An observational study of adolescent health outcomes associated with school-based health service utilization: A causal analysis

Safe spaces for youth mental health: A scoping review

INTRODUCTION

Mental illness is a significant challenge during adolescence and youth period, posing a threat to individuals' mental health, well-being, and productivity. Despite the global burden, comprehensive evidence on the use of youth-safe spaces to improve their mental health has been limited. Therefore, this review aims to explore the existing literature on the role of safe spaces in shaping the mental health outcomes of youth.

METHODS

We followed the Joanna Briggs Institute (JBI) scoping review guidelines. This review focused on individuals aged 10 to 25. It explores safe spaces for youth, including community centers, schools, clubs, and online forums, and their role in promoting youth mental health. We conducted a comprehensive search using PubMed/MEDLINE, PsycINFO, Web of Science, Scopus, Google Scholar, and grey literature sources. Study selection and screening were done using Covidence software, with two independent reviewers applying predefined criteria. We used the standardized table for data extraction; findings were presented using graphical and tabular formats alongside narrative synthesis. Reporting followed the PRISMA extension for scoping reviews (PRISMA-ScR) framework.

RESULTS

The review included 23 studies from various regions, notably North America (USA) and Europe. These studies found that safe spaces, primarily within schools, offered youth mental health support, resources, and guidance. Additionally, community organizations, outreach programs, and primary care clinics were identified as safe spaces to enhance the mental well-being of young adults. The interventions used in these safe spaces included cognitive-behavioral therapy, mindfulness programs, and multi-component approaches. Positive outcomes included reduced posttraumatic stress disorders, anxiety, and substance use, along with improved mental well-being and interpersonal relationships. However, there needs to be more focus on methodological diversity and research in other regions. Geographic imbalances exist, and evidence beyond schools and communities as safe spaces is limited. Intersectional factors are often overlooked.

CONCLUSION

This review emphasizes the significant impact of safe spaces on youth mental health. It suggests that fostering supportive environments within schools, recreational clubs, and communities can significantly benefit youth mental well-being. The findings highlight the need to expand safe space initiatives to address young people's challenges during their developmental stage.

The use of youth healthcare services and its association with health-related quality of life, physical and mental health and over-the-counter analgesics use in 13-19-year-old adolescents: a cross-sectional study

BACKGROUND

Youth healthcare services in Norway include a public health nurse (PHN) at school and local youth health centres (YHCs). They provide health services for all adolescents free of charge, focusing on health promotion and disease prevention. The present study aimed to assess possible associations between health-related quality of life (HRQoL), physical and mental health, over-the-counter analgesics (OTCA) use and use of youth healthcare services among 13-19-year-old adolescents.

METHODS

This study was based on national, cross-sectional data from the Ungdata Survey conducted in 2022. The sample was comprised of 16 482 adolescents. Multiple logistic regression was used to analyse the associations between HRQoL, headaches, selected physical symptoms, psychological distress, use of OTCA, PHN availability, sociodemographic variables, and use of the PHN at school or at a YHC. The KIDSCREEN-10 was used to measure HRQoL, and the Hopkins Symptoms Checklist 10 was used to measure symptoms of psychological distress.

RESULTS

Girls used the youth healthcare services more frequently than boys. Better HRQoL was significantly associated with fewer visits to the PHN at school. Girls reported lower HRQoL and mental health, and more pain and frequent OTCA use than boys. When having symptoms of psychological distress, boys had greater odds of visiting the PHN at school than girls. For girls in senior high school, headaches and OTCA use were strongly associated with visiting the PHN at school and the YHC. In senior high school, boys with an immigration background had greater odds of visiting the YHC than native Norwegian boys, while girls with an immigration background were less likely to visit the YHC than native Norwegian girls.

CONCLUSIONS

Our results show that more girls than boys use youth healthcare services. When adolescents experience pain, have mental problems, use OTCA, or report low levels of HRQoL, they have greater odds of using youth healthcare services. Youth healthcare services offer excellent opportunities to support and follow up with adolescents. The findings provide important insights into youth healthcare services used by adolescents for various stakeholders, including PHNs and policy makers, with potential implications for future public health efforts.

An observational study of adolescent health outcomes associated with school-based health service utilization: A causal analysis

OBJECTIVE

Our aim is to examine the unbiased association between use of school-based health services (SBHS) and student health outcomes.

DATA SOURCES

Data are from a nationally representative health and well-being survey of 8500 New Zealand high school students from 91 high schools.

STUDY DESIGN

Student data were linked to the level of SBHS available to them: no SBHS, regular clinics from visiting health professionals, a health professional onsite, or a health team onsite.

DATA COLLECTION/EXTRACTION METHODS

Causal analyses are used to compare utilization of SBHS and their association with student-reported health outcomes, including foregone health care, depressive symptoms, emotional and behavioral difficulties, suicide risk, substance use, and unsafe sexual behaviors.

PRINCIPAL FINDINGS

Results from the multinomial propensity score-weighted regressions show that the use of SBHS was associated with poorer health outcomes, suggesting that selection bias was present due to unmeasured confounders. Instrumental variable analyses found that that students using team-based SBHS had a 4.7 percent (95% CI 0.5-8.9) probability of high levels of depressive symptoms compared to 14.2 percent (95% CI 11.5-16.8) among students not using team SBHS. For suicide attempt, students using team-based SBHS had a 2.0 percent (95% CI -0.3-4.2) probability of a suicide attempt in the previous 12 months compared to 5.6 percent (95% CI 2.6-8.5) among students not using team SBHS.

CONCLUSIONS

These analyses suggest that team-based SBHS are associated with better mental health among students who attend them.