Good interaction skills are not enough - competency in mental health issues in child health clinics and school health services

Adolescent boys' experiences of mental health and school health services - an interview study from Norway

BACKGROUND

Mental health problems among adolescents is a global challenge. During the transition to adolescence, physiological, psychological, and social changes occur, leading to increased vulnerability. Thus, adolescent boys are less likely to seek help for mental health problems, which makes them an undetected group. The aim of this study was to gain a deeper understanding of adolescent boys' experiences of mental health and school health service.

METHODS

An inductive, qualitative design was chosen using three focus group interviews and three individual interviews. The study included 18 adolescent boys in 7th grade, in a school located in a medium-sized municipality in Norway. The interviews were analysed with qualitative content analysis. The consolidated criteria for reporting qualitative research (COREQ) were followed in this study.

RESULTS

The overall theme "barriers towards seeking help", and three categories- navigating stigma and privacy concerns; perceptions of self-responsibility; and lacking knowledge of mental health problems and help-seeking-described the adolescent boys experiences. The awareness and willingness to seek help were present, but there are barriers preventing the adolescent boys from acting on that willingness.

CONCLUSIONS

Lack of knowledge and a non-permissive culture for mental health problems among adolescents contributes to decreased help-seeking behaviour among adolescent boys. The school health service is the most related health service for adolescents and should focus on being available and strengthening empowerment and mental health literacy through the development and implementation of interventions to promote mental health.

The Perceived Power and Powerlessness in School Health Nurses' Mental Health Promotion Practices: A Synthesis of Qualitative Studies

Schools are important arenas for mental health promotion initiatives. School nurses have the opportunity and ability to support and promote students' mental health, but their role and practices have been perceived as somewhat unclear. Therefore, the aim of this study was to explore school nurses' mental health promotion practices. A total of 12 scientific studies were synthesized through a meta-ethnographic approach. The overarching results of the synthesis show that school nurses' mental health promotion practices are largely about balancing and combining the students' needs with different professional perspectives, competencies, and conditions. The school nurses perceived that they had the power to influence their practices through a variety of ways, highlighting the importance of letting the students' needs guide the practices. Yet, at the same time they described feelings of powerlessness because of the different organizational structures that were hindering their mental health promotion practices.

Meanings of nurses' role in Child and Adolescent Psychosocial Care Centers

OBJECTIVE

to analyze the meaning attributed to nurses' role in mental health care in Child and Adolescent Psychosocial Care Centers.

METHODS

qualitative research, anchored in the paradigm of complexity. Data collection was carried out through online semi-structured interviews with ten nurses from São Paulo, between March and September 2022, being analyzed thematically.

RESULTS

the diversity and specificity of a child and adolescent mental health clinic, with the need for expanded, territorial and intersectoral care, were unveiled in addition to a fragmented training in the area. There was a need for a deconstruction of being a nurse to make it possible to produce more inclusive and salutogenic practices.

FINAL CONSIDERATIONS

the need for training nurses with adequate knowledge and skills to care for the mental health of children, adolescents and their families is reinforced as well as permanent education of working teams.

"Our Job is to be so Temporary": Designing Digital Tools that Meet the Needs of Care Managers and their Patients with Mental Health Concerns

Digital tools have potential to support collaborative management of mental health conditions, but we need to better understand how to integrate them in routine healthcare, particularly for patients with both physical and mental health needs. We therefore conducted interviews and design workshops with 1) a group of care managers who support patients with complex health needs, and 2) their patients whose health needs include mental health concerns. We investigate both groups' views of potential applications of digital tools within care management. Findings suggest that care managers felt underprepared to play an ongoing role in addressing mental health issues and had concerns about the burden and ambiguity of providing support through new digital channels. In contrast, patients envisioned benefiting from ongoing mental health support from care managers, including support in using digital tools. Patients' and care managers' needs may diverge such that meeting both through the same tools presents a significant challenge. We discuss how successful design and integration of digital tools into care management would require reconceptualizing these professionals' roles in mental health support.

Mental health services in the school environment-Future visions using a phenomenographic approach

AIMS AND OBJECTIVES

First, to describe the variation in stakeholders' perceptions related to the desirable mental health services in school environments. Second, to construct alternative future visions based on these perceptions. Finally, to describe stakeholders' perceptions about the actions needed to reach such an ideal state.

BACKGROUND

The increased need for mental health care has challenged the role of schools and school health care in the area of mental health services for those of school-age. There is a need for future visions and comprehensive statements concerning the mental health services provided in the school environment.

DESIGN

The study was undertaken in Finland, between February 2020 and February 2021. Qualitative individual interviews were conducted with 15 professional stakeholders and focus group interviews with 10 stakeholders advocating for adolescents or parents.

METHOD

The study was conducted with the phenomenographic approach using a visioning methodology. The study is reported following the COREQ checklist.

RESULT

Four alternative future visions were formulated based on the perceptions of the stakeholders. They emphasised different aspects: (1) non-medicalising the school environment, (2) early and extensive intervention by school nurses enabled by work distribution with mental health specialists, (3) a multiprofessional team providing help on overall health questions and (4) a focusing of the services on mental disorders. Necessary changes were identified at the micro-, mezzo- and macro-level.

CONCLUSION

The future visions are based on opposite perceptions related to the mission and focus of school health care. One extreme emphasises overall health promotion for everyone, while the other accentuates treatment for those suffering from mental disorders. The former may lead to inadequate help for mental health problems and the latter insufficient help for other health problems.

RELEVANCE TO CLINICAL PRACTICE

This study contributes alternative future visions, promotes strategic planning and helps to clarify the future role of school nurses.

Examining family and community nurses' core competencies in continuing education programs offered in primary health care settings: An integrative literature review

AIM

To identify gaps in existing family and community nurse (FCN) continuing education programs and to investigate whether FCN core competencies are covered in continuing education programs offered in primary health care settings.

BACKGROUND

In global pandemics such as COVID-19, there is an urgent need for staff development using transformative learning and help registered nurses build up their competencies and form a new professional identity as family and community nurses (FCNs). Therefore, FCN education programs become of high importance to enhance nurses' core competencies through continuing education.

METHODS

An integrative review of the literature was conducted applying the Whittemore and Knafl methodological strategy for studies published between 2015- June 2021.

RESULTS

FCN core competencies, including the "decision-making process, navigation as care coordinator and patient advocate and promoting individual and family health to support the quality of nursing care," were poorly covered in the FCN programs. Specifically, e-health played a very limited role in FCN continuing education, while ethics, managing change, managing disparity and diversity and leadership skills, did not emerge at all.

CONCLUSION

The identified gaps can be incorporated into future FCN continuing education programs and may help improve nurses' competence and health care delivery and support new integrated models of care, namely, person-centered and community-based models.

Experiences of Norwegian child and school health nurses with the "Starting Right™" child health assessment innovation: a qualitative interview study

Background

Although child health services are well established in Norway, the use of information technology for the systematic collection of evidence-based child- and proxy-reported health measures may be beneficial in the early identification of child development problems. The Norwegian “Starting Right™” health service innovation consists of parent- and child-reported online structured health assessments tools, including practical routines for child and school health assessments. The aim of this study was to explore the experiences of child and school health nurses with the Starting Right innovation.

Methods

We used a qualitative design and conducted three focus group interviews with 18 child and school health nurses from three child health centres one year after the implementation of the innovation.

Results

The experiences of professionals with the Starting Right innovation were captured by three themes: (1) the digital innovation could be used to obtain a good overview of a child’s health and development; (2) interpreting the questionnaires was a challenge; and (3) implementing the new digital innovation was time-consuming.

Conclusions

Overall, the child and school health nurses experienced that the Starting Right innovation was useful for providing a comprehensive overview of child development and health. The challenges related to interpreting the parents’ scores and follow-up of children, as well as providing the questionnaires in relevant foreign languages, should be addressed to allow all children and families to be reached.

School Nurses’ Experiences in Dealing with Adolescents Having Mental Health Problems

Introduction

An increased number of adolescents experience mental health problems. School nurses have described spending more than 50% of their time working with mental health in students. The lack of knowledge and necessary training to meet students’ mental health needs has been described previously. School nurses have a responsibility to find and guide those who need help with mental health problems.

Objectives

The aim of this study was, therefore, to explore school nurses’ experiences with mental health and how they in this work identify, talk, and intervene with adolescents having mental health problems.

Methods

A qualitative study was conducted with 21 school nurses using focus group interviews which were analyzed by means of content analysis.

Results

Three descriptive categories emerged: Health-promoting or preventive approaches, Enabling students to talk about feelings, and Collaborating partners.

Conclusion

School nurses highlight their mandate to work with health promotion and prevention but also draw attention to their difficulties in identifying those who need help. School nurses use their creativity, intuition, and knowledge but have difficulty identifying those students who need help with mental health problems. They also highlight collaboration with other professionals both in schools and in the health system.