes and help-seeking was aligned to these explanatory beliefs. Caregivers commonly described reduced quality of life, which they attributed to their children's mental or neurodevelopmental condition, and additional reports of family disruption, caregiver psychological distress, and financial hardship. To strengthen mental health outcomes of young people, better mental health promotion information for caregivers is required along with improved engagement with communities and increased sensitivity to caregiver wellbeing and needs when developing interventions for children and adolescents.

Exploring the Alignment of Behavior Screening Policies and Practices in US Public School Districts

BACKGROUND

Although recent studies provide information regarding state-level policies and district-level practices regarding social, emotional, and behavioral screening, the degree to which these policies influence screening practices is unknown. As such, the purpose of this exploratory study was to compare state- and district-level policies and reported practices around school-based social, emotional, and behavioral screening.

METHODS

We obtained data for the present study from three sources: (1) a recent systematic review of state department of education websites; (2) a national survey of 1330 US school districts; and (3) a Web search and review of policy manuals published by the 1330 school districts. Comparative analyses were used to identify similarities and differences across state and district policies and practices.

RESULTS

Of the 1330 districts searched, 911 had policy manuals available for review; 87 of these policy manuals, which represented 10 states, met inclusion criteria, and thus, were included in analyses. Discrepancies were found across state and district policies and across state social, emotional, and behavioral screening guidance and district practices, but consistencies did exist across district policies within the same state.

CONCLUSION

District-level guidance around social, emotional, and behavioral screening appears to be limited. Our findings suggest a disconnect between state- and district-level social, emotional, and behavioral screening guidance and district reported practices, which signifies the need to identify the main influences on district- and school-level screening practices.

Internalizing Symptoms as Predictors of School Absenteeism Severity at Multiple Levels: Ensemble and Classification and Regression Tree Analysis

School attendance problems are highly prevalent worldwide, leading researchers to investigate many different risk factors for this population. Of considerable controversy is how internalizing behavior problems might help to distinguish different types of youth with school attendance problems. In addition, efforts are ongoing to identify the point at which children and adolescents move from appropriate school attendance to problematic school absenteeism. The present study utilized ensemble and classification and regression tree analysis to identify potential internalizing behavior risk factors among youth at different levels of school absenteeism severity (i.e., 1+%, 3+%, 5+%, 10+%). Higher levels of absenteeism were also examined on an exploratory basis. Participants included 160 youth aged 6-19 years (M = 13.7; SD = 2.9) and their families from an outpatient therapy clinic (39.4%) and community (60.6%) setting, the latter from a family court and truancy diversion program cohort. One particular item relating to lack of enjoyment was most predictive of absenteeism severity at different levels, though not among the highest levels. Other internalizing items were also predictive of various levels of absenteeism severity, but only in a negatively endorsed fashion. Internalizing symptoms of worry and fatigue tended to be endorsed higher across less severe and more severe absenteeism severity levels. A general expectation that predictors would tend to be more homogeneous at higher than lower levels of absenteeism severity was not generally supported. The results help confirm the difficulty of conceptualizing this population based on forms of behavior but may support the need for early warning sign screening for youth at risk for school attendance problems.

Who Benefits from Community Mental Health Care? Using Latent Profile Analysis to Identify Differential Treatment Outcomes for Youth

Treatment effectiveness has been shown to vary across subgroups of youth based on characteristics such as comorbidity, problem severity, gender, and age. The current study aims to explore if subgroups of youth, identified by applying latent profile analysis to parent-reported symptoms, age, and gender, are better served by specific usual care services. Archival data from a community mental health center were utilized, including parent-reports of symptoms for 953 youth (44.4% female; ages 4-18) across multiple time-points, and services received. Latent profile analysis identified five subgroups including Low Risk, High Risk, Internalizing, Externalizing, and Delinquent/Depressed. The relationship between the intensity level of services and symptoms varied across subgroups. Specifically, high intensity services were related to a greater reduction in symptoms for the Internalizing, Externalizing, and High Risk subgroups. Implications for future developmental research and clinical applications are discussed.