School Mental Health Programs Research Articles

Investing in School Mental Health: Strategies to Wisely Spend Federal and State Funding.

In the context of the current youth mental health crisis, it is prudent to reconsider how resources are allocated to facilitate the delivery of effective and comprehensive supports and services to children and adolescents. Schools are the main delivery sites for youth mental health services. Many districts have adopted comprehensive school mental health systems (CSMHS) to provide a multitiered approach comprising mental health promotion, prevention, and intervention to students via partnerships between school and community health and behavioral health providers. COVID-19 relief funding and other new federal and state investments in school mental health have led to expansions of school mental health programming in most states. An impending federal funding cliff necessitates an examination of how to wisely invest now to achieve the greatest positive future impact on youth mental health. To capitalize on opportunities to sustain effective school mental health and maximize return on investment, states may consider four strategies: leverage cross-sector partnerships to advance school mental health policies and funding, strengthen and expand Medicaid coverage of CSMHS, establish and enhance data systems, and create state technical assistance and professional development support for CSMHS implementation through local education agencies.

Child and adolescent mental health services in Khartoum State, Sudan: a desktop situational analysis.

Sudan is a Northeast African country, with 61.7% of its population under 24 years. With a large youth population and significant cultural and linguistic diversity, Sudan, like most low-income countries, has contributed minimal data to global child and adolescent mental health (CAMH) research. This study aimed to perform the first ever situational analysis of CAMH services and systems in Khartoum State, Sudan. The study focused on Khartoum state and covered the calendar years 2019 and 2020. Using the World Health Organization Assessment Instrument for Mental Health Systems (WHO-AIMS) version 2.2 adapted for CAMH, the study focused on the publically available data sources. Findings were described and presented in tables and figures using the WHO-AIMS template. The situational analysis found no CAMH-specific policies, no separate budget for CAMH, and no supervising body for CAMH services in Khartoum. Three tertiary mental health hospitals provided CAMH services, all combined with adult mental health services. Essential medicines were available in all facilities, except methylphenidate available only in 3 central pharmacies. There was no free access to essential psychotropic drugs for children and adolescents except in emergency settings. Data about training to primary healthcare providers and the process of referral to specialized services were limited. A school mental health programme existed which provided early identification and management of CAMH problems in schools. The workforce was small and variable across all levels of care. No formal public health awareness campaigns and little evidence of formal intersectoral collaboration on CAMH were identified. A health information system existed, but no CAMH-specific items were reported. Among a handful of publications on CAMH, no national studies on CAMH were identified. This situational analysis represented the first systematic collation of data and information about CAMH in Sudan. Findings highlighted some areas of strength, but also many gaps in CAMH services and systems. We acknowledge the need to complement the desktop analysis with in-depth data collection with stakeholders across multiple levels, but hope that this will serve as a first step towards strengthening CAMH services in Sudan and other low-income countries.

Suicide bombing and impending mental health disaster in Pakistan

Pakistan grapples with a significant mental health burden, with 10-16% of its population experiencing psychiatric disorders. Depression and anxiety affect 34% of the population, with regional variations. The scarcity of mental health facilities and professionals exacerbates the situation, leading many to seek help from traditional healers. Socioeconomic challenges, terrorism, and internal conflicts contribute to the mental health crisis. Recent suicide bombings, such as the one in Peshawar, highlight the emotional aftermath and challenges faced by survivors. The complex interplay of factors, including sociocultural influences, contributes to the emergence of a martyrdom subculture. Understanding terrorism requires examining the broader sociocultural and political context. The prevalence of mental illness and rising terrorism suggests a potential connection, although causality is complex. Coping with terrorism-induced trauma poses challenges for survivors, necessitating comprehensive mental health support. Recommendations include nationwide studies, school mental health programs, and initiatives to counter misinformation and radicalization through media. Establishing telepsychiatry services and collaboration between mental health experts and religious scholars is crucial for enhancing social cohesion and mental wellbeing in Pakistan.

Sociodemographic characteristics, social support, and family history as factors of depression, anxiety, and stress among young adult senior high school students in metro Manila, Philippines, during the COVID-19 pandemic.

Academic institutions must consider the students at risk for developing poor mental health and the factors influencing them. With the scarcity of literature concerning student mental health in the Philippines, this study determined the factors influencing the risk of anxiety, depression, and stress among senior high school students in metro Manila. This cross-sectional study explored the influence of sociodemographic characteristics, social support, and family history on depression, anxiety, and stress among young adult senior high school students using the Depression, Anxiety, and Stress Scale-21 (DASS-21) and the Multidimensional Scale of Perceived Social Support (MSPSS). After describing the data, regression analyses were performed. A total of 187 participants were recruited. Three out of five participants have a significant risk for depression. Four out of five participants were at significant risk for anxiety. One out of four participants was at risk for significant stress. Social support from a significant other and one's family may be protective factors for significant depression among the participants. Having female sex may be a risk factor for significant anxiety. In addition, having female sex and a family history of mental disorders may be risk factors for significant stress. Social support should be strengthened among senior high school students to improve their mental well-being. Students at risk for poor mental health, including females and those with a family history of mental disorders, may need additional support in school mental health programs. Finally, further research is recommended to fully understand mental health among Filipino students.

Generating Actionable Evidence for School-Based Mental Health Service Delivery: Public-Academic Partnership Based Evaluations.

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.

Propelling the Global Advancement of School Mental Health.

Rates of mental health problems and disorders in children and youth have been increasing for at least three decades, and these have escalated due to the pandemic and multiple other societal stressors. It is increasingly recognized that students and families frequently struggle to receive needed care through traditional locations such as specialty mental health centers. Upstream mental health promotion and prevention strategies are gaining support as a public health approach to supporting overall population well-being, better utilizing a limited specialty workforce, and reducing illness. Based on these recognitions, there has been a progressive and escalating movement toward the delivery of mental health support to children and youth "where they are," with a prominent and more ecologically valid environment being schools. This paper will provide a brief review of the escalating mental health needs of children and youth, advantages of school mental health (SMH) programs in better meeting these needs, example model SMH programs from the United States and Canada, and national and international SMH centers/networks. We conclude with strategies for further propelling the global advancement of the SMH field through interconnected practice, policy, and research.

School Mental Health Program in India-Issues and Possible Practical Solutions.

School Mental Health Program in India-Issues and Possible Practical Solutions.

Evaluating the Efficacy of School Mental Health Promotion Program in Iranian Schools: A Qualitative Study

Objectives Considering the importance of identifying the mental health problems among school students and their proper management by offering specialized services to them, the present study aims to evaluate the efficacy of school mental health (SMH) program in Iranian schools, identify its shortcomings and provide recommendations for it improvement. Methods This is a qualitative study using conventional content analysis method. A semi-structured in-depth interview was used to collect information from 35 participants who included teachers, principals, and developers of the SHM Program in Iran. Results Based on the results, four themes (strengths, weaknesses, barriers, and recommendations) and 14 subthemes were extracted. Overall, 50 codes were obtained. The results showed the effectiveness of the SMH program. Conclusion The SMH program is effective and has opened a new perspective to school-based interventions. However, expecting the full implementation and continuation of this program in the short term and with limited resources does not seem logical. Therefore, it is first recommended to improve the infrastructure for implementing this program, use trained personnel, upgrade the counseling departments of schools, and remove the time limit of teachers and legal limitations. Then, this project should be implemented at the national level for all schools in Iran.

Change Talks: An overview of the mental health and wellbeing programme

In recent years, the mental health needs of children and young people have risen substantially. Sam Tyrer takes us through the development of a school mental health and wellbeing programme and Naomi Hardman shares her work on adapting the content for special educational needs schools and Start Talks and Ready Talks.

Psychological Well-Being of School Teachers: Predictive Role of Mindfulness and Emotional Intelligence

Psychological well-being (PWB) is an indicator of the optimal functioning of individuals and can act as psychological capital. Studying PWB among school teachers can help identify factors that can prevent burnout, cope with stress, and effectively manage their classroom. This study analyses the relationship between PWB, mindfulness, and emotional intelligence of school teachers and examines the predictive capability of mindfulness and emotional intelligence for PWBs. This study uses a correlational research design. Participants (N=125) consist of female teachers recruited from English medium private schools in Bangalore, India, through a convenience sampling method. Data were collected using a survey consisting of a demographic information sheet, Scales of Psychological Well-Being (Ryff, 1989), Five Facets of Mindfulness Questionnaire (Baer et al., 2006), and Assessing Emotions Scale (Schutte et al., 2009). Results reveal that PWB has a strong association with mindfulness and a moderate association with emotional intelligence. The association between mindfulness and emotional intelligence is moderate. Data shows that mindfulness and emotional intelligence contributed to higher variance in PWB than only mindfulness. Thus, mindfulness and emotional intelligence may impact the PWB of school teachers and should be considered for school mental health programmes.

The Impact of Implicit Bias on Black and Latinx Students.

The Impact of Implicit Bias on Black and Latinx Students.

Impact of a School Mental Health Program on Children's and Adolescents' Socio-Emotional Skills and Psychosocial Difficulties.

The challenges of today's society demand high levels of socio-emotional skills in children and adolescents; therefore, mental health is an important issue to be addressed and promoted in schools. The present study aims to investigate the effectiveness of a school mental health program (Promoting Mental Health at Schools; PROMEHS) designed to promote socio-emotional learning and prevent psychosocial difficulties in children and adolescents. The study was conducted on a sample of 1392 students (evaluated by 104 teachers) from kindergarten (n = 446), primary school (n = 426), secondary school (n = 354), and high school (n = 166). A quasi-experimental study design with experimental and waitlist control groups was used to evaluate the program's effectiveness. Students were non-randomly assigned to the experimental (n = 895) and control group (n = 497). Students belonging to the experimental group received one-hour lessons once a week for 12 weeks. The teachers evaluated their students' social-emotional skills, strengths, and difficulties before and after the intervention. The results indicated the effectiveness of the PROMEHS program in improving social-emotional skills for all school levels, reducing internalizing problems in primary and secondary school chil-dren, and reducing externalizing issues for kindergarten and primary school children. The PROMEHS program is a promising approach to enhancing childrens' and adolescents' social and emotional skills and to decreasing psychosocial difficulties, such as internalizing and externalizing problems.

71.4 Texas Tech Health Sciences Center El Paso: Child and Adolescent Psychiatry, Education, and Community

Texas Tech University Health Sciences Center, El Paso (TTUHSCEP) is 1 of 12 medical schools that are part of the state-funded Texas Child Mental Health Care Consortium (TCMHCC). Initiatives include the Child Psychiatry Access Network, a school mental health program, workforce expansion projects, and 2 research projects. Each medical school operates independently to allow for regional variation but meets regularly to coordinate and standardize. Education in many forms and for diverse audiences is central to achieving our state’s vision of our youth having the best possible mental health outcomes.

2 DEVELOPING AN INTERNATIONAL SCHOOL MENTAL HEALTH PROGRAM FOR THE WHO: LESSONS LEARNT

I will describe the process of development of an international school mental health program for the World Health Organization (WHO) in the Eastern Mediterranean region and implications for the United States and elsewhere.

39.1 Crisis Assessments, Triage, and Intervention: Coordinating With Schools

The top tier of our multitiered school mental health program provides dedicated access for our partnering school districts (21 districts, over 100 schools) to 2 community-embedded behavioral health crisis centers that allows our child and adolescent psychiatry–led clinical teams to help support schools with triage, crisis evaluations (same or next day access), short-term care and care coordination to both higher levels, and ongoing long-term care.

A systematic review of the long-term benefits of school mental health and wellbeing interventions for students in Australia

BackgroundOver the last decade there has been increased recognition about the role of school staff in preventing mental ill health and promoting wellbeing in young people. Despite this, information regarding the long-term benefits of school mental health programs is not widely available.AimsThe aim of this systematic review was to synthesize the evidence for school-based mental health and wellbeing programs which are available in Australia and have been shown to have long-term benefits for children and adolescents.ResultsThis systematic review of the literature identified 74 articles reporting long-term outcomes for student mental health and wellbeing, distributed across 29 unique programs. Common features of efficacious programs included cognitive behavioral interventions, mental health literacy, and social-emotional skills programs.ConclusionsSome of the identified school-based interventions for student mental health and wellbeing demonstrated long-term positive impacts on students' physical and psychological health and wellbeing.

Popularity Goals and Bullying Behaviors Among Chinese Adolescents: The Moderating Roles of Popularity Status and Cognitive Empathy

Bullying is a goal-directed behavior that has long been in the spotlight of worldwide school mental health programs and research. However, the role of popularity goals in bullying and its potential mechanisms are unclear for adolescents in a non-Western cultural context. Based on 333 Chinese adolescents (52% female), the current study was the first to explore the potential moderating roles of popularity status and cognitive empathy in the association between popularity goals and early Chinese adolescents’ bullying behaviors. Moderated moderation analyses indicated that popularity status and cognitive empathy significantly moderated the positive relationship between popularity goals and Chinese adolescents’ bullying behaviors. Specifically, the statistically significant three-way interaction revealed that low popularity status and low cognitive empathy strengthen the positive links between popularity goals and bullying. The significant two-way interaction showed that the positive relations between popularity goals and bullying were stronger for low popularity among Chinese adolescents.

A randomized controlled trial on the interconnected systems framework for school mental health and PBIS: Focus on proximal variables and school discipline

This study reviews findings for the first randomized controlled trial (RCT) on the Interconnected Systems Framework (ISF) for school mental health (SMH) and Positive Behavioral Interventions and Supports (PBIS). Since its development in the late 2000s, the ISF has been supported by federally funded centers for SMH and PBIS, and, guided by a national workgroup, is being implemented in >50 communities in the United States. This experimental evaluation of the ISF involved an RCT implemented in 24 schools in two southeastern states, with the ISF implemented in eight schools, PBIS alone implemented in eight schools, and typically co-located PBIS+SMH implemented in eight schools. Related to very poor implementation, documented by two sources of fidelity data, two ISF schools were dropped from major analyses; hence, the study used a treatment on the treated (ToT; Rubin, 1974) as compared to a more traditional Intent-to-Treat approach (ITT; Lachin, 2000). This is the first paper from this large study, with emphasis here on proximal variables and school discipline. Within schools' multi-tiered systems of support (MTSS), ISF schools delivered more Tier 2 (early intervention) and Tier 3 (treatment) interventions to a greater proportion of students than the other two conditions by the second year of the intervention. There was also a dramatic difference in the provision of interventions by community mental health clinicians in ISF schools (almost half of interventions delivered) as compared to PBIS+SMH schools (around 3% of interventions delivered), underscoring the critical role of the ISF in integrating clinicians into MTSS teams and core school functions in SMH. As compared to the other two conditions, ISF schools also had reduced office discipline referrals (ODRs) and in-school suspensions, as well as reduced ODRs and out-of-school suspensions for African American students. Findings are discussed in relation to future directions of education-mental health system partnerships in improving the delivery and impact of SMH programs and services, demonstrated in the ISF.

Effectiveness of a school-based mental health intervention for school teachers in urban Pakistan: a randomized controlled trial

BackgroundSchools have a major role in promoting children’s physical and psychological health and well-being and the mental health literacy of all key stakeholders, especially teachers, is critical to achieving this goal. Teachers’ knowledge and beliefs about psychological problems influence the way they deal with their students’ mental health issues. This study is a preliminary investigation evaluating the effectiveness and feasibility of a School Mental Health Programme (SMHP) developed by the World Health Organization’s Eastern Mediterranean Regional Office (WHO-EMRO) in improving mental health literacy and self-efficacy among school teachers in an inner-city area of urban Lahore.MethodsTeachers were randomly assigned to 3 days standardized WHO-EMRO School Mental Health Manual based Intervention (n = 118) or to a wait list delayed intervention control group (n = 113). Teachers were assessed pre and post training and at 3 months follow up using measures for mental health literacy (Primary outcome) and self-efficacy. School Heads completed the WHO School Psychosocial Profile and students reported socioemotional skills and psychological problems using Strengths and Difficulties questionnaire at baseline and 3 months post intervention.ResultsCompared with waitlist group, teachers in intervention group presented a significant increase in mental health literacy (F2,181 = 8.92; P < 0.001), as well as better teacher’s self-efficacy in classroom management and student engagement (F2,181 = 16.45; P ≤ 0.000 and F2,181 = 4.65; P ≤ 0.011, respectively). Increase confidence in helping students with mental health problems was also noted in the intervention arm (F2,181 = 15.96 P ≤ 0.000). Improvement in overall school environment was also found. No statistical difference in the emotional and behavioural difficulties in students was noticed at 3 months.ConclusionThis study is one of the first preliminary investigation of WHO-EMRO school mental health intervention in Pakistan. The study showed that intervention led to significant improvement in mental health literacy and self-efficacy among teachers, which was largely sustained over time. Despite a major limitation of lack of clustering and likely contamination affecting follow up outcomes, the study showed promising results in the context of mental health promotion, prevention and early intervention in schools in Lahore, Pakistan. A larger cluster randomised trial is justified, given the level of participant engagement and acceptability by schools.Trail Registration: ClinicalTrials.gov registry (NCT02937714) Registered 13th October 2016, https://register.clinicaltrials.gov.

Wellbeing of School Communities in the Context of COVID-19 Pandemic: A Qualitative Study in Chilean Low-SES Schools.

The COVID-19 pandemic continues to impact schools and how education is conveyed to students. One of the aspects that has gained strength is supporting the wellbeing of educational communities. The purpose of this study was to describe and understand the construction of school wellbeing during the pandemic, based on the notion of collective and sustainable wellbeing. Through a qualitative design, we conducted a study in four Chilean low-SES schools in which a national school mental health program is implemented. A total of 41 in-depth interviews and one group interview were conducted with students, parents, teacher, teacher assistants, school principals, psychosocial professionals, and the school mental health officers during the second half of the 2020 school year. Thematic content analyses showed that, while facing the school closure challenges, schools strived to protect students’ and teachers’ wellbeing. However, participants highlighted necessary conditions for sustaining the school community’s wellbeing and mental health in the context of the COVID-19 pandemic: assuring digital connectivity for all students; coordinated work with families and within the school; strengthening networks; curriculum adaptation and diversified pedagogical strategies; and emotional support toward teachers, families, and students. We discuss these findings and their implications for a sustainable and collective perspective of the wellbeing of school communities in low-SES schools, as well as for policy, practice, and research from the perspective of schools for social justice and health promotion.