Youth Mental Health Research Articles

"When one has no REAL illness"-analysis of the knowledge component of mental health literacy in children and adolescents of parents with a mental illness.

Mental Health Literacy (MHL) is important in promoting youth mental health. One key aspect of MHL is knowledge about mental disorders, which is particularly relevant for populations at risk for developing mental disorders, such as children of parents with a mental illness (COPMI), representing a mechanism within the transgenerational transmission. Currently, COPMI's level of disorder knowledge in general, and about the specific parental disorder has not been comprehensively researched. We, therefore, aimed to assess COPMI's disorder knowledge and clarify its association with COPMI's age and sex exploratively. To assess both general and disorder-specific knowledge, we took a novel approach that makes disorder knowledge comparable across samples and over time. A mixed method analysis of N = 181 semi-structured MHL interviews with COPMI (aged 5 to 17 years) was carried out in the COMPARE-family study in Germany. We conducted a DSM-oriented deductive qualitative content analysis to assess COPMI's general and specific disorder knowledge. Chi-square tests served to identify age and sex differences. Children revealed limited knowledge of mental disorders in general, whereas adolescents displayed more knowledge that was also partly consistent with descriptions of classification systems like the DSM-5. The level of specific knowledge about the parent's disorder depended on the disorder group. More children displayed adequate knowledge of somatic and anxiety disorders compared to trauma and depressive disorders, and more adolescents displayed adequate knowledge of depressive and anxiety disorders. COPMI's age and sex were found to be significantly associated with disorder knowledge: adolescents exhibited higher levels of adequate general and specific disorder knowledge, and males exhibited higher levels of adequate general disorder knowledge. Assessing COPMI's disorder knowledge and identifying associated age and sex differences yield valuable insights into the knowledge component of the MHL theory. Our findings can help to improve psychoeducational interventions for COPMI by orienting them to their prevailing levels of disorder knowledge. We recommend employing and extending the DSM-oriented deductive approach to assess knowledge within MHL. Analyses involving additional assessments within the COMPARE-family study are in preparation to identify potential knowledge gains over time, and associations to COPMI's own well-being and mental health symptoms.

Strengthening Youth Emotional and Behavioral Well-Being Through Community-Academic Partnership: The EMPOWER Project.

The onset of mental health issues frequently starts during adolescence, where one third of adolescents who are 14 years and younger receive a mental health diagnosis. The state of youth mental health is a major public health concern. The EMPOWER project was developed during the COVID-19 pandemic to address youth mental health. The EMPOWER project is a partnership between two after-school programs and an academic mental health hospital in Toronto, Canada, that aims to bolster youth mental well-being. In this Practice Note, we share our community-based participatory research process of how we built the EMPOWER partnership and highlight our lessons learned so far. Through EMPOWER, we aim to codesign, deliver, and evaluate a scalable, evidence-based, and community-informed youth mental wellness curriculum that will be implemented in after-school programs.

Psychometric properties of the nine-item avoidant/restrictive food intake disorder screen (NIAS) in Turkish adolescents

BackgroundThis study evaluates the psychometric properties of the Turkish version of the Nine-Item Avoidant/Restrictive Food Intake Disorder Screen (NIAS) in a population of Turkish adolescents.MethodThe NIAS, designed to screen for ARFID symptoms, including picky eating, fear-related eating behaviors, and low appetite, was administered to secondary school students between 13 and 18 ages in Muğla, Turkiye.ResultsBased on a sample of 268 adolescents, the NIAS’s reliability and validity in this demographic are supported. The research utilized confirmatory factor analysis to verify its three-factor structure and various reliability tests, including Cronbach’s alpha and test-retest reliability, confirming the scale’s internal consistency and temporal stability. The descriptive analysis highlighted significant differences in NIAS scores across BMI categories, with underweight adolescents scoring higher, suggesting a potential link between ARFID symptoms and lower body weight. Criterion validity was supported by significant correlations between NIAS subscales and measures of anxiety, depression, and eating behaviors, indicating the scale’s effectiveness in reflecting relevant psychopathological features.ConclusionOverall, the study establishes the Turkish NIAS as a useful tool for identifying ARFID in Turkish adolescents, aiding early detection and intervention in this at-risk age group. Further research is recommended to explore the scale’s utility across different clinical settings and refine its diagnostic accuracy, enhancing our understanding of ARFID’s impact on youth mental health and nutritional status.

Effect of Summer Holiday Programs on Children's Mental Health and Well-Being: Systematic Review and Meta-Analysis.

Poor youth mental health is an area of global concern. Summer holiday programs may provide environments that support mental health when the structures and supports of school are not available. The aim of this review was to determine the effectiveness of summer holiday programs in improving the mental health, social-emotional well-being, and cognitive (non-academic) outcomes of children and adolescents. Studies of summer holiday programs for school-aged children (5-18 years) were included if they measured any mental, socio-emotional or cognitive (non-academic) outcome. Studies were excluded if they were published prior to 2000, targeted clinical populations or lasted less than five days. Six databases were searched (April 2023). Risk of bias was assessed using the PEDro tool. Study outcomes were grouped according to three main constructs: mental health (psychological well-being, anxiety, depression, distress, and self-perception including self-esteem, self-worth, self-concept, confidence, and competence); social-emotional well-being (behavior and social skills, e.g., communication, bullying, conflict resolution, empathy, and social skills); and cognitive function (memory, selective attention, and executive function). A fourth "other" group captured substance use, personality traits, character skills, and values. Effect sizes were calculated as the standardized mean difference between pre- and post-intervention scores. The synthesis involved a random-effects meta-analysis (presented in forest plots), where possible, with the remaining outcomes narratively synthesized. Twenty-six studies (n = 6812 participants) were included. The results of the meta-analysis suggested that summer programs showed a statistically non-significant trend toward reducing symptoms of anxiety and depression (k = 2 studies, SMD = -0.17, 95% CI -2.94, 2.60), psychological distress (k = 2 studies, SMD -0.46, 95% CI -1.71, 0.79), and no effect on self-esteem (k = 6 studies, SMD = 0.02, 95% CI -0.02, 0.06) or self-worth (k = 3 studies, SMD = 0.05, 95% CI 0.00, 0.11). Narrative syntheses indicated a pattern toward improvements in general mental health, self-perception, social-emotional outcomes, and cognition. Studies were generally small, with a high risk of bias. Summer holiday programs for children and adolescents show trends toward improving mental, social, emotional, and cognitive outcomes. Programs targeting disadvantaged children showed stronger patterns of improvement related to mental health and self-perception than programs targeting the general population. While effect sizes are small to negligible, they consistently indicate improvements. Summer programs present a promising avenue to promote mental health in children; however, further rigorously designed, clearly reported control-group studies are required to more fully understand their effects.

Make (digital) space for and with the young: Arts-inspired co-design of civic tech for youth mental health policies

Public engagement, digital or in-person, is mostly adult-centric and ableist, often universalising the experience of participation of a narrow demographic (white, older and middle class). In Mindset Revolution we combined arts-based and creative methods with civic tech to co-design participatory spaces with a diverse group of young people, where to discuss and influence mental health policy and practice. The paper examines the digital element of the project, where young people, supported by a team of academics and digital designers, used the Decidim civic tech platform to engage with their peers and policymakers. This co-design work helped inform changes to the platform towards more accessible and margin-responsive participation that can better support active engagement of traditionally excluded groups. The young people evaluated their own participation and social impact, challenging assumptions about youth participation. The flexibility afforded by the digital platform was crucial to sustain engagement. However, although often branded as digital natives, the young people we worked with perceived digital participation as an enabler but not a central element of their work on social change. Follow-up work on the platform is shaping it as a space for collective oversight, with opportunities for open-ended dialogue between young people, the community and policymakers to identify and navigate barriers to implementation of young people’s proposals.

Welfare of the therapy animal within facilitated youth psychotherapy: A scoping review

As mental health challenges grow in prevalence within the youth population in the United States, professionals within the industry are looking to alternative therapeutic approaches where other therapeutic interventions have failed. This has led to the growth of therapeutic interventions utilizing animals as a complementary approach in psychotherapy addressing the mental health of youth. Nevertheless, with this growth comes the concern of the welfare of the therapy animal, particularly with the prevalence of animal abusive behaviors associated with various youth mental health disorders. Thus, a scoping review was conducted with an aim to compile research conducted on therapy animals in youth psychotherapy to uncover themes within the studies available and to determine potential areas for which further research is needed. Four questions were developed to target therapy animal welfare within youth psychotherapy. These questions were utilized for the scoping review and within each question inclusion and exclusion criteria were implemented. Reviewed literature determined limited research targeting welfare assessment methods outside of heart rate measurement, cortisol concentration, and behavioral stress scaling using ethograms. Further areas lacking within the literature reviewed were associated with the makeup of the therapy session including the breeds of animals utilized and the lengths of the therapy sessions. Each question independently lacked substantial research as fifteen articles was the largest number of articles reviewed within a question after application of inclusion and exclusion criteria. In addition, all questions resulted in contradictions within the findings and had at least one inclusion criteria where no articles were available. Further, when reviewing across all four questions, the horse and dog were the only therapy animals studied within the reviewed literature. As such, further research is warranted targeting areas where research is lacking in order to ensure the welfare of animals being utilized within a youth psychotherapy setting.

Tuned In! An affirmative mindfulness intervention for sexual and gender diverse young people

Sexual and gender diverse youth and young adults (SGDY) experience significant mental health disparities compared to non-SGDY, which is exacerbated by ongoing anti-LGBTQIA + political attacks across the U.S. SGDY lack access to culturally responsive mental health supports and are overlooked in clinical practice/research. Mindfulness is a transformative practice that fosters well-being and provides tools to address the psychological impact of discriminatory experiences. This study investigated feasibility, acceptability, and outcomes of a mindfulness-based intervention (MBI), Tuned In!, co-developed with SGDY to improve mental health and navigate and challenge the current anti-LGBTQIA + sociopolitical context. Participants (n = 56), 16 to 29 yrs., were recruited and participated online. Surveys were administered pre, post-intervention, and at 6-month follow-up. Hierarchical Linear Modeling and Reflexive Thematic Analysis were used to analyze data. Rates of engagement and retention were high. High levels of satisfaction and acceptability, a significant decrease in depression, anxiety, and psychological distress, and a significant increase in sexual self-efficacy, mindfulness, and self-compassion were found, with gains maintained at 6-month follow-up. Qualitative analysis uncovered the following themes: Development of Crucial Coping Skills and Strategies, A Sense of Community Among SGDY, Learning from Peers Through Dialogue. Study results suggest that Tuned In! is a promising intervention to improve SGDY mental health.

Officer gunpoint during police stops: Repercussions for youth mental health and perceived safety.

Youth-police contact is increasingly acknowledged as a stressor and a racialized adverse childhood experience that can undermine youths' mental health. The present study investigates a particularly distressing feature of youths' direct and witnessed in-person police stops-officer gunpoint (i.e., officers drawing of firearms and pointing them at youth, their peers, or other community members). We examine patterns of youths' officer gunpoint exposure and associations with youth mental health and safety perceptions. Data come from the Survey of Police-Adolescent Contact Experiences (SPACE), a cross-sectional survey of a community-based sample of Black youth ages 12-21 in Baltimore City, Maryland (n = 335), administered from August 2022 to July 2023. Findings indicate that ~33% of youth reporting in-person police stops had been exposed to officer gunpoint during stops. Officer gunpoint was significantly and positively associated with being male, unemployed, having an incarcerated parent, living in a neighborhood with greater disorder, and having been directly stopped by police, in addition to youth delinquency and impulsivity. Net of covariates, experiencing officer gunpoint was associated with a significantly higher rate of youth emotional distress during stops. Significant associations between officer gunpoint and youths' current police violence stress, police avoidance, and diminished safety perceptions also emerged and were largely explained by youths' heightened emotional distress at the time of police stops. Trauma-informed approaches are needed to mitigate the mental health harms of youth experiencing officer gunpoint.

Rural community perceptions on youth mental health: Developing the case for a community-engaged approach.

Rural community perceptions on youth mental health: Developing the case for a community-engaged approach.

Pilot study of implementing Managing and Adapting Practice in a German psychotherapy master’s program

Despite a significant accumulation of research, there has been little systemic implementation of evidence-based practices (EBP) in youth mental health care. The fragmentation of the evidence base complicates implementation efforts. In light of this challenge, we sought to pilot a system that consolidates and coordinates the entire evidence base in a single direct service model (i.e., Managing and Adapting Practice; MAP) in the context of a legal reform of psychotherapy training in Germany. This pilot study aimed to evaluate the feasibility of the implementation of MAP into the curriculum of the reformed German master's program. Eligible participants were students in the master’s program at Philipps-University Marburg during the winter-term 2022/2023. Students first learned about MAP through introductions and role plays (seminar 1), followed by actively planning and conducting interventions using MAP resources for patients in a case seminar under supervision (seminar 2). A repeated-measures survey was conducted to investigate students’ knowledge gains, perception of MAP and changes in their self-rated confidence to use EBP. Results indicated that students perceive MAP to be manageable to learn. Positive progress was achieved with regard to their knowledge and self-reported confidence to use EBP, although interpretation and generalization of the results are limited by small and homogeneous samples, lack of statistical power and missing comparison groups. The feasibility of the implementation and suitability of measures are discussed. Important implications could be drawn with regard to future investigations.

Understanding the factors related to how East and Southeast Asian immigrant youth and families access mental health and substance use services: A scoping review.

The objective of the review is to identify factors related to how East and Southeast Asian immigrant youth aged 12-24 and their families access mental health and substance use (MHSU) services. To address how East and Southeast Asian youth and their families access mental health and substance use services, a scoping review was conducted to identify studies in these databases: PubMed, MEDLINE (Ovid), EMBASE (Ovid), PsychINFO, CINAHL, and Sociology Collection. Qualitative content analysis was used to deductively identify themes and was guided by Bronfenbrenner's Ecological Systems Theory, the process-person-context-time (PPCT) model, and the five dimensions of care accessibility (approachability, acceptability, availability and accommodation, appropriateness, affordability). Seventy-three studies met the inclusion criteria. The dimensions of healthcare accessibility shaped the following themes: 1) Acceptability; 2) Appropriateness; 3) Approachability; 4) Availability and Accommodation. Bronfenbrenner's Ecological Systems Theory and the PPCT model informed the development of the following themes: 1) Immediate Environment/Proximal Processes (Familial Factors, Relationships with Peers; 2) Context (School-Based Services/Community Resources, Discrimination, Prevention, Virtual Care); 3) Person (Engagement in Services/Treatment/Research, Self-management); 4) Time (Immigration Status). The study suggests that there is a growing body of research (21 studies) focused on identifying acceptability factors, including Asian cultural values and the model minority stereotype impacting how East and Southeast Asian immigrant youth access MHSU services. This review also highlighted familial factors (16 studies), including family conflict, lack of MHSU literacy, reliance on family as support, and family-based interventions, as factors affecting how East and Southeast Asian immigrant youth access MHSU care. However, the study also highlighted a dearth of research examining how East and Southeast Asian youth with diverse identities access MHSU services. This review emphasizes the factors related to the access to MHSU services by East and Southeast Asian immigrant youth and families while providing insights that will improve cultural safety.

Psychosocial Risks and Adolescent Mental Health: The Moderating Role of Objective Neighborhood Characteristics

PurposeAlthough previous studies have examined the association between youth psychosocial risks and their perceptions of their neighborhood, it is unclear how objective neighborhood characteristics are associated with psychosocial risks and mental health symptoms among adolescents. We investigated how neighborhood characteristics moderate the relationship between youth psychosocial characteristics and mental health symptoms. MethodsThis cross-sectional study examined 13,837 emergency department visits by 14–18-year-olds who completed a standardized Behavioral Health Screening in a tertiary pediatric hospital in Philadelphia from 2013 to 2020. Psychosocial risk factors and mental health symptoms were assessed based on self-reported survey responses. We characterized neighborhoods as low-, moderate-, and high-stress based on gun violence incidence from 2013 to 2020 and the census tract–level Child Opportunity Index. Mixed effects logistic regression and Poisson models were used to examine moderation effects. ResultsThe 9,814 included patients were 64% female and 64% non-Hispanic Black. The following psychosocial risk factors were associated with two to eight times higher odds of depressive symptoms and suicide risk: exposure to trauma, bullying at school, at-risk substance use, fighting, and retaliation. Adolescents living in high-stress neighborhoods were twice as likely to report fighting and retaliation and reported more psychosocial risk factors than those in low-stress neighborhoods. Odds of mental health symptoms increased with the number of psychosocial risk factors, particularly in youth from low-stress neighborhoods. DiscussionObjective neighborhood characteristics had a significant interaction effect on the relationship between psychosocial risks and depression and suicide risk among adolescents seeking care in a pediatric emergency department.

Caregiver-reported emotional-behavioral symptoms in Spanish youth during the COVID-19 pandemic: a longitudinal study.

COVID-19 pandemic stressors affected youth's mental health. This longitudinal study aims to explore these effects while considering predictive factors such as age and sex. An initial sample of 1502 caregivers answered a longitudinal survey evaluating their youths' (4-17 years of age) emotional/behavioral symptoms using the Pediatric Symptom Checklist (PSC) screening tool. First assessment in May-July 2020 included the prior year's retrospective (TR) and since-lockdown-start (T0) PSC, followed by monthly evaluations until February 2021. A positive screening PSC (PSC+) was reported in 13.09% of cases at TR and 35.01% at T0, but the likelihood of PSC+ quickly decreased over time. At T0, a more pronounced impact was found on children (39.7%) compared to adolescents (25.4%); male children exhibited higher risk for a PSC+ at T0 and longitudinally than females. Adolescents presented a weaker effect of time-improvement. PSC+ at TR, experienced stressors, and caregiver's stress/depressive symptoms positively predicted PSC+ at T0 and longitudinally; adolescents' unproductive coping style predicted PSC+ at T0. CONCLUSION: The study shows a caregiver-reported increase in emotional/behavioral symptoms in youths during the COVID-19 pandemic, affecting predominantly younger children in the early stages and showing gradual improvement over time, albeit possibly slower in adolescents. The results show the anticipated surge in emotional and behavioral symptoms during the COVID-19 lockdown in youth reported by caregivers, followed by subsequent amelioration. Of greater significance, the study reveals a heightened impact on young children initially, yet it suggests a slower improvement trajectory in adolescents. The study also identifies risk factors linked to emotional and behavioral symptoms within each age group. Alongside the longitudinal approach, the authors underscore the remarkable inclusion of a significant representation of young children, an unusual feature in such surveys.

The roles of dating and victimization on adverse mental health among teens: Survey findings during the COVID-19 pandemic.

The relationship between romantic involvement, dating violence, other victimizations, and mental health among adolescents in the context of the COVID-19 pandemic is understudied. This study analyzed 2021 survey data collected from a representative sample of 9th-12th grade students (n = 10,792) from 24 high schools in a US Midwestern state. Most respondents identified as White, heterosexual, and US-born, with more than three-quarters aged 15-17 years. Guided by the poly-victimization framework, this study explored: (a) How do youth victimizations and mental health concerns differ by their experience of dating and dating violence? (b) What are the associations between youth mental health concerns, victimizations, and dating? Youths reported mental health concerns and victimizations at considerable rates during the COVID-19 pandemic when in-person interactions were limited. Those who experienced dating violence were at a higher risk of reporting other victimizations (i.e., unwanted sexual comments, unwanted sexual contact, sexual photos/videos, sex trading for compensation, discrimination, and bullying). The number of victimizations demonstrated a cumulative effect on teen mental health. Most individual victimizations showed significant net associations with mental health concerns, even when controlling for other differing victimizations. Dating violence plays a critical role in the interconnectedness of victimizations, and the number of victimizations has a cumulative effect on teen mental health. The high prevalence of youth victimizations during the time when in-person interactions were limited suggests that victimizations may transfer from in-person forms to virtual forms and occur offline. Implications for individual and community prevention and interventions are discussed.

A Global Study of the Wellbeing of Adolescent Students During the COVID-19 2020 Lockdown

AbstractAs the COVID-19 (SARS-CoV-2) virus spread across the world, countries took drastic measures to counter the disease by requiring their citizens to home self-isolate i.e., lockdown. While it was not known how young people would cope with the social distancing restrictions, there was concern that the lockdown would have a debilitating effect on youth mental health. This study examined whether there was an association between adolescent subjective wellbeing and the amount of time spent in lockdown. Global Research Alliance researchers in 15 countries collected data using the Mental Health Continuum (Keyes in Am J Orthopsych 76:395–402, 2006) from over 7000 middle-school students aged 11–18. Findings show a decline in eudemonic wellbeing, particularly among females during the first 6 months of lockdown, which was most strongly associated with diminished psychological wellbeing, followed by social wellbeing, while emotional wellbeing remained relatively stable. An adaptation effect was noted after approximately 6 months. There was evidence suggesting females were slower to adapt to lockdown conditions compared to males. More attention should be paid to the wellbeing of students in lockdown to overcome languishing tendencies and educators should be cognizant of diminished student wellbeing, particularly among females, when students return to school. Positive school experiences, and positive relationships within the school community, may assist in reducing the risk of languishing in lockdown conditions, so schools should design interactive online activities for off-campus learning.

Anything goes for participant, patient and public involvement in youth mental health research

AbstractBackgroundParticipant and Public Involvement in youth mental health research aims at making research more responsive to the needs of youth struggling with mental health issues, their parents, and mental health professionals and other stakeholders. Do characteristics of Patient and Public Involvement (PPI) in youth mental health research align with transparency and replication prerequisites as necessary conditions for translation? Relatedly, the question is addressed whether co‐authorship should be assigned to youth involved in the study.MethodsHere we address these questions re‐visiting 50 PPI studies included in two recent systematic reviews of PPI on characteristics that are pertinent to questions about transparency, replicability, translatability, and co‐authorship in PPI research.ResultsAlmost two‐third of the studies on youth mental health incorporating PPI translate their results to policy or practice, mostly as recommendations but sometimes also by dissemination of (online) interventions. At the same time the authors of a substantial majority of the studies (70%) also suggest the need for further work on their results, for example, in randomized controlled trials to validate the outcome of their exploratory inquiry. Only a quarter of the studies using PPI met the conditions for replicability, thus a majority of the PPI studies suggest premature translation of results. Authorship to involved participants was assigned in 24% of the studies.Conclusions“Anything goes” for PPI in an exploratory stage to generate fruitful hypotheses. Translation of the findings of PPI studies however require a firm evidence base of replicated results. Radical merging of research and action in participatory action research seems incompatible with replicable and therefore translatable inquiry. Assigning co‐authorship to PPI representatives is often at odds with current guidelines for authorship. More evidence from randomized trials on the translational impact of PPI is needed before grant foundations should require PPI in grant proposals.

Educating the Youth Mental Health Workforce: Introduction to the Special Issue (Part I)

Educating the Youth Mental Health Workforce: Introduction to the Special Issue (Part I)

Children's charities on issues the next government must prioritise

Improved special educational needs support, expansion of social prescribing to boost youth mental health a and investment in health visiting services are key policy asks sought by children's charities, finds Amrit Virdi

Socioeconomic Disadvantage and Youth Mental Health During the COVID-19 Pandemic Lockdown

Adolescence is a period in which mental health problems emerge. Research suggests that the COVID-19 lockdown may have worsened emotional and behavioral health. To examine whether socioeconomic status was associated with mental health outcomes among youths during the COVID-19 pandemic. The Adolescent Brain Cognitive Development (ABCD) Study is a multisite 10-year longitudinal study of youth neurocognitive development in the US. Recruitment was staggered where the baseline visit (ages 9 to 10 years) occurred from 2016 to 2018, and visits occurred yearly. The COVID-19 lockdown halted research collection during the 2-year follow-up visits (ages 11 to 12 years), but eventually resumed. As some youths already underwent their 2-year visits prior to lockdown, this allowed for a natural experiment-like design to compare prepandemic and intrapandemic groups. Thus, data were gathered from the 1-year follow-up (pre-COVID-19 lockdown for all youths) and the 2-year follow-up, of which a portion of youths had data collected after the lockdown began, to compare whether a period of near social isolation was associated with mental health symptoms in youths. The prepandemic group consisted of youths with a 2-year follow-up visit collected prior to March 11, 2020, and the intrapandemic group had their 2-year follow-up visit after lockdown restrictions were lifted. Assessments included measures on income-to-needs ratio (INR; derived from total household income), the Child Behavior Checklist (a measure of mental health symptomology), and the Family Environmental Scale. The final sample included 10 399 youths; 3947 (52.3%) were male; 2084 (20.3%) were Latinx/Hispanic; 6765 (66.0%) were White; 4600 (44.2%) reported caregiver education levels below a 4-year college degree; and 2475 (26.2%) had INR either below 100% (indicating poverty) or between 100% and less than 200% (near poverty). Among youths in the intrapandemic group, worse mental health symptoms (eg, more total problems, greater depression, and greater anxiety) over time were associated with being from a household with higher socioeconomic status (eg, when comparing individuals who differed by 1 unit on INR between prepandemic and intrapandemic groups from 1-year to 2-year follow-up, their expected difference in total problems score was 0.79 [95% CI, 0.37-1.22]; false discovery rate-corrected P < .001). This cohort study found that the COVID-19 lockdown was associated with disproportionately negative mental health outcomes among youths from higher socioeconomic status backgrounds. Although this study does not shed light on the direct mechanisms driving these associations, it does provide some support for positive outcomes for youths. Future studies are needed to understand whether these associations persist over longer periods of time.

National mixed methods evaluation of Adult and Youth Mental Health First Aid

ObjectiveMental Health First Aid (MHFA) is an international, early intervention, public education program that teaches participants to identify, understand, and respond to signs of mental health and substance use challenges. Until now, all evaluations on MHFA courses in the United States have been performed externally, which have limits in generalizability and the ability to address insights in a timely manner. Additionally, few evaluations have assessed the newest versions of MHFA courses. Therefore, this evaluation aimed to understand key outcomes and participant responses to Adult and Youth MHFA courses in a nationwide sample, spanning nearly a year of real-world implementation. MethodsAn internal, mixed methods program evaluation was performed on the second edition of the in-person versions of Adult and Youth MHFA. Pre- and post-course evaluation data from 3,586 Adult and 2,314 Youth MHFA participants trained between October 2022 and July 2023 were used in this evaluation. Key quantitative constructs, such as mental health literacy, intentions to perform MHFA skills, and confidence to use MHFA skills, were analyzed using paired sample t tests. Rapid thematic analysis methods were used to analyze participants' qualitative responses to the course. ResultsSignificant increases in mental health literacy, intentions, and confidence were observed in both Adult and Youth MHFA participants from pre- to post-course. Qualitative analyses revealed key themes in participant responses, including the helpfulness of the activities, materials, and the MHFA action plan. Adjustments to materials, the length or pace of the course, and other specifics were noted as opportunities for improvement. These findings will be used to inform the future practice, implementation, and revisions of MHFA. ConclusionCompletion of Adult or Youth MHFA by adults in the United States led to improvements in mental health literacy and intentions and confidence to assist someone in need. Both programs may benefit from implementation and content-related changes to enhance participant experience.