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Hoskote AR, Croce E, Johnson KE. The Evolution of the Role of U.S. School Nurses in Adolescent Mental Health at the Individual, Community, and Systems Level: An Integrative Review. J Sch Nurs 2023; 39:51-71. [PMID: 35019803 DOI: 10.1177/10598405211068120] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
School nurses are crucial to addressing adolescent mental health, yet evidence concerning their evolving role has not been synthesized to understand interventions across levels of practice (i.e., individual, community, systems). We conducted an integrative review of school nurse roles in mental health in the U.S. related to depressive symptoms, anxiety, and stress. Only 18 articles were identified, published from 1970 to 2019, and primarily described school nurses practicing interventions at the individual level, yet it was unclear whether they were always evidence-based. Although mental health concerns have increased over the years, the dearth of rigorous studies made it difficult to determine the impact of school nurse interventions on student mental health outcomes and school nurses continue to feel unprepared and under supported in this area. More research is needed to establish best practices and systems to support school nursing practice in addressing mental health at all levels of practice.
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Affiliation(s)
- Ashwini R Hoskote
- Robert Wood Johnson Foundation Future of Nursing Scholar, 12330University of Texas at Austin School of Nursing
| | - Emily Croce
- 12330The University of Texas at Austin School of Nursing; Dell Children's Medical Group, Austin, TX
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Kaskoun J, McCabe E. Perceptions of School Nurses in Addressing Student Mental Health Concerns: An Integrative Review. J Sch Nurs 2021; 38:35-47. [PMID: 34636656 DOI: 10.1177/10598405211046223] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Mental health disorders in school-aged children are on the rise. The need for mental health care is well recognized, and the provision of this care in schools is recommended. An integrative review explored how school nurses view their role in addressing students' mental health. Fourteen articles were identified, eleven using a qualitative design and three using a quantitative design. Findings suggest that school nurses see their role as trusted members of the school community. They perceive upholding standards of practice as an integral part of their position and recognize competence in mental health care to be highly important. Practice recommendations include providing school nurses with evidence-based training on managing the mental health needs of students, as well as ensuring access to school nurses who can provide mental health supervision in the community.
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Affiliation(s)
- Jeannine Kaskoun
- Department of Nursing, 14772The Graduate Center, City University of New York, New York, New York
| | - Ellen McCabe
- Hunter College School of Nursing, 5924Hunter College, New York, New York The authors wish to recognize the support and guidance from Dr. Shiela Strauss, the CUNY Graduate Center faculty, especially Dr. Steven Baumann, Dr. Kathleen Nokes, and Dr. Lorie Goshin. Additionally, Hunter College librarian John Carey, and CUNY Graduate Center librarian Beth Posner
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Terry D, Trott K. A Qualitative Analysis of School Nurses' Experience Caring for Students With Psychogenic Nonepileptic Events. J Sch Nurs 2019; 37:441-448. [PMID: 31789104 DOI: 10.1177/1059840519889395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Psychogenic nonepileptic events (PNEE) are paroxysmal changes in behavior resembling epileptic seizures but with no electrographic correlate and are instead caused by psychological factors. In this qualitative study, semistructured interviews were conducted with 10 school nurses to identify how they perceive the experience of caring for a student with PNEE as well as supportive factors and barriers to optimal management of PNEE in schools. Several themes were identified: lack of diagnosis awareness by school staff leading to impressions that the student was "faking" the events, inadequate information provided by a health-care provider regarding the diagnosis in general and specifically about the individual student leading to a reliance on information from the student's family, feelings of doubt and insecurity about the diagnosis and management of the events, and reliance on the school nurse to develop a response plan and to manage the events which can be very time-consuming.
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Affiliation(s)
- Debbie Terry
- Division of Neurology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Kristen Trott
- Department of Psychology, Nationwide Children's Hospital, Columbus, OH, USA
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Tanner A, Miller WR, Gaudecker JV, Buelow JM. An Integrative Review of School-Based Mental Health Interventions and Implications for Psychogenic Nonepileptic Seizures. J Sch Nurs 2019; 36:33-48. [DOI: 10.1177/1059840519854796] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Millions of students with mental health concerns attend school each day. It is unknown how many of those students experience psychogenic nonepileptic seizures (PNES); however, quality of life, academic, and mental health outcomes for students experiencing PNES can be bleak. Currently, no authors have addressed potential school nurse interventions for students with PNES. Because PNES is a mental health condition and is often influenced by underlying anxiety and/or depression, an integrative review of school nurse interventions and outcomes for students with general mental health concerns was conducted. An integrative review resulted in the identification of 13 quantitative and 2 qualitative studies that met inclusion criteria. The findings from this review suggest school nurses, following principles from the Framework for 21st Century School Nursing Practice, play an active role in mental health interventions and should be involved in replicating and testing known mental health interventions to investigate their effectiveness for students with PNES.
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Affiliation(s)
- Andrea Tanner
- Indiana University School of Nursing, Indianapolis, IN, USA
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McQuillin SD, Lyons MD, Becker KD, Hart MJ, Cohen K. Strengthening and Expanding Child Services in Low Resource Communities: The Role of Task-Shifting and Just-in-Time Training. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 63:355-365. [PMID: 30834554 DOI: 10.1002/ajcp.12314] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In the United States, the demand for child mental health services is increasing, while the supply is limited by workforce shortages. These shortages are unlikely to be corrected without significant structural changes in how mental health services are provided. One strategy for bridging this gap is task-shifting, defined as a process by which services that are typically delivered by professionals are moved to individuals with less extensive qualifications or training. Although task-shifting can increase the size of the workforce, there are challenges related to training new workers. In this paper, we propose Just-In-Time Training (JITT) as one strategy for improving task-shifting efforts. We define JITT as on-demand training experiences that only include what is necessary, when it is necessary, to promote competent service delivery. We offer a proof of concept from our own work shifting counseling and academic support tasks from school mental health professionals to pre-baccalaureate mentors, citing lessons learned during our iterative process of JITT development. We conclude with a series of key considerations for scaling up the pairing of task-shifting and JITT, including expanding the science of JITT and anticipating how task-shifting and JITT would work within the context of dynamic mental health service systems.
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Affiliation(s)
| | | | | | | | - Katie Cohen
- University of South Carolina, Columbia, SC, USA
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Mufson L, Rynn M, Yanes-Lukin P, Choo TH, Soren K, Stewart E, Wall M. Stepped Care Interpersonal Psychotherapy Treatment for Depressed Adolescents: A Pilot Study in Pediatric Clinics. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2018; 45:417-431. [PMID: 29124527 PMCID: PMC5911397 DOI: 10.1007/s10488-017-0836-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Adolescents with depression are at risk for negative long-term consequences and recurrence of depression. Many do not receive nor access treatment, especially Latino youth. New treatment approaches are needed. This study examined the feasibility and acceptability of a stepped collaborative care treatment model (SCIPT-A) for adolescents with depression utilizing interpersonal psychotherapy for adolescents (IPT-A) and antidepressant medication (if needed) compared to Enhanced Treatment as Usual (E-TAU) in urban pediatric primary care clinics serving primarily Latino youth. Results suggest the SCIPT-A model is feasible, acceptable and potentially beneficial for urban Latino adolescents. Clinicians delivered the SCIPT-A model with fidelity using supervision successfully implemented in a community setting.
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Affiliation(s)
- Laura Mufson
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA.
- New York State Psychiatric Institute, 1051 Riverside Drive, Unit 74, New York, NY, 10032, USA.
| | - Moira Rynn
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Paula Yanes-Lukin
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Unit 74, New York, NY, 10032, USA
| | - Tse Hwei Choo
- New York State Psychiatric Institute, 1051 Riverside Drive, Unit 74, New York, NY, 10032, USA
- Department of Biostatistics, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Karen Soren
- Department of Pediatrics, NYP-Morgan Stanley Children's Hospital, Columbia University Medical Center, New York, NY, USA
- Department of Social Work, NYP-Morgan Stanley Children's Hospital, Columbia University Medical Center, New York, NY, USA
| | - Eileen Stewart
- Department of Social Work, NYP-Morgan Stanley Children's Hospital, Columbia University Medical Center, New York, NY, USA
| | - Melanie Wall
- New York State Psychiatric Institute, 1051 Riverside Drive, Unit 74, New York, NY, 10032, USA
- Department of Biostatistics, Columbia University College of Physicians and Surgeons, New York, NY, USA
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