Preparing for the Impact of COVID-19 on the Mental Health of Youth

Outer-context determinants on the implementation of school-based interventions for LGBTQ+ adolescents

Background

Schools are critical venues for supporting LGBTQ+ youth well-being. Implementing LGBTQ-supportive practices can decrease experiences of stigmatization, discrimination, and victimization that lead to adverse mental health outcomes like anxiety, depression, and suicidality. However, schools are also subject to a wide range of outer-context pressures that may influence their priorities and implementation of LGBTQ-supportive practices. We assessed the role of emergent outer-context determinants in the context of a 5-year cluster randomized controlled trial to study the implementation of LGBTQ-supportive evidence-informed practices (EIPs) in New Mexico high schools.

Method

Using an iterative coding approach, we analyzed qualitative data from annual interviews with school professionals involved in EIP implementation efforts.

Results

The analysis yielded three categories of outer-context determinants that created challenges and opportunities for implementation: (a) social barriers related to heterocentrism, cisgenderism, and religious conservatism; (b) local, state, and national policy and political discourse; and (c) crisis events.

Conclusions

By exploring the implications of outer-context determinants for the uptake of LGBTQ-supportive practices, we demonstrate that these elements are dynamic-not simply reducible to barriers or facilitators-and that assessing outer-context determinants shaping implementation environments is crucial for addressing LGBTQ health equity.

Adolescent Anxiety, Depression and Flourishing before and During COVID-19 and the Predictive Role of Baseline Psychological Capital (PsyCap) on Student Mental Health and Subjective Wellbeing During the Pandemic

Studies indicate the COVID-19 pandemic has resulted in rises in adolescent mental health symptoms globally, although the impact of the pandemic on subjective wellbeing is under-researched in this population. Psychological capital (PsyCap), a cluster of four positive psychological constructs comprising hope, efficacy, resilience and optimism (HERO), has demonstrated preventative and promotive qualities on mental health symptoms and subjective wellbeing outcomes with adult populations (employees, university students). However, PsyCap's influence on these outcomes in young people is unclear. The present exploratory study investigated changes in self-reported anxiety and depressive symptoms (measured via the RCADS-SV) and subjective wellbeing (measured by the Flourishing Scale) from pre-pandemic levels to 3 months into the pandemic and explored gender differences at each time point in a sample of Australian Year 10 students (N = 56, Mage = 14.93 years, SD = 0.50, 51.8% male). The longitudinal predictive role of baseline PsyCap on follow-up assessments of anxiety symptoms, depressive symptoms and flourishing were also examined. There were no significant changes in levels of anxiety and depressive symptoms between the timepoints, but flourishing significantly declined from T1 to T2. Baseline PsyCap was not a significant predictor of T2 anxiety and depressive symptoms but was a significant predictor of T2 flourishing. Further, different baseline HERO constructs predicted T2 mental health symptoms and flourishing. Future larger studies building on the current preliminary findings investigating the roles of student PsyCap, mental health and subjective wellbeing are warranted to better understand these constructs in the COVID-19 era and beyond.

School Nurse Management of Behavioral Health, Violence, and Trauma-Related Emergencies: Findings from a Statewide Survey

School nurses are critical components of school-based interdisciplinary teams supporting student behavioral health. The purpose of the present study is to understand the extent to which school nurses in New Mexico across grade levels manage emergencies related to behavioral health, violence, and trauma. The study also seeks to identify which topics the school nurses received continuing education (CE) for, and which topics they consider to be important to their practice. Analyses of 2019 statewide survey data show a considerable number of school nurses in New Mexico provide management for behavioral health, violence, and trauma-related emergencies, and nurses in secondary schools are significantly more likely than nurses in primary schools to report managing these emergencies and to have received CE on behavioral health topics. Our findings reaffirm the essential role of school nurses in addressing emergent student health issues and underscore the need for practice- and competency-based behavioral health CE opportunities.

Problemas emocionais e comportamentais em adolescentes no contexto da COVID-19: um estudo de método misto

Resumo Objetivo: estimar a prevalência de problemas emocionais e comportamentais em adolescentes no contexto da pandemia de COVID-19 e explorar a percepção dos adolescentes sobre os problemas emocionais e comportamentais identificados. Método: estudo de método misto de desenho explanatório sequencial. Participaram 479 adolescentes de 15 a 18 anos de uma capital do Centro-Oeste brasileiro. Resultados: dos 479 participantes, a média de idade foi de 16,03 anos (DP=1,01). A prevalência de problemas emocionais e comportamentais foi de 61,17% e houve diferença em relação ao sexo (ORb=2,93; p<0,01). As maiores prevalências foram relativas aos problemas de relacionamentos com os pares (54,49%) e aos sintomas emocionais (52,40%). Os adolescentes perceberam o aumento de solidão, ansiedade, tristeza, distanciamento dos amigos e dificuldades de socialização durante a pandemia. Conclusão: a maioria dos adolescentes foi classificada com problemas emocionais e comportamentais, sendo que as meninas apresentaram maior chance de manifestá-los em comparação aos meninos. Os depoimentos dos adolescentes reforçam os resultados quantitativos. Dessa forma, nota-se a necessidade de implementar ações de promoção e restabelecimento da saúde mental dos adolescentes, de modo a mitigar o impacto socioemocional da pandemia de COVID-19 junto a essa população.

Emotional and behavioral problems in adolescents in the context of COVID-19: a mixed method study

Abstract Objective: to estimate the prevalence of emotional and behavioral problems in adolescents in the context of the COVID-19 pandemic e to explore adolescents’ perception of emotional and behavioral problems identified. Method: mixed-method explanatory sequential design. Participants were 479 adolescents aged 15 to 18 from a Brazilian Central-West region capital. Results: with a total of 479 participants, mean age was 16.03 years (SD=1.01). The prevalence of emotional and behavioral problems was 61.17%, and there was a difference between the sexes (ORb=2.93; p<0.01). The highest prevalence was related to peer relationship problems (54.49%) and emotional symptoms (52.40%). Adolescents noticed an increase in loneliness, anxiety, sadness, distancing from friends and difficulties in socializing during the pandemic. Conclusion: most of the investigated adolescents were classified as having emotional and behavioral problems, and girls were more likely to have them than boys. The adolescents’ statements reinforce the quantitative findings. In this way, there is a need to implement actions to promote and restore the adolescents’ mental health, in order to mitigate the COVID-19 pandemic socio-emotional impact on this population.

Problemas emocionales y de comportamiento en adolescentes en el contexto de COVID-19: un estudio de método mixto

Resumen Objetivo: estimar la prevalencia de problemas emocionales y de comportamiento en adolescentes en el contexto de la pandemia de COVID-19 e explorar la percepción de los adolescentes acerca de los problemas emocionales y de comportamiento identificados. Método: un estudio de método mixto de diseño explicativo secuencial. Participaron 479 adolescentes de 15 a 18 años de una capital de la región Centro-Oeste brasileña. Resultados: de los 479 participantes, la media de las edades fue los 16,03 años (DP=1,01). La prevalencia de PEC fue del 61,17% y había una diferencia en cuanto al sexo (ORb=2,93; p<0,01). Las mayores prevalencias se relacionaron con los problemas de relación entre pares (54,49%) y con los síntomas emocionales (52,40%). Los adolescentes notaron un aumento de soledad, ansiedad, tristeza, alejamiento de amigos y dificultades de socialización durante la pandemia. Conclusión: se clasificó la mayoría de los adolescentes investigados con problemas emocionales y de comportamiento, y las chicas presentaron una mayor probabilidad de manifestarlos en comparación con los chicos. Las declaraciones de los adolescentes refuerzan los resultados cuantitativos. Así, se señala la necesidad de implementar acciones para promover y restaurar la salud mental de los adolescentes, para mitigar los impactos socioemocionales de la pandemia de COVID-19 en esa población.

Student safety in middle school: Implications for school nurse and teacher collaboration

OBJECTIVE

Adolescent suicide is a public health crisis. School connectedness, a protective factor, may be especially important in low-income rural schools, with fewer resources and higher rates of suicide as compared to urban schools. The purpose of this study was to explore teacher perceptions of safety and school connectedness in a low-income, rural middle school, and implications for collaborative practice between school nurses and teachers.

DESIGN AND SAMPLE

A qualitative secondary data analysis was used. Data were taken from transcripts from four focus groups comprised of middle school teachers (n = 20).

MEASUREMENT

An inductive approach to content analysis was conducted using in vivo Coding and Venn diagrams.

RESULTS

Three themes were identified: (1) defiant and aggressive student behaviors were safety concerns, as teachers perceived they may be obscuring mental health needs; (2) teachers were sometimes placed in a position to assist students with safety management strategies; and (3) managing safety concerns was an obstacle to building connectedness, as reflected in safety and school connectedness.

CONCLUSION

Collaborative strategies between school nurses and teachers are essential to identify student behaviors that may be masking mental health needs. Strategies have the potential to enhance school connectedness and support student safety.