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Grunewald W, Waitz-Kudla SN, Daruwala SE, Smith AR, Anestis MD. Testing rurality as a moderator of associations between masculinity constructs, help-seeking, and firearm storage practices. Suicide Life Threat Behav 2024. [PMID: 39155868 DOI: 10.1111/sltb.13124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 07/31/2024] [Accepted: 08/06/2024] [Indexed: 08/20/2024]
Abstract
INTRODUCTION Self-reliance, emotional control, and honor ideology may prevent help-seeking when suicidal ideation emerges. Furthermore, these factors are associated with an increased likelihood of firearm ownership and unsecure storage, which could facilitate suicide attempts. The rurality of residence may impact these associations, as rural regions report increased independence, honor culture, and firearm prevalence. Therefore, this study examined how emotional control, self-reliance, and honor ideology relate to firearm storage and help-seeking for suicidal ideation, with rurality moderating these associations. METHODS Participants were 733 adults (63.6% female, 33.5% male, and 2.9% transgender/other) who reported past-month suicidal ideation. Analyses tested associations between emotional control, self-reliance, and honor ideology with help-seeking for suicidal ideation and firearm storage, with rurality moderating these associations. RESULTS The association of self-reliance and decreased help-seeking willingness for suicidal ideation was significant for those in non-urban areas. The association of emotional control and decreased help-seeking willingness for suicidal ideation was significant for those in urban areas. No variables predicted firearm storage. CONCLUSIONS Self-reliance and emotional control could be barriers for help-seeking regardless of gender identity that depend on rurality. Clinicians may target emotional control/self-reliance via strengths-based approaches with an emphasis on when these constructs could be maladaptive, as this could promote help-seeking.
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Affiliation(s)
- William Grunewald
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
| | | | - Samantha E Daruwala
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA
| | - April R Smith
- Department of Psychological Sciences, Auburn University, Auburn, Alabama, USA
| | - Michael D Anestis
- New Jersey Gun Violence Research Center, Piscataway, New Jersey, USA
- Department of Urban-Global Public Health, Rutgers University, New Brunswick, New Jersey, USA
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2
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Smith SN, Almirall D, Choi SY, Andrews C, Koschmann E, Rusch A, Bilek E, Lane A, Abelson JL, Eisenberg D, Himle JA, Liebrecht C, Kilbourne AM. Student mental health outcomes of a clustered SMART for developing an adaptive implementation strategy to support school-based CBT delivery. J Affect Disord 2024:S0165-0327(24)01265-5. [PMID: 39151756 DOI: 10.1016/j.jad.2024.08.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 08/07/2024] [Accepted: 08/11/2024] [Indexed: 08/19/2024]
Abstract
PURPOSE Most youth experiencing anxiety/depression lack access to evidence-based mental health practices (EBPs). School-delivered care improves access, and various support can help school professionals (SPs; school social workers, counselors) deliver EBPs, like Cognitive Behavioral Therapy (CBT). Understanding implementation strategies' impact on downstream mental health outcomes is crucial to scaling up EBPs to address the treatment gap, but it has rarely been assessed. METHODS This paper compares implementation strategies' impact on change in student outcomes, collected as exploratory outcomes from a type III hybrid implementation-effectiveness trial. A clustered, sequential, multiple-assignment randomized trial design was used, which embedded four implementation supports that differentially sequence three implementation strategies, Replicating Effective Programs (REP), Coaching, and Facilitation. Prior to the first randomization, N = 169 SPs from 94 Michigan high schools each identified up to 10 students whom they believed could benefit from CBT and facilitated student survey completion. Changes in students' depression (Patient Health Questionnaire-9, modified for teens) and anxiety symptoms (Generalized Anxiety Disorder-7) over 10 months were compared across the four sequences of implementation support using a generalization of a marginal, weighted least squares approach developed for a clustered SMARTs. RESULTS Small, non-clinically significant reductions in symptoms over the study period were found. Pairwise comparisons found no significant differences in symptom change across the four implementation strategies. The difference in the estimated mean PHQ-9 T/GAD-7 scores between the least and the most intensive strategies (REP vs. REP+Coaching+Facilitation) was 1.04 (95%CI = -0.95, 3.04) for depression and 0.82 (95%CI = -0.89, 2.52) for anxiety. DISCUSSION No difference in symptom change was found across the four implementation strategies. Multiple forms of implementation support may be useful for improving student mental health outcomes. TRIAL REGISTRATION NCT03541317-Registered on 29 May 2018 on ClinicalTrials.gov PRS.
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Affiliation(s)
- Shawna N Smith
- Department of Health Management and Policy, School of Public Health, University of Michigan, USA; Department of Psychiatry, Michigan Medicine, University of Michigan, USA.
| | - Daniel Almirall
- Survey Research Center, Institute of Social Research, University of Michigan, USA; Department of Statistics, University of Michigan, USA
| | - Seo Youn Choi
- Department of Health Management and Policy, School of Public Health, University of Michigan, USA
| | - Carolyn Andrews
- Department of Health Management and Policy, School of Public Health, University of Michigan, USA
| | | | - Amy Rusch
- Department of Health Management and Policy, School of Public Health, University of Michigan, USA
| | - Emily Bilek
- Department of Psychiatry, Michigan Medicine, University of Michigan, USA
| | - Annalise Lane
- Department of Health Management and Policy, School of Public Health, University of Michigan, USA
| | - James L Abelson
- Department of Psychiatry, Michigan Medicine, University of Michigan, USA
| | | | - Joseph A Himle
- Department of Psychiatry, Michigan Medicine, University of Michigan, USA; School of Social Work, University of Michigan, USA
| | - Celeste Liebrecht
- Department of Learning Health Sciences, Michigan Medicine, University of Michigan, USA
| | - Amy M Kilbourne
- Department of Learning Health Sciences, Michigan Medicine, University of Michigan, USA; Quality Enhancement Research Initiative (QUERI), US Department of Veterans Affairs, USA
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Close J, Arshad SH, Soffer SL, Lewis J, Benton TD. Adolescent Health in the Post-Pandemic Era: Evolving Stressors, Interventions, and Prevention Strategies amid Rising Depression and Suicidality. Pediatr Clin North Am 2024; 71:583-600. [PMID: 39003003 DOI: 10.1016/j.pcl.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/15/2024]
Abstract
Prior to COVID-19, there were already increasing rates of youth with mental health concerns, including an increase in youth presenting to medical emergency departments (EDs) with mental health chief complaints and limited access to treatment. This trend worsened during the pandemic, and rates of youth presenting to medical EDs with suicidal ideation and self-harm increased 50% from 2019 to 2022. This resulted in a "boarding" crisis, in part, due to a lack of inpatient psychiatric hospitalization beds, and many youth were left without access to adequate treatment. Additional study of innovations in health care delivery will be paramount in meeting this need.
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Affiliation(s)
- Jeylan Close
- National Clinician Scholars Program, Department of Psychiatry and Behavioral Sciences, Child & Family Mental Health & Community Psychiatry Division, Duke University School of Medicine, 710 West Main Street, Durham, NC 27701, USA; Duke Margolis Center for Health Policy, Duke University, 710 West Main Street, Durham, NC 27701, USA.
| | - Sarah H Arshad
- Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine and UC Irvine School of Medicine, The Hub for Clinical Collaboration, DCAPBS, Floor 12, 3500 Civic Center Boulevard, Philadelphia, PA 19104, USA
| | - Stephen L Soffer
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, 4601 Market Street, 3rd Floor, Philadelphia, PA 19139, USA
| | - Jason Lewis
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, 4601 Market Street, 3rd Floor, Philadelphia, PA 19139, USA
| | - Tami D Benton
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, 4601 Market Street, 3rd Floor, Philadelphia, PA 19139, USA
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Linkous O, Soon K, Lee JD, Du A, Shih W, Bearss K, Kasari C, Locke J. Short report: Examining race, ethnicity, sex, and gender among autistic youth and their educators who participated in school-based research. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241262144. [PMID: 39056323 DOI: 10.1177/13623613241262144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Abstract
LAY ABSTRACT Schools are the main provider of behavioral health services in the United States (US). Conducting research in schools may help increase access for autistic youth, but there is limited research about who participates in school-based autism research. The researchers examined data spanning 14 years of participation in school-based autism research. All data were collected in the US. Researchers found that in this sample, more than half of the youth identified as racial/ethnic minoritized (REM) youth. However, demographics of sampled youth were significantly different than expected, based on publicly available school-based population demographics. More youth identified as White non-Hispanic than would be expected in those schools. Majority of the sampled educators also identified as White non-Hispanic. High percentages of autistic REM youth suggest school-based autism research may be an effective way of providing services to more diverse populations. However, sampled schools were also not representative of a US national sample, with sampled schools having fewer White non-Hispanic youth than would be expected from US national statistics. Complexity around representation of schools sampled and demographics of service environments suggests a need for more research.
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Affiliation(s)
| | | | | | | | - Wendy Shih
- University of California, Los Angeles, USA
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5
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Lawson GM, Azad G. School-Based Mental Health Interventions: Recommendations for Selecting and Reporting Implementation Strategies . THE JOURNAL OF SCHOOL HEALTH 2024; 94:581-585. [PMID: 38627895 DOI: 10.1111/josh.13458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/22/2024] [Accepted: 03/28/2024] [Indexed: 05/14/2024]
Affiliation(s)
- Gwendolyn M Lawson
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Gazi Azad
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, USA
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von der Embse N, De Los Reyes A. Advancing equity in access to school mental health through multiple informant decision-making. J Sch Psychol 2024; 104:101310. [PMID: 38871419 DOI: 10.1016/j.jsp.2024.101310] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 12/31/2022] [Accepted: 03/21/2024] [Indexed: 06/15/2024]
Abstract
There has been a substantial increase in the number of students with mental health needs, yet significant discrepancies exist in access to timely intervention. Traditional gatekeeping to intervention has been the provenance of single information sources. Multi-informant decision-making is a promising mechanism to improve equitable access. However, critical advancements are necessary to improve decision-making relating to (a) who is identified, (b) what type of need is determined, (c) the type of intervention necessary, and (d) where or under what circumstances to implement the intervention. We review critical components of effective mental health decision-making, contributors to inequities in school mental health services, and offer future directions for research and practice to increase equitable student outcomes.
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Ilakkuvan V, De Biasi A. Delivering Medicaid Mental Health Services and Supports in Schools: Current Landscape and Opportunities to Expand. THE JOURNAL OF SCHOOL HEALTH 2024; 94:562-570. [PMID: 38320292 DOI: 10.1111/josh.13427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 11/14/2023] [Accepted: 12/18/2023] [Indexed: 02/08/2024]
Abstract
BACKGROUND Medicaid is a key policy lever for expanding access to mental health services and supports for children in schools, especially low-income and minority children. This study examines how Medicaid finances mental health promotion and prevention (tier 1), screening and selected interventions (tier 2), and treatment (tier 3) in schools, informing policy recommendations to expand school mental health. METHODS Seventeen key informant interviews were conducted virtually from March to October 2022 with research, practice, and policy leaders in school mental health and Medicaid. Interview transcripts were thematically coded to inform recommendations. RESULTS Interview themes included that Medicaid is a key funder of mental health services, primarily in tier 3, and that braiding and blending funds is necessary to support services across all tiers in schools. Interviewees underscored the need to expand tier 2 in schools, to expand and diversify the behavioral health workforce (including via non-licensed providers, aligning school-employed provider licensure and billing requirements and building school-community referral relationships), strengthen teaming structures (including state children's cabinets, student case management, and education/Medicaid agency coordination), and leverage technical assistance and training to speed up adoption of new policies (including via guidance and templates that facilitate billing for school health services). CONCLUSIONS Policymakers, practitioners, and advocates can use these findings to identify policies and strategies to expand school mental health and reduce inequities.
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Affiliation(s)
- Vinu Ilakkuvan
- PoP Health, Fairfax, VA
- George Washington University, Milken Institute School of Public Health, Washington, DC
| | - Anne De Biasi
- PoP Health, Fairfax, VA
- Policy, WE in the World, Nashua, NH
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Ghose SS, Patel NA, Marshall T, George P, Taylor J, Karakus M, Crocker L, Hoey T, Goldman HH. Assessing the Evidence Base for School-Based Promotion and Prevention Interventions: Introduction to the Series. Psychiatr Serv 2024:appips20230542. [PMID: 38736359 DOI: 10.1176/appi.ps.20230542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
Schools are an important component in the mental health system of care for youths. Teachers and other school staff have unique opportunities to promote emotional wellness and prevent mental health conditions. Although numerous programs are available, identifying evidence-based and effective options is a significant challenge. This introduction lays out the rationale and methodology of the Assessing the Evidence Base (AEB) Series, a collection of systematic reviews of school-based mental health promotion and prevention approaches recommended by the National Academies of Sciences, Engineering, and Medicine for students in kindergarten through grade 12. Authors of the current AEB Series used the rating criteria derived from the 2014 AEB Series, which provided systematic reviews of a wide spectrum of interventions for mental and substance use disorders. Like its predecessor, the current series upholds a high standard of scientific rigor while ensuring that the information is easily accessible to various stakeholders in education, behavioral health, and communities. It describes the universal features included in each systematic review, such as a rating of the level of evidence for interventions, intervention program components, identification of interventions that have yielded positive outcomes for students from underserved populations, and a review of cost data. The AEB systematic reviews will serve as an important tool for decision makers involved in managing limited resources for various programs in school-based mental health services by synthesizing large bodies of research for use by leaders in education and behavioral health.
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Affiliation(s)
- Sushmita Shoma Ghose
- Westat (Ghose, Marshall, George, Taylor, Karakus, Crocker, Hoey) and Substance Abuse and Mental Health Services Administration (SAMHSA) (Patel), Rockville, Maryland; Department of Psychiatry, University of Maryland, College Park (Goldman)
| | - Nikhil A Patel
- Westat (Ghose, Marshall, George, Taylor, Karakus, Crocker, Hoey) and Substance Abuse and Mental Health Services Administration (SAMHSA) (Patel), Rockville, Maryland; Department of Psychiatry, University of Maryland, College Park (Goldman)
| | - Tina Marshall
- Westat (Ghose, Marshall, George, Taylor, Karakus, Crocker, Hoey) and Substance Abuse and Mental Health Services Administration (SAMHSA) (Patel), Rockville, Maryland; Department of Psychiatry, University of Maryland, College Park (Goldman)
| | - Preethy George
- Westat (Ghose, Marshall, George, Taylor, Karakus, Crocker, Hoey) and Substance Abuse and Mental Health Services Administration (SAMHSA) (Patel), Rockville, Maryland; Department of Psychiatry, University of Maryland, College Park (Goldman)
| | - Jeffrey Taylor
- Westat (Ghose, Marshall, George, Taylor, Karakus, Crocker, Hoey) and Substance Abuse and Mental Health Services Administration (SAMHSA) (Patel), Rockville, Maryland; Department of Psychiatry, University of Maryland, College Park (Goldman)
| | - Mustafa Karakus
- Westat (Ghose, Marshall, George, Taylor, Karakus, Crocker, Hoey) and Substance Abuse and Mental Health Services Administration (SAMHSA) (Patel), Rockville, Maryland; Department of Psychiatry, University of Maryland, College Park (Goldman)
| | - Laura Crocker
- Westat (Ghose, Marshall, George, Taylor, Karakus, Crocker, Hoey) and Substance Abuse and Mental Health Services Administration (SAMHSA) (Patel), Rockville, Maryland; Department of Psychiatry, University of Maryland, College Park (Goldman)
| | - Tabitha Hoey
- Westat (Ghose, Marshall, George, Taylor, Karakus, Crocker, Hoey) and Substance Abuse and Mental Health Services Administration (SAMHSA) (Patel), Rockville, Maryland; Department of Psychiatry, University of Maryland, College Park (Goldman)
| | - Howard H Goldman
- Westat (Ghose, Marshall, George, Taylor, Karakus, Crocker, Hoey) and Substance Abuse and Mental Health Services Administration (SAMHSA) (Patel), Rockville, Maryland; Department of Psychiatry, University of Maryland, College Park (Goldman)
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Beard LM, Choi KW. Disrupted family reunification: Mental health, race, and state-level factors. Soc Sci Med 2024; 348:116768. [PMID: 38537452 DOI: 10.1016/j.socscimed.2024.116768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 02/10/2024] [Accepted: 03/07/2024] [Indexed: 04/29/2024]
Abstract
The children's mental health landscape is rapidly changing, and youth with mental health conditions (MHCs) are overrepresented in the child welfare system. Mental health is the largest unmet health need in child welfare, so MHCs may affect the likelihood of system reentry. Concerns regarding mental health contribute to calls for expanded supports, yet systems contact can also generate risk of continued child welfare involvement via surveillance. Still, we know little about how expanded supports at the state-level shape child welfare outcomes. Using the Adoption and Foster Care Analysis Reporting System (AFCARS), we examine the association between MHCs and system reentry within 36 months among youth who reunified with their families in 2016 (N = 41,860). We further examine whether this association varies across states and White, Black, and Latinx racial and ethnic groups via two- and three-way interactions. Results from multilevel models show that, net of individual and state-level factors, MHCs are associated with higher odds of reentry. This relationship is stronger for youth in states that expanded Medicaid by 2016 and with higher Medicaid/CHIP child participation rates. The results also show evidence of the moderating role of state-level factors, specifically student-to-school counselor ratio, diverging across racial and ethnic groups. Our results suggest a need for systems of care to better support youth mental health and counteract potential surveillance.
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Chronis-Tuscano A, Bounoua N. ADHD Prevalence Rose, Yet Disparities Remain: Commentary on the 2022 National Survey of Children's Health. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024; 53:361-372. [PMID: 38905157 PMCID: PMC11193851 DOI: 10.1080/15374416.2024.2359075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/23/2024]
Abstract
This is a commentary on Danielson and colleagues' report entitled "ADHD Prevalence Among U.S. Children and Adolescents in 2022: Diagnosis, Severity, Co-Occurring Disorders, and Treatment," which provides updated prevalence rates related to ADHD diagnosis and treatment utilization using data from the 2022 National Survey of Children's Health (NSCH). This timely article is among the first to report on ADHD prevalence rates since the COVID-19 pandemic, and highlights important patterns related to ADHD diagnosis and treatment utilization. In this commentary, we contextualize these findings with consideration to the COVID-19 pandemic and within the existing literature on health disparities among youth with ADHD and their families. We end with recommendations for future work involving researchers, clinicians, and policymakers with the intention of reducing disparities in ADHD diagnosis and treatment in the U.S.
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Baumann SE, Kameg BN, Wiltrout CT, Murdoch D, Pelcher L, Burke JG. Visualizing Mental Health Through the Lens of Pittsburgh Youth: A Collaborative Filmmaking Study During COVID-19. Health Promot Pract 2024; 25:368-382. [PMID: 36546679 PMCID: PMC9791059 DOI: 10.1177/15248399221141688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Youth mental health has been significantly impacted by COVID-19, with concerns of rising anxiety-related and depressive symptoms and reduced quality of life. This study provides a nuanced understanding of mental health stressors and supports in the lives of youth during the pandemic. Using Collaborative Filmmaking, an embodied, visual, and participatory research method, participants in Pittsburgh, Pennsylvania, were trained to create, analyze, and screen films about mental health. The films elucidated numerous stressors impacting youth mental health, including educational stressors (e.g., academic pressure and relationships with teachers), personal and social stressors (e.g., social and cultural expectations), and current events (e.g., the election and the political system). Supports included individual level supports (e.g., hobbies, self-care, spending time outdoors), and interpersonal level supports (e.g., family and socializing). Several themes were discussed as both stressors and supports, such as family, COVID-19, and social media. Overall, educational stressors are major contributors to adverse mental health symptoms among youth, which have been magnified by the COVID-19 pandemic. Youth discussions of the importance of self-care and engaging in healthy hobbies demonstrated strong awareness about maintaining mental health, though structural-level recommendations are still needed to improve youth mental health. Screening the Collaborative Films with the public illuminated several additional opportunities for action, including structural and social actions (e.g., changing policies and social norms around mental health). Given the structural nature of the stressors mentioned by participants, systemic changes as well as policy level action and programming are needed to address the intersectional nature of current mental health concerns among youth.
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Affiliation(s)
- Sara E. Baumann
- University of Pittsburgh School of
Public Health, Pittsburgh, PA, USA
| | - Brayden N. Kameg
- University of Pittsburgh School of
Public Health, Pittsburgh, PA, USA
| | | | | | - Lindsay Pelcher
- University of Pittsburgh School of
Public Health, Pittsburgh, PA, USA
| | - Jessica G. Burke
- University of Pittsburgh School of
Public Health, Pittsburgh, PA, USA
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Gesselman AN, Kaufman EM, Weeks LYS, Moscovici Z, Bennett-Brown M, Adams OR, Campbell JT, Piazza M, Bhuyan L, Dubé S, Hille JJ, Garcia JR. Exploring patterns in mental health treatment and interests of single adults in the United States: a secondary data analysis. Front Public Health 2024; 12:1292603. [PMID: 38711766 PMCID: PMC11073498 DOI: 10.3389/fpubh.2024.1292603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 03/15/2024] [Indexed: 05/08/2024] Open
Abstract
Objective The objective of this study is to examine mental health treatment utilization and interest among the large and growing demographic of single adults in the United States, who face unique societal stressors and pressures that may contribute to their heightened need for mental healthcare. Method We analyzed data from 3,453 single adults, focusing on those with possible mental health treatment needs by excluding those with positive self-assessments. We assessed prevalence and sociodemographic correlates of mental health treatment, including psychotherapy and psychiatric medication use, and interest in attending psychotherapy among participants who had never attended. Results 26% were in mental health treatment; 17% were attending psychotherapy, 16% were taking psychiatric medications, and 7% were doing both. Further, 64% had never attended psychotherapy, of which 35% expressed interest in future attendance. There were differences in current psychotherapy attendance and psychiatric medication use by gender and sexual orientation, with women and gay/lesbian individuals more likely to engage in both forms of mental health treatment. Additionally, interest in future psychotherapy among those who had never attended varied significantly by age, gender, and race. Younger individuals, women, and Black/African-American participants showed higher likelihoods of interest in psychotherapy. Conclusion Our research highlights a critical gap in mental health treatment utilization among single adults who may be experiencing a need for those services. Despite a seemingly higher likelihood of engagement in mental health treatment compared to the general population, only a minority of single adults in our sample were utilizing mental health treatment. This underutilization and the observed demographic disparities in mental health treatment underscore the need for targeted outreach, personalized treatment plans, enhanced provider training, and policy advocacy to ensure equitable access to mental healthcare for single adults across sociodemographic backgrounds.
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Affiliation(s)
- Amanda N. Gesselman
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
| | - Ellen M. Kaufman
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
| | - Lee Y. S. Weeks
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
- Department of Gender Studies, College of Arts and Sciences, Indiana University Bloomington, Bloomington, IN, United States
| | - Zoe Moscovici
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
- Department of Gender Studies, College of Arts and Sciences, Indiana University Bloomington, Bloomington, IN, United States
| | - Margaret Bennett-Brown
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
- Communication Studies, College of Media and Communications, Texas Tech University, Lubbock, TX, United States
| | - Olivia R. Adams
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
- Department of Gender, Sexuality, and Women’s Studies, College of Liberal Arts and Sciences, University of Florida, Gainesville, FL, United States
| | - Jessica T. Campbell
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
| | - Malia Piazza
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
- Department of Anthropology, College of Arts and Sciences, Indiana University Bloomington, Bloomington, IN, United States
| | - Lucy Bhuyan
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
- Department of Counseling and Educational Psychology, School of Education, Indiana University Bloomington, Bloomington, IN, United States
| | - Simon Dubé
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
- Department of Psychology, Faculty of Arts and Science, Concordia University, Montreal, QC, Canada
| | - Jessica J. Hille
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
| | - Justin R. Garcia
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
- Department of Gender Studies, College of Arts and Sciences, Indiana University Bloomington, Bloomington, IN, United States
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Rungan S, Liu HM, Smith-Merry J, Eastwood J. Kalgal Burnbona: An Integrated Model of Care Between the Health and Education Sector. Int J Integr Care 2024; 24:14. [PMID: 38706536 PMCID: PMC11067974 DOI: 10.5334/ijic.7745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 04/17/2024] [Indexed: 05/07/2024] Open
Abstract
Introduction Kalgal Burnbona is a framework developed for applying school-based integrated care (SBIC) across Sydney Local Health District (SLHD). Description Kalgal Burnbona is an innovative and integrative framework developed to provide holistic, integrated, multidisciplinary child and family centred care to school-aged children from priority populations within SLHD, such as those belonging to the Aboriginal community. The expected outcomes include improved health, behavioural, education and social outcomes. This article contextualises the development of the Kalgal Burnbona framework from its beginnings as a pilot site called Ngaramadhi Space (NS) within the Healthy Homes and Neighbourhoods (HHAN) initiative, through to its evolution to an integrated partnership between the New South Wales (NSW) health and education sector. An example of how the framework can be implemented in other settings within SLHD is described. Discussion A tiered approach to integrated care across SLHD is postulated based on evidence from a mixed methods evaluation of NS and in line with the Rainbow Model of Integrated Care (RMIC). Kalgal Burnbona is an example of a community-driven response through collaborative partnerships to improve health, education and social outcomes. The framework described provides structure for multisector teams to work within, recognising that each community and school has its own history and needs. Conclusion The Kalgal Burnbona model can be scaled up to serve a wider network of students across SLHD. The initial successes of the model, which include improving access and engagement for children with unmet physical health, mental health and social needs while being accepted by communities provide evidence for policy changes and advocacy that centre on collaborative cross-sector partnerships.
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Affiliation(s)
- Santuri Rungan
- Croydon Health Centre, 24 Liverpool Road, Croydon, NSW, 2132, Australia
| | - Huei Ming Liu
- Menzies Centre for Health Policy, University of Sydney, Australia
- The George Institute for Global Health, University of New South Wales, Australia
| | - Jennifer Smith-Merry
- Centre for Disability Research and Policy (CDRP), Susan Wakil Health Building (D18), Camperdown Campus, The University of Sydney, NSW, 2006, Australia
| | - John Eastwood
- School of Population Health, University of New South Wales, Kensington, NSW, 2050, Australia
- Sydney Local Health District, Level 11, King George V Building, Missenden Road, Camperdown, NSW, 2050, Australia
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14
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Young E, Szucs LE, Suarez NA, Wilkins NJ, Hertz M, Ivey-Stephenson A. Disparities and Trends in Middle School Students' Suicidal Thoughts and Behaviors: Results From the Youth Risk Behavior Survey, 2015-2019. J Adolesc Health 2024; 74:720-728. [PMID: 38127017 PMCID: PMC10960693 DOI: 10.1016/j.jadohealth.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 11/09/2023] [Accepted: 11/10/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE To examine trends and racial and ethnic disparities in early adolescent suicidal thoughts and behaviors in the years immediately prior to the COVID-19 pandemic. METHODS This study used pooled data from Centers for Disease Control and Prevention's middle school Youth Risk Behavior Survey (n = 127,912) between 2015 and 2019. Three dichotomized measures of suicide-related behaviors were assessed: suicidal thoughts, planning, and attempts. Weighted prevalence estimates with 95% confidence intervals were calculated for each survey year. Linear trends examined disparities in the prevalence of suicidal thoughts and behaviors, overall and by student demographic characteristics. Main effects odds ratios compared estimates among racial and ethnic minority adolescents with non-Hispanic White students, controlling for sex and grade. RESULTS Significant linear increases were observed for the percentage of middle school students who reported seriously thinking about suicide (18.2%-22.3%), ever making a suicide plan (11.8%-14.7%), and ever attempting suicide (6.9%-9.3%). Racial and ethnic minority students, other than non-Hispanic Asian, showed higher odds of suicidal thoughts and behaviors compared with non-Hispanic White students. DISCUSSION Findings indicate a need for comprehensive suicide prevention to address health equity and disparities in suicide-related behaviors among middle school-aged adolescents.
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Affiliation(s)
- Emily Young
- Division of Adolescent and School Health, The Centers for Disease Control and Prevention, Atlanta, Georgia; Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, Tennessee.
| | - Leigh E Szucs
- Division of Adolescent and School Health, The Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nicolas A Suarez
- Division of Adolescent and School Health, The Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Natalie J Wilkins
- Division of Adolescent and School Health, The Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Marci Hertz
- Division of Overdose Prevention, The Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Asha Ivey-Stephenson
- Division of Injury Prevention, The Centers for Disease Control and Prevention, Atlanta, Georgia
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15
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Berhanu RD, Feyisa JW, Boru JD, Jabana DE, Senbeta BS, Tekle MG, Alemayehu Y, Aga HT. COVID-19-related dysfunctional anxiety and associated factors among adolescents in Southwest Ethiopia: a cross-sectional study. BMC Psychiatry 2024; 24:167. [PMID: 38413896 PMCID: PMC10900736 DOI: 10.1186/s12888-024-05587-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 02/05/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND COVID-19 pandemic causes serious threats to people's mental health, particularly it has huge negative mental health outcomes for adolescents. However, there is lack of studies examining COVID-19-related anxiety among adolescents in Ethiopia. Hence, this study was aimed to examine COVID-19-related dysfunctional anxiety and its associated factors among adolescents in Mettu town. METHODS Community-based cross-sectional study was conducted from September 1 to 30, 2020 among 847 adolescents selected by stratified sampling technique. IBM SPSS Statistics Version 26.0 was used for analysis. Descriptive statistics such as frequency, percentage, mean, and standard deviation were computed. Bivariate and multivariate binary logistic regression analyses were done to identify factors associated with COVID-19-related dysfunctional anxiety. The statistical significance was declared at p ≤ 0.05; and the strength of association was described in terms of adjusted odds ratio. RESULTS Out of the total sample, 819 adolescents participated in this study. The mean age of the participants was 14.9 (SD = 2.798) years. The magnitude of COVID-19-related dysfunctional anxiety was found to be 20.9% (95% CI (18.1, 23.9)). The finding indicates that sex [(AOR (95% CI)); (0.724 (0.502, 1.043))], having both parents deceased [(AOR (95% CI)); (2.981 (1.138, 7.814))], living alone [(AOR (95% CI)); (2.363 (1.050, 5.321))], having unemployed mothers [(AOR (95% CI)); (1.943 (1.194, 3.163))], absence of close friend [(AOR (95% CI)); (0.377 (0.225, 0.630))], and medical problem [(AOR (95% CI)); (0.408 (0.278, 0.597))] were significantly associated with COVID-19-related anxiety. CONCLUSION The magnitude of COVID-19-related dysfunctional anxiety was found to be high in the study area. The findings have shown that the likelihood of developing COVID-19-related dysfunctional anxiety was linked to several factors. Provision of continued psychological support for adolescents is extremely encouraged.
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Affiliation(s)
- Robera Demissie Berhanu
- School of Nursing and Midwifery, Institute of Health Sciences, Wallaga University, Nekemte, Ethiopia.
| | - Jira Wakoya Feyisa
- Department of Public Health, Institute of Health Sciences, Wallaga University, Nekemte, Ethiopia
| | - Jibril Dori Boru
- School of Nursing and Midwifery, Institute of Health Sciences, Wallaga University, Nekemte, Ethiopia
| | - Desalegn Emana Jabana
- School of Nursing and Midwifery, Institute of Health Sciences, Wallaga University, Nekemte, Ethiopia
| | | | - Million Girma Tekle
- Department of Psychiatry, College of Health Sciences, Mattu University, Mettu, Ethiopia
| | - Yadeta Alemayehu
- Department of Psychiatry, College of Health Sciences, Mattu University, Mettu, Ethiopia
| | - Hunde Tarafa Aga
- Department of Psychiatry, College of Health Sciences, Mattu University, Mettu, Ethiopia
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16
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Murphy AN, Moskowitz K, Fernandez F, Risser HJ. Perceived Parent Needs for Improving Parent Participation in School-Based Therapies for Children with Disabilities Using the Parent-Therapist Partnership Survey. J Autism Dev Disord 2024:10.1007/s10803-024-06282-w. [PMID: 38393438 DOI: 10.1007/s10803-024-06282-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2024] [Indexed: 02/25/2024]
Abstract
Rehabilitative and habilitative therapies can help children with disabilities increase independence and overall wellbeing. However, children and their caregivers face many barriers to accessing these therapies and often rely on the school for therapy access. Given the limited resources available within the special education system, increasing parent involvement in special education therapies could improve service delivery. However, providers must first understand what parents need to participate in therapies before attempting to engage families. 217 parents completed an online survey consisting of the Parent-Therapist Partnership Survey and demographic questionnaires about theirfamiliesand their child[ren] with disabilities. The percentage of needs parents endorsed as important and thepercentageofimportantneedsendorsedasunmetwere calculated. Differences across demographic variables were assessed. Overall, parents reported an average of 75% of needs as important with significantly more needs endorsed as important regarding being an informed, engaged member of the child's care team (M = 83%) than needs related to support and guidance (M = 65%, p < 0.001). Furthermore, parentsreportedan average of 58% of important needs as unmet, with no significant differences in subscale averages. Significant associations were found for race/ethnicity, education, income, partner availability, number of children with disabilities in the household, transportation access, neighborhood opportunities, parent efficacy and social, emotional, and behavioral concerns. Parents reported a high percentage of needs as important, but a large percentage of these important needs were considered unmet. Significant disparities based on racial/ethnic identities and access to resources were found. In order to successfully engage parents in special education therapy activities, providers must work to understand and address parents' engagement needs, paying special attention to each family's unique circumstances to optimize engagement.
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Affiliation(s)
- Ashley N Murphy
- Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 710 N. Lake Shore Drive, Suite 1200, Chicago, IL, 60611, USA.
| | - Kathleen Moskowitz
- Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 710 N. Lake Shore Drive, Suite 1200, Chicago, IL, 60611, USA
| | - Francesca Fernandez
- Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 710 N. Lake Shore Drive, Suite 1200, Chicago, IL, 60611, USA
| | - Heather J Risser
- Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 710 N. Lake Shore Drive, Suite 1200, Chicago, IL, 60611, USA
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17
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Pickard K, Maddox B, Boles R, Reaven J. A cluster randomized controlled trial comparing the effectiveness of two school-based interventions for autistic youth with anxiety. BMC Psychiatry 2024; 24:6. [PMID: 38166851 PMCID: PMC10763300 DOI: 10.1186/s12888-023-05441-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Recent systematic reviews have indicated that cognitive behavioral therapy (CBT) is effective in reducing anxiety symptoms for autistic and non-autistic children. However, the vast majority of CBT research for autistic youth has been implemented within university settings and primarily by mental health providers. Schools hold great promise to equitably manage the mental health symptoms of autistic youth. Although preliminary research evaluating CBT within schools has been promising, CBT has not yet been compared to another readily available school mental health program. The goal of this protocol paper is to describe a multi-site study comparing two school-based interventions, Facing Your Fears-School Based (FYF-SB) and Zones of Regulation (ZOR) via a cluster randomized controlled type 1 hybrid effectiveness-implementation trial to determine which of the two interventions will best support autistic youth with anxiety in schools. METHODS Up to 100 elementary and middle schools will be randomized into FYF-SB or ZOR. Once schools are randomized, a minimum of two interdisciplinary school providers at each school will be trained to deliver either FYF-SB or ZOR over the course of 12 weeks to groups of 2-5 autistic students ages 8-14 years. Over the course of two years, a total of 200 autistic students will receive either ZOR or FYF-SB. The primary outcome of this trial is child anxiety, as rated by masked evaluators and via caregiver- and student-report, which will be measured at baseline, post-treatment, and 6-month follow-up. Semi-structured interviews will also be conducted with a purposive sample of students, caregivers, and school providers to understand the acceptability, appropriateness, and feasibility of either ZOR or FYF-SB. Stakeholder engagement is a central component of this project via two stakeholder advisory boards that will directly inform and oversee the project. DISCUSSION Results of this study will provide evidence about the relative impact of two school-based mental health interventions on outcomes reported as meaningful by caregivers and school providers. The additional focus on evaluating factors that support the implementation of FYF-SB and ZOR will allow future studies to test targeted implementation strategies that support mental health programming uptake and implementation within public schools. TRIAL REGISTRATION This trial is registered with clinicaltrials.gov (NCT05863520).
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Affiliation(s)
- Katherine Pickard
- Emory School of Medicine Department of Pediatrics, Division of Autism and Related Disabilities, 1920 Briarcliff Road, Atlanta, GA, 30329, USA.
| | - Brenna Maddox
- University of North Carolina, Chapel Hill, North Carolina, USA
| | - Richard Boles
- University of Colorado Anschutz Medical Campus, JFK Partners, Aurora, CO, USA
| | - Judy Reaven
- University of Colorado Anschutz Medical Campus, JFK Partners, Aurora, CO, USA
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18
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Burrell TD, Sheu YS, Kim S, Mohadikar K, Ortiz N, Jonas C, Horberg MA. COVID-19 and Adolescent Outpatient Mental Health Service Utilization. Acad Pediatr 2024; 24:68-77. [PMID: 37302698 PMCID: PMC10250250 DOI: 10.1016/j.acap.2023.05.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 05/20/2023] [Accepted: 05/27/2023] [Indexed: 06/13/2023]
Abstract
OBJECTIVE The COVID-19 pandemic created challenges in accessing mental health (MH) services when adolescent well-being declined. Still, little is known about how the COVID-19 pandemic affected outpatient MH service utilization for adolescents. METHODS Retrospective data were collected from electronic medical records of adolescents aged 12-17 years at Kaiser Permanente Mid-Atlantic States, an integrated health care system from January 2019 to December 2021. MH diagnoses included anxiety, mood disorder/depression, anxiety and mood disorder/depression, attention-deficit/hyperactivity disorder, or psychosis. We used interrupted time series analysis to compare MH visits and psychopharmaceutical prescribing before and after the COVID-19 onset. Analyses were stratified by demographics and visit modality. RESULTS The study population of 8121 adolescents with MH visits resulted in a total of 61,971 (28.1%) of the 220,271 outpatient visits associated with an MH diagnosis. During 15,771 (7.2%) adolescent outpatient visits psychotropic medications were prescribed. The increasing rate of MH visits prior to COVID-19 was unaffected by COVID-19 onset; however, in-person visits declined by 230.5 visits per week (P < .001) from 274.5 visits per week coupled with a rise in virtual modalities. Rates of MH visits during the COVID-19 pandemic differed by sex, mental health diagnosis, and racial and ethnic identity. Psychopharmaceutical prescribing during MH visits declined beyond expected values by a mean of 32.8 visits per week (P < .001) at the start of the COVID-19 pandemic. CONCLUSIONS A sustained switch to virtual visits highlights a new paradigm in care modalities for adolescents. Psychopharmaceutical prescribing declined requiring further qualitative assessments to improve the quality of access for adolescent MH.
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Affiliation(s)
- Tierra D Burrell
- Kaiser Permanente Mid-Atlantic Permanente Research Institute (TD Burrell, YS Sheu, S Kim, K Mohadikar, C Jonas, and MA Horberg), Rockville, Md; Kaiser Permanente Mid-Atlantic Permanente Medical Group (TD Burrell, YS Sheu, S Kim, K Mohadikar, N Ortiz, C Jonas, and MA Horberg), Rockville, Md.
| | - Yi-Shin Sheu
- Kaiser Permanente Mid-Atlantic Permanente Research Institute (TD Burrell, YS Sheu, S Kim, K Mohadikar, C Jonas, and MA Horberg), Rockville, Md; Kaiser Permanente Mid-Atlantic Permanente Medical Group (TD Burrell, YS Sheu, S Kim, K Mohadikar, N Ortiz, C Jonas, and MA Horberg), Rockville, Md
| | - Seohyun Kim
- Kaiser Permanente Mid-Atlantic Permanente Research Institute (TD Burrell, YS Sheu, S Kim, K Mohadikar, C Jonas, and MA Horberg), Rockville, Md; Kaiser Permanente Mid-Atlantic Permanente Medical Group (TD Burrell, YS Sheu, S Kim, K Mohadikar, N Ortiz, C Jonas, and MA Horberg), Rockville, Md
| | - Karishma Mohadikar
- Kaiser Permanente Mid-Atlantic Permanente Research Institute (TD Burrell, YS Sheu, S Kim, K Mohadikar, C Jonas, and MA Horberg), Rockville, Md; Kaiser Permanente Mid-Atlantic Permanente Medical Group (TD Burrell, YS Sheu, S Kim, K Mohadikar, N Ortiz, C Jonas, and MA Horberg), Rockville, Md
| | - Nancy Ortiz
- Kaiser Permanente Mid-Atlantic Permanente Medical Group (TD Burrell, YS Sheu, S Kim, K Mohadikar, N Ortiz, C Jonas, and MA Horberg), Rockville, Md
| | - Cabell Jonas
- Kaiser Permanente Mid-Atlantic Permanente Research Institute (TD Burrell, YS Sheu, S Kim, K Mohadikar, C Jonas, and MA Horberg), Rockville, Md; Kaiser Permanente Mid-Atlantic Permanente Medical Group (TD Burrell, YS Sheu, S Kim, K Mohadikar, N Ortiz, C Jonas, and MA Horberg), Rockville, Md
| | - Michael A Horberg
- Kaiser Permanente Mid-Atlantic Permanente Research Institute (TD Burrell, YS Sheu, S Kim, K Mohadikar, C Jonas, and MA Horberg), Rockville, Md; Kaiser Permanente Mid-Atlantic Permanente Medical Group (TD Burrell, YS Sheu, S Kim, K Mohadikar, N Ortiz, C Jonas, and MA Horberg), Rockville, Md
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19
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Parchem B, Wheeler A, Talaski A, Molock SD. Comparison of anxiety and depression rates among LGBTQ college students before and during the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:31-39. [PMID: 34919495 DOI: 10.1080/07448481.2021.2013238] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 09/16/2021] [Accepted: 11/28/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To compare rates of anxiety and depression among LGBTQ college students before and during the COVID-19 pandemic and examine pandemic-related stressors and protective factors. PARTICIPANTS Two cohorts of LGBTQ college students, aged 18-25, sampled before (N = 3,484) and during (N = 1,647) the pandemic. METHODS The Healthy Minds Study (HMS) is an annual mental health survey administered to college students in the United States, which included additional items related to the COVID-19 pandemic. RESULTS Mean anxiety symptoms were significantly lower mid-pandemic compared to pre-pandemic, but no differences in mean depressive symptoms were detected. Results varied by sexual and gender minority status. Financial stress, pandemic-related concerns, and witnessing discrimination were risk factors while academic persistence, positive mental health, and formal support were protective factors. CONCLUSIONS Mental health and instrumental support from institutions will be critical for college students during the pandemic. Affirming and empowering spaces for LGBTQ college students may leverage protective factors.
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Affiliation(s)
- Benjamin Parchem
- Department of Psychological and Brain Sciences, George Washington University, Washington, District of Columbia, USA
| | - Adam Wheeler
- Healthy Minds Network, Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Amber Talaski
- Healthy Minds Network, Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Sherry Davis Molock
- Department of Psychological and Brain Sciences, George Washington University, Washington, District of Columbia, USA
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20
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Sielaty R, Boutzoukas AE, Zimmerman KO, Caison B, Charles CO, CoyneSmith T, Darden T, Overman RA, Benjamin DK, Brookhart MA. Trends in Pediatric Emergency and Inpatient Healthcare Use for Mental and Behavioral Health Among North Carolinians During the Early COVID-19 Pandemic. J Pediatric Infect Dis Soc 2023; 12:S20-S27. [PMID: 38146861 PMCID: PMC10750307 DOI: 10.1093/jpids/piad092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/18/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Widespread school closures and health care avoidance during the COVID-19 pandemic led to disruptions in access to pediatric mental health care. METHODS We conducted a retrospective study of emergency and inpatient administrative claims from privately insured children aged 6-20 years in North Carolina between January 2019 and December 2020. We compared rates of emergency department (ED) visits (per 100 000 person-days) and risks of hospitalizations (per 100 000 persons) with diagnosis codes in each category (mental/behavioral health; suicidal ideation, suicide attempt, and intentional self-harm [SI/SA/ISH]; and social issues) across 3 time periods (pre-pandemic, lockdown, and reopening). We calculated the proportion and 95% confidence intervals (CI) of total ED visits and total hospitalizations attributable to mental/behavioral health and SI/SA/ISH across the 3 time periods. RESULTS Rates of all categories of ED visits decreased from pre-pandemic to the lockdown period; from pre-pandemic to the reopening period, mental/behavioral health visits decreased but rates of SI/SA/ISH visits were unchanged. The proportion of ED visits attributable to mental/behavioral health increased from 3.5% (95% CI 3.2%-3.7%) pre-pandemic to 4.0% (95% CI 3.7%-4.3%) during reopening, and the proportion of SI/SA/ISH diagnoses increased from 1.6% (95% CI 1.4%-1.8%) pre-pandemic to 2.4% (95% CI 2.1%-2.7%) during the reopening period. Emergency care use for social issues and hospital admissions for mental/behavioral health and SI/SA/ISH diagnoses were unchanged across the study periods. CONCLUSIONS In the early pandemic, pediatric mental health care and acute suicidal crises accounted for increased proportions of emergency care. During pandemic recovery, understanding the populations most impacted and increasing access to preventative mental health care is critical.
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Affiliation(s)
| | - Angelique E Boutzoukas
- Duke Clinical Research Institute, Durham, NC, USA
- Department of Pediatrics, Duke University, Durham, NC, USA
| | - Kanecia O Zimmerman
- Duke Clinical Research Institute, Durham, NC, USA
- Department of Pediatrics, Duke University, Durham, NC, USA
| | - Bria Caison
- Duke Clinical Research Institute, Durham, NC, USA
| | | | | | - Toni Darden
- Duke Clinical Research Institute, Durham, NC, USA
| | | | - Daniel K Benjamin
- Duke Clinical Research Institute, Durham, NC, USA
- Department of Pediatrics, Duke University, Durham, NC, USA
| | - M Alan Brookhart
- Department of Population Health Sciences, Duke University, Durham, NC, USA
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21
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Lim C, Chung PJ, Biely C, Jackson NJ, Puffer M, Zepeda A, Anton P, Leifheit KM, Dudovitz R. School Attendance Following Receipt of Care From a School-Based Health Center. J Adolesc Health 2023; 73:1125-1131. [PMID: 37702648 DOI: 10.1016/j.jadohealth.2023.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/28/2023] [Accepted: 07/05/2023] [Indexed: 09/14/2023]
Abstract
PURPOSE School-based health centers (SBHCs) may mitigate barriers to health care access and improve students' academic outcomes, but few studies test this hypothesis. We examined whether school attendance improved after students received care at an SBHC. METHODS We conducted a secondary analysis of data from 17 SBHCs affiliated with a single large urban school district and demographic and attendance data from SBHC users (N = 14,030) and nonusers (N = 230,046) from August 2015-February 2020. We examined the percent of full school days present each month for three years before and after students' first SBHC visit and a proxy visit date for SBHC nonusers. Propensity weighted linear regression models tested whether visiting an SBHC was associated with a change in the attendance trajectory compared to a matched sample of SBHC nonusers. RESULTS Among SBHC users, attendance trajectories declined more steeply prior to their first SBHC visit than after the first visit (preslope -0.71%, postslope -0.05%), whereas SBHC nonusers had a similar attendance trajectory over the entire period (preslope -0.18%, postslope -0.17%), with difference-in-difference 0.65. Changes in trajectories were more pronounced for students with a mental health encounter. Prior to the first SBHC mental health visit, SBHC users displayed a marked decline in monthly attendance (preslope -1.02%). After the first mental health visit, attendance increased (postslope 1.44%), with difference-in-difference 2.33. DISCUSSION SBHC utilization was associated with improved school attendance over time, particularly for students with a mental health diagnosis. Investing in SBHCs may reduce school absenteeism and support student health.
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Affiliation(s)
- Caryssa Lim
- Department of Health Systems Science, Kaiser Permanente School of Medicine, Pasadena, California.
| | - Paul J Chung
- Department of Health Systems Science, Kaiser Permanente School of Medicine, Pasadena, California; Departments of Pediatrics and Health Policy & Management, University of California Los Angeles, Los Angeles, California
| | - Christopher Biely
- Departments of Pediatrics and Health Policy & Management, University of California Los Angeles, Los Angeles, California
| | - Nicholas J Jackson
- Department of Medicine, University of California Los Angeles, Los Angeles, California
| | - Maryjane Puffer
- The L.A. Trust for Children's Health, Los Angeles, California
| | - Alex Zepeda
- The L.A. Trust for Children's Health, Los Angeles, California
| | | | - Kathryn M Leifheit
- Departments of Pediatrics and Health Policy & Management, University of California Los Angeles, Los Angeles, California
| | - Rebecca Dudovitz
- Departments of Pediatrics and Health Policy & Management, University of California Los Angeles, Los Angeles, California.
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22
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Rungan S, Montgomery A, Smith-Merry J, Liu HM, Eastwood J. Retrospective audit of a school-based integrated health-care model in a specialised school for children with externalising behaviour. J Paediatr Child Health 2023; 59:1311-1318. [PMID: 37964701 DOI: 10.1111/jpc.16515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 01/17/2023] [Accepted: 10/27/2023] [Indexed: 11/16/2023]
Abstract
AIM Problematic externalising behaviours in adolescents are associated with high individual and societal burden. A school-based multidisciplinary health clinic, Ngaramadhi Space (NS), was developed at Yudi Gunyi School, a specialised behavioural school in Sydney, Australia, to improve access to holistic health-care and behavioural support. This evaluation aimed to describe the demographics, clinic attendance, health screening, recommendations made, and changes in Strengths and Difficulties Questionnaire (SDQ) scores of students attending the clinic. METHODS Retrospective evaluation of students including changes in SDQ scores using descriptive statistics (26 July 2016 to 14 May 2019; n = 79). RESULTS Prior to the assessment, few students engaged with a paediatrician or mental health professional (22.8%; 27.8%, respectively). Child protection services were involved with 76%. NS attendance was high (failure-to-attend = 7.6%; cancellations = 8.9%). New issues found at the assessment included: parental separation (31.6%); trauma history (27.8%); substance use (19%); emotional wellbeing concerns (16.5%), learning difficulties (12.7%), domestic violence (12.7%) and medical conditions (10.1%). SDQ teacher reports showed a significant decrease in total difficulties scores (M = 6.2, SD = 6.165, P < 0.05, eta squared = 1.013 (large effect)) and all subsets. No significant differences in parent and self-reported SDQ. CONCLUSIONS Students with problematic externalising behaviour have unmet health and social needs. The NS school-based integrated health-care model offers a novel, convenient and innovative way to engage these students. This approach has high initial attendance rates with teacher-reported SDQ results showing some behavioural improvement. Further qualitative studies are required.
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Affiliation(s)
- Santuri Rungan
- Croydon Community Health Centre, Sydney Local Health District, Melbourne, New South Wales, Australia
| | - Alicia Montgomery
- Croydon Community Health Centre, Sydney Local Health District, Melbourne, New South Wales, Australia
| | - Jennifer Smith-Merry
- Centre for Disability Research and Policy (CDRP), The University of Sydney, Sydney, New South Wales, Australia
| | - Huei Ming Liu
- Croydon Community Health Centre, Sydney Local Health District, Melbourne, New South Wales, Australia
| | - John Eastwood
- Croydon Community Health Centre, Sydney Local Health District, Melbourne, New South Wales, Australia
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von der Embse N, Kilgus S, Oddleifson C, Way JD, Welliver M. Reconceptualizing Social and Emotional Competence Assessment in School Settings. J Intell 2023; 11:217. [PMID: 38132835 PMCID: PMC10744213 DOI: 10.3390/jintelligence11120217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/08/2023] [Accepted: 11/19/2023] [Indexed: 12/23/2023] Open
Abstract
The mental health needs of youth are both significant and increasing. Recent advancements have highlighted the need to reduce psychological distress while promoting the development of important social and emotional competencies. Current social and emotional assessment tools are limited in important ways that preclude their widespread use. In the current article, these limitations are discussed. A novel social and emotional learning assessment framework guided by methodological and theoretical innovations is presented. Future research directions and opportunities are discussed.
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Affiliation(s)
- Nathaniel von der Embse
- Department of Educational and Psychological Studies, University of South Florida, Tampa, FL 33620, USA;
| | - Stephen Kilgus
- Department of Educational Psychology, University of Wisconsin, Madison, WI 53706, USA; (S.K.); (C.O.)
| | - Carly Oddleifson
- Department of Educational Psychology, University of Wisconsin, Madison, WI 53706, USA; (S.K.); (C.O.)
| | - Jason D. Way
- Renaissance Learning, Wisconsin Rapids, WI 54494, USA;
| | - Megan Welliver
- Department of Educational and Psychological Studies, University of South Florida, Tampa, FL 33620, USA;
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24
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Kohlboeck G, Barbieri V, Wenter A, Piccoliori G, Engl A, Sevecke K, Wiedermann CJ, Exenberger S. Comparative study of children's mental health outcomes in Tyrol, Austria, and South Tyrol, Italy, during the COVID-19 pandemic. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2023:10.1007/s40211-023-00483-y. [PMID: 37989911 DOI: 10.1007/s40211-023-00483-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 10/11/2023] [Indexed: 11/23/2023]
Abstract
PURPOSE This study aimed to compare the mental health outcomes of children in North Tyrol, Austria, and South Tyrol, Italy, during the coronavirus disease 2019 (COVID-19) pandemic, considering the sociocultural and contextual differences between the two regions. METHODS The Tyrolean COVID-19 Children's Study (TCCS: n = 401; June 2021 to July 2021) and the Corona and Psyche in South Tyrol 2021 Study (COP‑S; n = 3402; May 2021 to June 2021) were used for data analyses. Both studies employed cross-sectional designs and collected data through online questionnaires completed by children aged 7-13 years and their parents. Various psychosocial assessment tools including the Child and Adolescent Trauma Screening, Children Anxiety Test, Child Behavior Check List, Screen for Child Anxiety Related Emotional Disorders, and Health Behaviour in School-Aged Children were used in the surveys. RESULTS The comparison between North Tyrol and South Tyrol revealed no significant differences in perceived threats, trauma, or anxiety among children. Similarly, there were no substantial disparities in psychosomatic complaints, indicating similar manifestations of emotional distress across the two regions. CONCLUSION The comparative analysis of children's mental health outcomes in North Tyrol and South Tyrol during the COVID-19 pandemic confirmed the analogous influence of sociocultural and contextual factors on their wellbeing. Despite presumable variations in pandemic events, management strategies, and healthcare systems, the study suggests comparable resilience among children and highlights the importance of sociocultural factors in shaping their wellbeing. The findings emphasize the need for comprehensive understanding and targeted interventions to support children's mental health during challenging times.
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Affiliation(s)
- Gabriele Kohlboeck
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Tirol Kliniken, Innsbruck, Austria.
- Department of Child and Adolescent Psychiatry, Medical University of Innsbruck, Innsbruck, Austria.
| | - Verena Barbieri
- Institute of General Practice and Public Health, Claudiana College of Health Professions, Bolzano, Italy.
| | - Anna Wenter
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Tirol Kliniken, Innsbruck, Austria
- Department of Child and Adolescent Psychiatry, Medical University of Innsbruck, Innsbruck, Austria
- Department of Psychology, University of Innsbruck, Innsbruck, Austria
| | - Giuliano Piccoliori
- Institute of General Practice and Public Health, Claudiana College of Health Professions, Bolzano, Italy
| | - Adolf Engl
- Institute of General Practice and Public Health, Claudiana College of Health Professions, Bolzano, Italy
| | - Kathrin Sevecke
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Tirol Kliniken, Innsbruck, Austria
- Department of Child and Adolescent Psychiatry, Medical University of Innsbruck, Innsbruck, Austria
| | - Christian J Wiedermann
- Institute of General Practice and Public Health, Claudiana College of Health Professions, Bolzano, Italy
- Department of Public Health, Medical Decision Making and Health Technology Assessment, University of Health Sciences, Medical Informatics and Technology, Hall, Tyrol, Austria
| | - Silvia Exenberger
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Tirol Kliniken, Innsbruck, Austria
- Department of Child and Adolescent Psychiatry, Medical University of Innsbruck, Innsbruck, Austria
- Department of Psychology, University of Innsbruck, Innsbruck, Austria
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25
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Kang-Yi CD, Kuriyan A, Kinkler G, Pisciella AE, Williams T, Wolk CB. Generating Actionable Evidence for School-Based Mental Health Service Delivery: Public-Academic Partnership Based Evaluations. Community Ment Health J 2023; 59:1588-1600. [PMID: 37289384 DOI: 10.1007/s10597-023-01147-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 05/19/2023] [Indexed: 06/09/2023]
Abstract
Public-academic partnership-based program evaluations can generate actionable evidence for policymaking, program design and implementation in improving school-based mental health service delivery. The University of Pennsylvania Center for Mental Health and public behavioral health care agencies in Philadelphia in the United States have evaluated Philadelphia's school mental health programs reimbursable through Medicaid billing since 2008. The variety of evaluations include (1) examining acute mental health service use of children receiving school-based mental health care and Medicaid expenditure, (2) examining children's externalizing and internalizing behaviors to measure school mental health providers' performance, and (3) examining effects of different types of school mental health programs on children's behavioral health functioning, school outcomes, and other out-of-school service use. This paper reports key findings of these evaluations, discusses how programs have been refined based on evaluation results, and shares lessons learned for successful public-academic partnership-based evaluations to promote use of actionable evidence.
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Affiliation(s)
- Christina D Kang-Yi
- Department of Psychiatric Rehabilitation and Counseling Professions, School of Health Professions, Rutgers Biomedical and Health Sciences, NJ, USA.
| | - Aparajita Kuriyan
- Center for Mental Health, University of Pennsylvania Perelman School of Medicine, PA, USA
| | - Grace Kinkler
- Center for Mental Health, University of Pennsylvania Perelman School of Medicine, PA, USA
| | | | - Tamra Williams
- Department of Health and Human Services, Pennsylvania Montgomery County, PA, USA
| | - Courtney Benjamin Wolk
- Center for Mental Health, University of Pennsylvania Perelman School of Medicine, PA, USA
- The Leonard Davis Institute of Health Economics, University of Pennsylvania, PA, USA
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26
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Stuenkel M, Koob C, Richardson E, Griffin SF, Sease KK. School-Based Mental Health Service Utilization Through the COVID-19 Pandemic and Beyond. THE JOURNAL OF SCHOOL HEALTH 2023; 93:1000-1005. [PMID: 37525409 DOI: 10.1111/josh.13384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 06/22/2023] [Accepted: 07/17/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND We examined trends in mental health service utilization before, during, and in the immediate return to in-person learning throughout the COVID-19 pandemic. METHODS Retrospective chart review was assessed for changes in odds of any visit being a mental health encounter from five school-based health centers from the 2018-2019 to the 2021-2022 school years. Data are limited to the in-person school year from mid-August to early June. RESULTS Data were assessed from 1239 students seen through 2256 visits over the 4 school years (Mage = 12.93). The odds of any visit being related to a mental health encounter increased each school year, with the 2020 to 2021 and 2021 to 2022 school years having significant increases in odds (both compared to the first and to the antecedent school year). In addition, during the 2019 to 2020 and 2020 to 2021 school years, the odds of a repeated mental health encounter significantly increased from year to year. CONCLUSIONS Findings indicate a steadily increasing number of mental health service utilization needs among adolescent students that was significantly exponentiated throughout the COVID-19 pandemic.
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Affiliation(s)
- Mackenzie Stuenkel
- Bradshaw Insititute for Community Child Health & Advocacy, Prisma Health Children's Hospital, Greenville, SC
| | - Caitlin Koob
- Department of Public Health Sciences, Clemson University, Clemson, SC
| | - Emily Richardson
- Bradshaw Insititute for Community Child Health & Advocacy, Prisma Health Children's Hospital, Greenville, SC
| | - Sarah F Griffin
- Department of Public Health Sciences, Clemson University, Clemson, SC
| | - Kerry K Sease
- Bradshaw Insititute for Community Child Health & Advocacy, Prisma Health Children's Hospital, Greenville, SC
- Pediatrics, University of South Carolina School of Medicine, Greenville, SC
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Rungan S, Gardner S, Liu HM, Woolfenden S, Smith-Merry J, Eastwood J. Ngaramadhi Space: An Integrated, Multisector Model of Care for Students Experiencing Problematic Externalising Behaviour. Int J Integr Care 2023; 23:19. [PMID: 38107833 PMCID: PMC10723013 DOI: 10.5334/ijic.7612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 03/30/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction Behavioural and emotional disorders are a significant cause of morbidity for young people aged 10-19 years. School-based health care (SBHC) provides an innovative approach to addressing these issues within Australia. Description We describe an innovative and integrative SBHC model called Ngaramadhi Space (NS) based at a specialised behavioural school called Yudi Gunyi school (YGS) in metropolitan Sydney, Australia. NS was developed in partnership with the Aboriginal community to provide holistic, integrated, multidisciplinary child and family centred care to students experiencing problematic externalising behaviour. We contextualise the historical factors leading to the development of NS, highlighting the importance of effective partnerships between sectors, and providing the theoretical framework and key components underpinning the model of care. Discussion In Australia, schools are an under-utilised resource for the delivery of health and support alongside education. Collaboration between sectors can be challenging but allows a more coordinated approach to the management of complex social and health issues. By forming effective partnerships with schools and communities, the health sector has an opportunity to improve access to health and social care in a culturally safe and acceptable way. This is in line with national and international frameworks for improving health service delivery and addressing inequity. Conclusion The health sector can play a pivotal role in improving the wellbeing of children by forming effective partnerships with schools and communities. The NS model is a practice-based example of this.
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Affiliation(s)
- Santuri Rungan
- Sydney Local Health District, University of Sydney, Sydney Institute for Women, Children & their Families, AU
| | | | - Huei-Ming Liu
- The George Institute for Global Health, University of New South Wales, AU
| | - Susan Woolfenden
- Sydney Local Health District, University of Sydney, AU
- Sydney Institute Women, Children and their Families, University of New South Wales, AU
| | - Jennifer Smith-Merry
- Centre for Disability Research and Policy, Sydney School of Health Sciences, The University of Sydney, AU
| | - John Eastwood
- University of New South Wales, Sydney, AU
- Ingham Institute of Applied Medical Research, Liverpool, NSW, AU
- University of Sydney, Sydney Institute for Women, Children and their Families and Sydney Local Health District, AU
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Hopkins L, Whitehead R, Pedwell G. Integrating Substance Misuse Specialists in a Youth Early Psychosis Service: Increasing Mental Health Clinicians' Knowledge and Confidence. Community Ment Health J 2023; 59:1321-1329. [PMID: 37000301 DOI: 10.1007/s10597-023-01117-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 03/09/2023] [Indexed: 04/01/2023]
Abstract
Substance misuse and mental health disorders are commonly occurring co-morbidities in young people. This paper reports on a pilot project to embed three specialist Alcohol and Other Drug (AoD) workers to be embedded in a youth early psychosis service to upskill mental health clinicians in managing substance misuse. Evaluation of the project used a mixed methods approach. Quantitative results showed that clinical staff members' knowledge of substance misuse, knowledge of AoD treatments and services, and overall confidence in working with young people with a substance misuse issue improved following implementation of the project. Qualitative results indicated four themes which emerged: defining the role of the AoD workers; support and upskilling of the mental health staff; openness and effective communication between the embedded workers and mental health teams; and barriers to collaboration. The results provide support for the embedding of specialist alcohol and drug workers in youth mental health services.
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Affiliation(s)
- Liza Hopkins
- Alfred Health, 999 Nepean Hwy, Moorabbin, 3189, Australia.
| | | | - Glenda Pedwell
- Alfred Health, 999 Nepean Hwy, Moorabbin, 3189, Australia
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29
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Fein EH, Agbangnin G, Murillo-León J, Parsons M, Sakai-Bismark R, Martinez A, Gomez PF, Chung B, Chung P, Dudovitz R, Inkelas M, Kataoka S. Encouraging "Positive Views" of Mental Illness in High Schools: An Evaluation of Bring Change 2 Mind Youth Engagement Clubs. Health Promot Pract 2023; 24:873-885. [PMID: 36154511 PMCID: PMC10481624 DOI: 10.1177/15248399221098349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
"Bring Change 2 Mind" (BC2M) high school clubs may destigmatize mental illness among club members, but clubs' (1) reach and impact on non-club members at the same school, (2) connection to student help-seeking attitudes, and (3) mechanisms by which they destigmatize mental illness, are unknown. This community-partnered evaluation involved pre/post surveys of predominantly Latino (72%) students at three urban public schools and focus groups and interviews with a sample of club members (n = 26/65, 40%) and all club staff (n = 7, 100%). Multivariate regressions tested relationships between variables. In 84% of the student body responded in the Fall (n = 1,040) and Spring (n = 1,031). Non-club member engagement in BC2M (reach) increased from 25% (Fall) to 44% (Spring) (p < .01). Engagement with BC2M clubs was associated with decreased stigma among members (p < .05) but not non-members (p = .19). Decreased stigma was associated with help-seeking attitudes (p < .01). Possible BC2M mechanisms identified by students and staff include the following: (1) fostering a positive campus climate, (2) normalizing mental health discussions, (3) increasing peer support and help-seeking, and (4) increasing awareness of positive coping behaviors. While BC2M clubs likely reduce stigma for members, effects did not reach non-members, challenging the potential of BC2M clubs as a schoolwide strategy to destigmatize mental health services. Future projects could investigate how to reach non-BC2M members, complement BC2M with other school climate interventions to increase impact, and measure BC2M impact alongside other outcomes relevant to schools, such as academic achievement.
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Affiliation(s)
| | | | | | - Marni Parsons
- Bright Star Secondary Charter Academy, Los Angeles, CA, USA
| | | | | | | | - Bowen Chung
- Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Paul Chung
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
| | | | - Moira Inkelas
- University of California, Los Angeles, Los Angeles, CA, USA
| | - Sheryl Kataoka
- University of California, Los Angeles, Los Angeles, CA, USA
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30
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Murphy JL, Kim Y. The Utilization Profiles of Comprehensive School Mental and Behavioral Health Needs Among Adolescents. THE JOURNAL OF SCHOOL HEALTH 2023; 93:537-546. [PMID: 36825483 DOI: 10.1111/josh.13302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 12/01/2022] [Accepted: 02/05/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Schools have become a primary access point for mental health services to cover the gap between need and service utilization that has long existed, particularly among vulnerable populations. This study aims to identify the profiles of comprehensive school mental and behavioral health system (CSMBHS) needs and examine related characteristics. METHODS We used the 2019 National Survey of Drug Use and Health (NSDUH) collected from a nationally representative sample in the United States. The sample included 6th through 12th-grade adolescents who had received CSMBHS services in the last 12 months (N = 1346). The study conducted latent class analysis and multinomial logistic regression using Vermunt's 3-step approach. RESULTS The analysis identified 3 profiles of student CSMBHS service need: depression needs (42%), multiple endorsements in most needs (depressed, friend, and school problems; 6.5%), and low endorsement (51.4%). Findings suggest that the profiles differed by age, a lifetime major depressive episode, family income, and use of other mental health services. IMPLICATIONS FOR SCHOOL HEALTH, POLICY, PRACTICE, AND EQUITY Emphasis should be placed on proactively identifying student needs and advocating for appropriate interventions based on student needs. CONCLUSIONS The study reveals important information regarding how schools best support students in need and in seeking services.
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Affiliation(s)
- Jennifer L Murphy
- School of Social Work, Virginia Commonwealth University, 1000 Floyd Avenue, Richmond, VA, 23284
| | - Youngmi Kim
- School of Social Work, Virginia Commonwealth University, 1000 Floyd Avenue, Richmond, VA, 23284
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31
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Kohlboeck G, Wenter A, Sevecke K, Exenberger S. Differences in perceived threat and trauma in children during the COVID-19 pandemic. Child Adolesc Psychiatry Ment Health 2023; 17:83. [PMID: 37386592 DOI: 10.1186/s13034-023-00628-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 06/12/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND The past 2 years of the COVID-19 pandemic were stressful for most children and adolescents; some children may have experienced a high level of stress and trauma. To date, no study has examined self-reported stress and trauma levels due to COVID-19 in children. This study aimed to assess perceived threat, exposure and trauma symptoms in children aged 7-13 years. In addition, we explored whether parent-reported factors could predict a higher risk of COVID-19 vulnerability in their children. METHOD Cross-sectional data were collected from 752 children to assess COVID-19 threat, exposure and trauma symptoms using the self- and parent-reported Child and Adolescent Trauma Screening Self-Report (CATS) Trauma questionnaire. We used exploratory analyses (factor analysis of mixed data and hierarchical clustering) to identify subgroups (i.e., clusters) of children sharing similar characteristics in the dataset. Linear regression modeling was applied to determine the likelihood of higher threat and vulnerability in children with parent-reported COVID-19 threat, exposure, CATS trauma symptoms, behaviors on the Child Behavior Checklist (CBCL), and posttraumatic growth (PTG). RESULTS We identified a high-risk group of children reporting clinically relevant trauma symptoms and COVID-19-related fears. Parents' reports of trauma could be used to identify children at high risk. CONCLUSIONS Approximately 25% of children reported moderate to clinically relevant levels of trauma symptom. It is especially important to offer adequate support to these children to ease the trauma and prevent their symptoms from developing into psychopathology.
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Affiliation(s)
- Gabriele Kohlboeck
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Tirol Kliniken, Milser Straße 10, 6060, Hall in Tirol, Innsbruck, Austria.
| | - Anna Wenter
- Department of Child and Adolescent Psychiatry, Medical University of Innsbruck, Innsbruck, Austria
- Department of Psychology, University of Innsbruck, Innsbruck, Austria
| | - Kathrin Sevecke
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Tirol Kliniken, Milser Straße 10, 6060, Hall in Tirol, Innsbruck, Austria
- Department of Child and Adolescent Psychiatry, Medical University of Innsbruck, Innsbruck, Austria
| | - Silvia Exenberger
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Tirol Kliniken, Milser Straße 10, 6060, Hall in Tirol, Innsbruck, Austria
- Department of Child and Adolescent Psychiatry, Medical University of Innsbruck, Innsbruck, Austria
- Department of Psychology, University of Innsbruck, Innsbruck, Austria
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32
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Lawson GM, Jawad AF, Comly R, Khanna M, Glick HA, Beidas RS, Goldstein J, Brizzolara-Dove S, Wilson T, Rabenau-McDonnell Q, Eiraldi R. A comparison of two group cognitive behavioral therapy protocols for anxiety in urban schools: appropriateness, child outcomes, and cost-effectiveness. Front Psychiatry 2023; 14:1105630. [PMID: 37426105 PMCID: PMC10328418 DOI: 10.3389/fpsyt.2023.1105630] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 05/16/2023] [Indexed: 07/11/2023] Open
Abstract
Background Cognitive behavioral therapy (CBT) for pediatric anxiety is efficacious for reducing anxiety symptoms and improving functioning, but many children are unable to access CBT for anxiety in community settings. Schools are an important setting in which children access mental health care, including therapy for anxiety. In this setting, therapy is usually delivered by Masters-level therapists. Objectives Friends for Life (FRIENDS), a 12-session, manualized, group CBT program for anxiety has demonstrated effectiveness when implemented in schools. However, prior research has also found challenges regarding feasibility and cultural fit when delivering FRIENDS in the urban school context. To address these challenges, we adapted FRIENDS for implementation in the school setting so that it might be more feasible and culturally appropriate for low-income, urban schools in the United States, while maintaining the core components of treatment. The current study uses a mixed-method approach to compare the effectiveness, cost-effectiveness, and perceived appropriateness of FRIENDS and CATS when delivered by Masters-level therapists with train-the-trainer support. Materials and methods First, we compared change scores for student outcomes (i.e., child-report MASC-2 total score, parent-report MASC-2 total score, teacher-report Engagement and Disaffection subscale scores) from pre- to post- treatment between students receiving FRIENDS and students receiving CATS to assess whether the two conditions resulted in equivalent outcomes. Second, we compared the cost and cost-effectiveness between the groups. Finally, we used an applied thematic analysis to compare appropriateness of the interventions as perceived by therapists and supervisors. Results The mean change score for the child-reported MASC-2 was 1.9 (SE = 1.72) points in the FRIENDS condition and 2.9 (SE = 1.73) points in the CATS condition; results indicated that the conditions were similar in their treatment effects, and symptom reductions were small in both groups. The modified protocol, CATS, was shown to cost significantly less to implement compared to FRIENDS and showed greater cost-effectiveness. Finally, compared to therapists and supervisors in the CATS condition, therapists and supervisors in the FRIENDS condition more strongly described aspects of the intervention that were not appropriate for their context and in need of more extensive adaptations. Conclusion Relatively brief, group CBT for anxiety, with adaptations to improve cultural fit, is a promising approach to treat youth anxiety symptom when delivered by school-based therapists with train-the-trainer implementation support.
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Affiliation(s)
- Gwendolyn M. Lawson
- Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Abbas F. Jawad
- Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Rachel Comly
- Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Muniya Khanna
- OCD and Anxiety Institute, Bryn Mawr, PA, United States
| | - Henry A. Glick
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Rinad S. Beidas
- Department of Medical Social Sciences, Feinberg School of Medicine Northwestern University, Chicago, IL, United States
| | - Jessica Goldstein
- Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | | | - Tara Wilson
- Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | | | - Ricardo Eiraldi
- Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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Duck AA, Carr K, Lim CS, Robinson JC. Integrating Behavioral Health and Primary Care in an Inner-City High School: Expanded Care in a School-Based Clinic in Mississippi, 2018-2020. Public Health Rep 2023; 138:16S-21S. [PMID: 37226942 PMCID: PMC10226072 DOI: 10.1177/00333549221128221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
Adolescence, a critical and rapid stage of human development, requires innovative approaches in the provision of health care. With considerable mental health issues occurring among adolescents, an urgent need exists to address their mental and behavioral health. School-based health centers can provide an important safety net, particularly for young people who lack access to comprehensive and behavioral health care. We describe the design and implementation of behavioral health assessment, screening, and treatment services in a primary care school-based health center. We reviewed primary care and behavioral health measures as well as the challenges and lessons learned of this process. Five hundred and thirteen adolescents and young adults aged 14-19 years from an inner-city high school in South Mississippi were screened for behavioral health issues from January 2018 through March 2020, and all 133 adolescents deemed at risk for behavioral health issues received comprehensive health care. Lessons learned included the importance of recruiting behavioral health providers to ensure sufficient staff, establishing academic-practice arrangements to ensure funding, increasing student enrollment by improving the return rate of consent for care, and enhancing data collection through process automation. This case study may help inform the design and implementation of integrated primary and behavioral health care in school-based health centers.
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Affiliation(s)
- Angela A Duck
- School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA
| | - Kayla Carr
- School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA
| | - Crystal S Lim
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
| | - Jennifer C Robinson
- School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA
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Rosenbaum LL, Bhakta S, Wilcox HC, Pas ET, Girgis K, DeVinney A, Hart LM, Murray SM. Cultural Adaptation of the teen Mental Health First Aid (tMHFA) Program from Australia to the USA. SCHOOL MENTAL HEALTH 2023; 15:1-19. [PMID: 37359156 PMCID: PMC10107592 DOI: 10.1007/s12310-023-09576-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2023] [Indexed: 06/28/2023]
Abstract
teen Mental Health First Aid (tMHFA) is an evidence-based program developed in Australia that teaches young people in grades 10-12 how to identify and respond to signs of mental health challenges and crises among peers. Recognizing the growing adolescent mental health crisis in the USA, the National Council for Mental Wellbeing, in partnership with a Johns Hopkins University research team, used a multimethod research approach to adapt the program culturally and contextually from Australia to the USA. The goals of the study were to engage adolescents, MHFA instructors, and content area experts (N = 171) in a process to determine: how to retain the elements of the course that were evidence-based and effective while adapting the program for US students, what topics to add so US students have the essential information and skills teens needed to help a friend experiencing a mental health challenge or crisis, what changes to make to curriculum materials to ensure the style and delivery resonate with US students, and what tools to include so the program is implemented safely and with fidelity in diverse US schools. This paper outlines the adaptation process, including engaging participants, identifying key recommendations for modification, and making changes to the tMHFA program. The findings demonstrate the types of adaptations that may be needed to facilitate implementation and maintenance of program effectiveness when introducing tMHFA to new populations of students in the USA. In addition, the process outlined can be replicated toward this purpose as the program continues to expand both in the USA and in other countries.
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Affiliation(s)
- Lacey L. Rosenbaum
- Mental Health First Aid, National Council for Mental Wellbeing, Washington, DC USA
- Mental Health and Resilience Group, Cheverly, MD USA
- International Psychology Department, The Chicago School of Professional Psychology, Washington, DC USA
| | - Sanjana Bhakta
- Mental Health First Aid, National Council for Mental Wellbeing, Washington, DC USA
| | - Holly C. Wilcox
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Elise T. Pas
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Karen Girgis
- Mental Health First Aid, National Council for Mental Wellbeing, Washington, DC USA
| | - Aubrey DeVinney
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Laura M. Hart
- Centre for Mental Health, Melbourne School of Population and Global Health, Melbourne, Australia
- School of Psychology and Public Health, Le Trobe University, Melbourne, Australia
| | - Sarah M. Murray
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
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Lee H, Rauktis ME, Mulzet M, Jenkins AS. A Mixed-Methods Study Exploring the Educational Experiences of Foster Youth and Foster Parents During COVID-19. CHILD & ADOLESCENT SOCIAL WORK JOURNAL : C & A 2023:1-25. [PMID: 37363070 PMCID: PMC10024912 DOI: 10.1007/s10560-023-00922-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/23/2023] [Indexed: 06/28/2023]
Abstract
The COVID-19 pandemic and measures taken to decrease the spread impacted youth in foster care and foster parents in a myriad of ways. One critical yet unexplored area is how educational changes during the first 2 years of the pandemic impacted this specific group of youth in foster care and foster parents. This exploratory study used three methods: (1) A scoping review of the prior research on pandemics/climate events and school closures and the research from early 2020; (2) individual interviews and focus groups with foster parents and teachers; and (3) an online survey of 88 foster parents. We endeavored to include findings at each stage of the process. Research from prior epidemics and school closures and predictive models predicted learning losses which were verified by the findings in the survey and interviews. Foster parents reported that the youth in foster care had great difficulty concentrating with on-line delivery and the absence or greatly limited access to mental health services compounded the challenges. Even as children returned to classrooms, the behavior of children, youth resulted in suspensions and expulsions likely increasing learning losses. The discussion identifies some approaches to addressing COVID-19 learning gaps and the mental health needs of this vulnerable group of children and youth.
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Affiliation(s)
- Hyunji Lee
- Florida Institute for Child Welfare, Florida State University, Tallahassee, FL USA
| | - Mary E. Rauktis
- School of Social Work, University of Pittsburgh, Pittsburgh, PA USA
| | - Morgan Mulzet
- Information Sciences, University of Pittsburgh, Pittsburgh, PA USA
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Richards EC, Allen MR, Weiss MD. The Impact of School Closures on Service Utilization in School-Based Health Centers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4588. [PMID: 36901598 PMCID: PMC10001771 DOI: 10.3390/ijerph20054588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The pandemic was followed by a severe mental health crisis in youth with both an increase in the prevalence of mental health problems and a decrease in requests for and access to care. METHODS data were extracted from the school-based health center records in three large public high schools that include under-resourced and immigrant communities. Data from 2018/2019 (pre-pandemic), 2020 during the pandemic, and then in 2021 after the return to in-person school were compared regarding the impact of in-person, telehealth, and hybrid care. RESULTS Despite the increase in mental health needs globally, there was a dramatic decrease in referrals, evaluations, and the total number of students seen for behavioral health care. The time course of this decrease in care was specifically associated with the transition to telehealth, although treatment did not return to pre-pandemic levels, even after in-person care became available. CONCLUSIONS Despite ease of access and increased need, these data suggest that telehealth has unique limitations when delivered in school-based health centers.
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Jenkins L, Kinney J, Kaminski S, Howell J. Innovations in University-School Partnerships to Provide Mental Health Services. JOURNAL OF APPLIED SCHOOL PSYCHOLOGY 2023. [DOI: 10.1080/15377903.2023.2182859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Affiliation(s)
| | | | | | - James Howell
- Florida State University, Tallahassee, Florida, USA
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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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Prins SJ, Shefner RT, Kajeepeta S, Hatzenbuehler ML, Branas CC, Metsch LR, Russell ST. Collateral consequences of the school-to-prison pipeline: Adolescent substance use and developmental risk. Addict Behav 2023; 137:107524. [PMID: 36279712 PMCID: PMC11017990 DOI: 10.1016/j.addbeh.2022.107524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 10/05/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The adolescent health consequences of the school-to-prison pipeline remain underexplored. We test whether initiating components of the school-to-prison pipeline-suspensions, expulsions, and school policing-are associated with higher school-average levels of student substance use, depressed feelings, and developmental risk in the following year. METHOD We linked 2003-2014 data from the California Healthy Kids Survey and the Civil Rights Data Collection from over 4,800 schools and 4,950,000 students. With lagged multi-level models, we estimated relationships between the school prevalence of total discipline, out-of-school discipline, and police-involved discipline, and standardized school-average levels of 6 substance use measures and 8 measures of developmental risk, respectively. RESULTS The prevalence of school discipline predicted subsequent school-mean substance use and developmental risk. A one-unit higher prevalence of total discipline predicted higher school levels (in standard deviations) of binge drinking alcohol (0.14, 95% CI: 0.11, 0.17), drinking alcohol (0.15, 95% CI: 0.12, 0.18), smoking tobacco (0.09, 95% CI: 0.06, 0.12), using cannabis (0.16, 95% CI: 0.14, 0.19), using other drugs (0.17, 95% CI: 0.14, 0.21), and violence/harassment (0.16, 95% CI: 0.12, 0.2). Total discipline predicted lower levels of reported community support (-0.07, 95% CI: -0.1, -0.05), feeling safe in school (-0.12, 95% CI: -0.16, -0.09), and school support (-0.16, 95% CI: -0.19, -0.12). Associations were greater in magnitude for more severe out-of-school discipline. Findings were inconsistent for police-involved discipline. CONCLUSION Exclusionary school discipline and school policing-core elements of the school-to-prison pipeline-are previously unidentified population predictors of adolescent substance use and developmental risk.
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Gruhn M, Miller AB, Machlin L, Motton S, Thinzar CE, Sheridan MA. Child Anxiety and Depression Symptom Trajectories and Predictors over 15 Months of the Coronavirus Pandemic. Res Child Adolesc Psychopathol 2023; 51:233-246. [PMID: 36048373 PMCID: PMC9435416 DOI: 10.1007/s10802-022-00963-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2022] [Indexed: 01/25/2023]
Abstract
Repeated measures are required to monitor and map trajectories of mental health symptoms that are sensitive to the changing distal and proximal stressors throughout the coronavirus (COVID-19) pandemic. Understanding symptoms in young children is particularly important given the short- and long-term implications of early-onset internalizing symptoms. This study utilized an intensive longitudinal approach to assess the course and environmental correlates of anxiety and depression symptoms in 133 children, ages 4-11 (Mage = 7.35, SD = 1.03), in the United States during the COVID-19 pandemic. Caregivers completed 48 repeated assessments from April 7, 2020, to June 15, 2021, on child and caregiver mental health symptoms, family functioning, and COVID-19-related environmental changes. Results from a series of multilevel growth models demonstrate that child depression symptoms were highest following initial stay-at-home orders (April 2020) and linearly decreased over time, while child anxiety symptoms were variable over the 15-month period. Caregiver depression symptoms and family conflict significantly predicted levels of child depression symptoms. In contrast, caregiver depression symptoms, caregiver anxiety symptoms, and time spent home quarantining significantly predicted levels of child anxiety symptoms. Results suggest that depression and anxiety symptoms in young children may have unique trajectories over the course of the coronavirus pandemic and highlight symptom-specific risk factors for each symptom.
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Affiliation(s)
- Meredith Gruhn
- University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA.
| | - Adam Bryant Miller
- University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA
- RTI International, Research Triangle Park, NC, USA
| | - Laura Machlin
- University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA
| | - Summer Motton
- University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA
| | - Crystal Ei Thinzar
- University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, NC, USA
- University of North Carolina at Greensboro, Greensboro, NC, USA
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Preventing Youth Suicide: Potential "Crossover Effects" of Existing School-Based Programs. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:382-392. [PMID: 36484887 PMCID: PMC9734872 DOI: 10.1007/s11121-022-01473-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2022] [Indexed: 12/13/2022]
Abstract
Notable increases in youth mental health problems combined with strains on the already stretched mental health workforce raise concerns that there will be an ensuing increase in youth suicide thoughts, behaviors, and even deaths. Schools are recognized as crucial settings for youth mental health support and suicide prevention activities, yet schools also face staff shortages and ever-increasing responsibilities for student well-being. Evidence is emerging that prevention programs originally designed to improve problem-solving skills and social-emotional functioning in youth have demonstrated downstream, "crossover effects," that is, unanticipated benefits, on youth suicidal behavior. Relatively little research on crossover effects has been conducted within school settings, despite the strong potential for commonly administered programs to have an impact on later suicide risk. We review key suicide risk factors and their proposed mechanisms of action; we also discuss factors that may protect against suicide risk. We then identify upstream prevention programs targeting the same factors and mechanisms; these programs may hold promise for downstream, crossover effects on youth suicide risk. This paper is intended to provide a framework to help researchers, practitioners, and policymakers as they consider how to prevent youth suicide using existing school-based resources. Rigorous investigation of upstream prevention programs is urgently needed to determine ideal approaches schools and communities can deploy to prevent youth suicide.
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Zink H, Anderson K. Mental Health and Student Support Service Providers in the Schools: Understanding Access and Equity Across the United States. SCHOOL PSYCHOLOGY REVIEW 2023. [DOI: 10.1080/2372966x.2022.2139156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Lawson GM, Comly R, Beidas RS, Khanna MS, Goldstein J, Brizzolara-Dove S, Wilson T, Rabenau-McDonnell Q, Eiraldi R. Therapist and supervisor perspectives about two train-the-trainer implementation strategies in schools: A qualitative study. IMPLEMENTATION RESEARCH AND PRACTICE 2023; 4:26334895231190854. [PMID: 37790186 PMCID: PMC10403977 DOI: 10.1177/26334895231190854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
Background Train-the-trainer (TT) implementation strategies (in which designated clinicians are trained to then train others in an intervention) are promising approaches to support mental health clinician use of evidence-based interventions in school contexts. However, there is little evidence to date examining clinicians' perceptions of the acceptability and feasibility of TT strategies, or comparing clinicians' perceptions of different types of TT strategies. Methods The current study was conducted as part of a larger hybrid effectiveness-implementation trial, in which school-based therapists and supervisors received one of two different types of implementation support to implement cognitive behavioral therapy (CBT) groups for anxiety: TT (i.e., initial training for therapists and supervisors) or enhanced TT (TT+; i.e., initial training for therapists and supervisors, and ongoing external consultation for supervisors). We used applied thematic analysis to compare qualitative interview transcripts from 28 therapist interviews and 33 supervisor interviews from therapists and supervisors who received TT or TT+ support and report themes that were similar and different across the two groups. Results Most themes were similar across the TT and TT+ conditions: therapists and supervisors in both conditions perceived the group anxiety intervention as acceptable and viewed supervision as acceptable, helpful, and feasible. Therapists and supervisors in both conditions had mixed impressions of the contextual appropriateness of the group anxiety intervention, and some reported logistical challenges with weekly supervision. Some unique themes were identified among the TT+ condition, including supervisors experiencing professional growth, and therapists and supervisors perceiving supervision as critically important and enjoyable. Conclusions These results suggest that TT implementation support, using a model in which an internal supervisor receives initial training and then provides ongoing supervision, is acceptable and feasible to support a group CBT intervention in schools. The results also highlight additional benefits that therapists and supervisors perceived when supervisors received ongoing consultation. Clinical Trial Registration Information The clinical trial from which these data were derived was registered at ClinicalTrials.gov (https://clinicaltrials.gov/) prior to the time of first patient enrollment. The registration number is: NCT02651402.
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Affiliation(s)
- Gwendolyn M. Lawson
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Rachel Comly
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Rinad S. Beidas
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | | | | | - Tara Wilson
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - Ricardo Eiraldi
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Choi SY, Rusch A, Lane A, Liebrecht C, Bilek EL, Eisenberg D, Andrews C, Perry M, Smith SN. Individual and organizational factors as predictors of early evidence-based practice adoption in Michigan high schools: Baseline data from an implementation trial. IMPLEMENTATION RESEARCH AND PRACTICE 2023; 4:26334895231159429. [PMID: 37091540 PMCID: PMC10052498 DOI: 10.1177/26334895231159429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
Background Adolescents increasingly access mental health services in schools. School mental health professionals (SPs; school counselors, social workers, etc.) can offer evidence-based mental health practices (EBPs) in schools, which may address access gaps and improve clinical outcomes. Although some studies have assessed factors associated with EBP adoption in schools, additional research focusing on SP- and school-level factors is warranted to support EBP implementation as SPs’ mental health delivery grows. Methods Baseline data were collected from SPs at Michigan high schools participating in a statewide trial to implement SP-delivered cognitive behavioral therapy (CBT) to students. Models examined factors associated with attitudes about EBPs, implementation climate, and implementation leadership, and their associations with CBT knowledge, training attendance, and pre-training CBT delivery. Results One hundred ninety-eight SPs at 107 schools (87%) completed a baseline survey. The mean Evidence-Based Practice Attitude Scale (EBPAS) total score was 2.9, and school-aggregated mean scores of the Implementation Climate Scale (ICS) and Implementation Leadership Scale (ILS) were 1.83 and 1.77, respectively, all on a scale ranging from 0 ( low) to 4 ( high). ICS and ILS scores were lower than typically reported in clinical settings, while EBPAS scores were higher. School characteristics were not significantly associated with EBPAS, ICS, or ILS scores, but scores did differ by SP role. Higher EBPAS scores were associated with more CBT knowledge (average marginal effect for 1 SD change [AME] = 0.15 points) and a higher probability of training completion (AME = 8 percentage points). Higher ICS scores were associated with a higher probability of pre-training CBT delivery (AME = 6 percentage points), and higher ILS scores were associated with higher probability of training completion (AME = 10 percentage points). Conclusions Our findings suggest that SPs’ attitudes toward EBPs and organizational support were positively associated with early signs of implementation success. As schools increasingly fill the adolescent mental healthcare access gap, efforts to strengthen both provider attitudes toward EBP and strategic organizational factors supporting EBP delivery will be key to encouraging EBP uptake in schools. Plain Language Summary Schools are an important setting in which adolescents receive mental healthcare. We need to better understand how to implement evidence-based practices (EBPs) in this setting to improve student mental health. This study examined the attitudes and perceptions of school professionals (SPs) as key contributors to the implementation of a particular EBP, the delivery of cognitive behavioral therapy (CBT) in schools. The study found that implementation climate and leadership scores in participating schools were lower than scores typically reported in clinical settings, while scores for SP attitudes about EBP adoption were higher than typical scores in clinical settings. Results further suggest that SPs with more positive attitudes toward EBPs are more knowledgeable of CBT and more likely to complete a 1-day CBT training. We also found that higher implementation climate scores were associated with SPs reporting pre-training CBT delivery (although this association was not statistically significant), and more implementation leadership was associated with SPs completing the CBT training. These findings suggest that SP attitudes toward EBPs and organizational support in schools are positively associated with early signs of implementation success. Early, low-intensity efforts to (1) improve SP attitudes about mental health EBPs, and (2) increase schools’ support for implementation may scaffold more intensive implementation efforts in schools down the road.
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Affiliation(s)
- Seo Youn Choi
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Amy Rusch
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Annalise Lane
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Celeste Liebrecht
- Department of Learning Health Sciences, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Emily L. Bilek
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Daniel Eisenberg
- Department of Health Policy and Management, Fielding School of Public Health, UCLA, Los Angeles, CA, USA
| | - Carolyn Andrews
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Morgan Perry
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Shawna N. Smith
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
- Seo Youn Choi, Department of Health Management and Policy, University of Michigan, SPH II, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
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Runkle JD, Sugg MM, Yadav S, Harden S, Weiser J, Michael K. Real-Time Mental Health Crisis Response in the United States to COVID-19. CRISIS 2023; 44:29-40. [PMID: 34674553 DOI: 10.1027/0227-5910/a000826] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Background: Data are scarce on assessing the impact of the COVID-19 pandemic on young people. Aim: To examine changes in crisis text patterns in the United States during the pandemic compared to the prepandemic period. Method: Nonintrusive data from a national digital crisis texting platform were analyzed using an interrupted time series design. Poisson regression with repeated-measures examined help-seeking patterns for stress, anxiety, depression, suicidal thoughts, and other mental health concerns in the pandemic (March 13 to July 20, 2020) compared to the prepandemic period (March 13 to July 20, 2019). Results: An abrupt increase in national crisis response texts occurred during the pandemic for stress and anxiety, substance abuse, bereavement, isolation, and abuse compared to the prepandemic period. Similar trends of excess texts for isolation and abuse were reported among children (relative risk [RR]abuse: 1.16, CI: 1.03, 1.31; RRisolation: 1.15, CI: 1.09, 1.21) and adolescents (RRabuse: 1.17, CI: 1.11, 1.24; RRisolation: 1.08, CI: 1.05, 1.11), bereavement among Black (RR: 1.31, CI: 1.12, 1.54) and Hispanic (RR: 1.28, CI: 1.10, 1.49) texters, and isolation and bereavement in female (RRisolation: 1.09, CI: 1.06, 1.11; RRbereavement: 1.21, CI: 1.13, 1.28) or nonconforming youth (RRisolation: 1.19, CI: 1.08, 1.32; RRbereavement: 1.50, CI: 1.08, 2.09) texters. Conversely, the risks of reporting bullying, depression, relationship issues, and suicidal thoughts as reasons for texting were significantly lower during COVID-19. Limitations: Results may underestimate crisis support-seeking in some groups because demographic data were not captured on all texters. Conclusion: Findings illuminated the real-time crisis response of young people across the United States and can inform more responsive interventions to alleviate the mental health consequences brought on by the COVID-19 pandemic.
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Affiliation(s)
- Jennifer D Runkle
- North Carolina Institute for Climate Studies, North Carolina State University, Asheville, NC, USA
| | - Margaret M Sugg
- Department of Geography and Planning, Appalachian State University, Boone, NC, USA
| | - Shrikanth Yadav
- North Carolina Institute for Climate Studies, North Carolina State University, Asheville, NC, USA
| | - Stella Harden
- Department of Geography and Planning, Appalachian State University, Boone, NC, USA
| | | | - Kurt Michael
- Department of Psychology, Appalachian State University, Boone, NC, USA
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Chu W, Chorpita BF, Becker KD. Race, racial matching, and cultural understanding as predictors of treatment engagement in youth mental health services. Psychother Res 2022; 33:669-682. [DOI: 10.1080/10503307.2022.2150582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Wendy Chu
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Bruce F. Chorpita
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Kimberly D. Becker
- Department of Psychology, University of South Carolina, Columbia, SC, USA
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Fisher HH, Hawkins GT, Hertz M, Sliwa S, Beresovsky V. Student and School Characteristics Associated With COVID-19-Related Learning Decline Among Middle and High School Students in K-12 Schools. THE JOURNAL OF SCHOOL HEALTH 2022; 92:1027-1039. [PMID: 35989509 PMCID: PMC9538687 DOI: 10.1111/josh.13243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/15/2022] [Accepted: 08/01/2022] [Indexed: 05/15/2023]
Abstract
BACKGROUND COVID-19-disrupted schools, including shifts to virtual learning which may have impacted academic progress. This study assessed characteristics associated with changes in academic grades (before and during the pandemic) for different learning modalities for US students ages 13-19. METHODS Students (N = 2152) completed a web survey on school-related experiences during the 2020-2021 school year. County social vulnerability and SARS-CoV-2 transmission data were merged with survey data. Multivariable logistic regression analysis for grade change was conducted with student and school characteristics for each learning modality, controlling for community characteristics. RESULTS Greater proportions of remote/virtual (34.4%) and hybrid (30.1%) learning students reported grade decline compared to in-person students (19.9%). Among in-person students, odds of reporting same/improved grades were 65% lower among non-Hispanic black students and 66% lower among non-Hispanic students from other races, compared to non-Hispanic white students. Among hybrid students, odds of reporting same/improved grades for students reporting anxiety were 47% lower than students without anxiety, and odds of reporting same/improved grades among students reporting substance use were 40% lower than students not reporting substance use. Among remote/virtual students, odds of reporting same/improved grades among students with depression were 62% lower than odds of students not reporting depression symptoms. Remote/virtual students who received school-provided educational services also had 1.55 times the odds of reporting same/improved grades, compared to remote/virtual students not receiving these services. CONCLUSIONS Academic grades were negatively impacted during COVID-19 and learning mode may have contributed. Understanding these impacts is critical to student health and academic achievement.
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Affiliation(s)
- Holly H. Fisher
- Division of Viral HepatitisNational Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and PreventionAtlantaGA
| | - Georgianne T. Hawkins
- Division of Population HealthNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and PreventionAtlantaGA
| | - Marci Hertz
- Division of Adolescent and School HealthNational Center for HIV, Hepatitis, STD, and Tuberculosis Prevention, Centers for Disease Control and PreventionAtlantaGA
| | - Sarah Sliwa
- Division of Population HealthNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and PreventionAtlantaGA
| | - Vladislav Beresovsky
- Division of Research and MethodologyNational Center of Health Statistics, Centers for Disease Control and PreventionHyattsvilleMD
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48
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Gallardo M, Zepeda A, Biely C, Jackson N, Puffer M, Anton P, Dudovitz R. School-Based Health Center Utilization During COVID-19 Pandemic-Related School Closures. THE JOURNAL OF SCHOOL HEALTH 2022; 92:1045-1050. [PMID: 35945893 PMCID: PMC9538881 DOI: 10.1111/josh.13226] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 07/10/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Little is known regarding utilization of school-based health centers (SBHCs) during prolonged school closures, such as those that occurred during the COVID-19 pandemic. We sought to compare SBHC utilization before and after pandemic-related school closures across a network of SBHCs affiliated with a large Southern Californian urban school district. METHODS We conducted a secondary analysis of encounter data extracted from electronic health records from 12 SBHCs that remained open despite school closures, including patient demographics and diagnostic and billing codes. We used the Clinical Classifications Software Refined to group encounters for common primary care conditions. Utilization before and during pandemic-related school closures was compared using logistic regression with cluster-robust standard errors to account for clustering within clinics, after adjusting for month of encounter. RESULTS During the pandemic, study SBHCs conducted 52,530 encounters and maintained ∼4040 encounters/month. The frequency of encounters for annual preventative health exams increased for school-aged patients but decreased for other age groups while the frequency of encounters for mental health problems increased for all age groups. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY Despite pandemic-related school closures, SBHCs appeared play a critical role in providing primary care to vulnerable communities. CONCLUSIONS SBHCs may hold value beyond their co-location with academic instruction.
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Affiliation(s)
| | - Alex Zepeda
- The L.A. Trust for Children's HealthLos AngelesCA
| | - Christopher Biely
- David Geffen School of Medicine at UCLA, Los Angeles, CA; UCLA Department of PediatricsLos AngelesCA
| | - Nicholas Jackson
- David Geffen School of Medicine at UCLA, Los Angeles, CA; UCLA General Internal MedicineLos AngelesCA
| | | | | | - Rebecca Dudovitz
- David Geffen School of Medicine at UCLA, Los Angeles, CA; UCLA Department of PediatricsLos AngelesCA
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49
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Wood BJ, Ellis F. Universal Mental Health Screening Practices in Midwestern Schools: A Window of Opportunity for School Psychologist Leadership and Role Expansion? CONTEMPORARY SCHOOL PSYCHOLOGY 2022:1-11. [PMID: 36217533 PMCID: PMC9534464 DOI: 10.1007/s40688-022-00430-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 09/22/2022] [Indexed: 11/20/2022]
Abstract
The conducting of universal mental health screening is one widely endorsed practice suitable for use within P-12 school settings to more proactively identify children and young people experiencing or displaying characteristics of a mental health disorder. Absent routine screening, many school-age youth with mental health concerns, especially those of an internalizing nature, may go unidentified and left without timely treatment, support, and services. The current study, which employed survey methodology with principal respondents from four Midwestern states, primarily sought to contribute to and update the literature on the universal mental health screening practice habits of P-12 schools. Most principal respondents reported that their school does not currently conduct universal mental health screening and cited barriers (e.g., money, time, lack of support system in place) to screening commonly documented in prior studies. Many principals reported at least a moderate degree of interest in their school beginning to conduct universal screening in their buildings; however, a similar majority reported little to no knowledge about this important practice. Fortunately, principal respondents were generally interested in and receptive to support from their school psychologist in exploring and eventually implementing the conducting of universal mental health screening in their building. Implications for practice and future research, along with the potential for school psychologist leadership and role expansion, are discussed.
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Affiliation(s)
- Brandon J. Wood
- School of Intervention and Wellness, University of Toledo, 2801 W. Bancroft St, Toledo, OH 43606 USA
| | - Faith Ellis
- School of Intervention and Wellness, University of Toledo, 2801 W. Bancroft St, Toledo, OH 43606 USA
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50
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Chavira DA, Ponting C, Ramos G. The impact of COVID-19 on child and adolescent mental health and treatment considerations. Behav Res Ther 2022; 157:104169. [PMID: 35970084 PMCID: PMC9339162 DOI: 10.1016/j.brat.2022.104169] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 07/14/2022] [Accepted: 07/22/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Denise A. Chavira
- University of California Los Angeles, Department of Psychology, USA,Corresponding author. 1285 Franz Hall, PO Box 951563, Los Angeles, CA 90095, USA
| | - Carolyn Ponting
- University of California Los Angeles, Department of Psychology, USA,University of California San Francisco, Department of Psychiatry and Biobehavioral Sciences, USA
| | - Giovanni Ramos
- University of California Los Angeles, Department of Psychology, USA
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