School Mental Health Programs Research Articles

Teachers’ Experiences of Handling Students with Mental Health Issues: Implications for School Mental Health Programs

Teachers’ Experiences of Handling Students with Mental Health Issues: Implications for School Mental Health Programs

Utilizing the CFIR framework for mapping the facilitators and barriers of implementing teachers led school mental health programs - a scoping review.

Ample evidence has been generated regarding the effectiveness of school-based mental health interventions as part of the continuum of care for children and capacity building of teachers to deal with the emotional and behavioral challenges of students. The increasing trend of utilization of teachers as the natural support system of children and the huge financial impact of public health interventions highlights the need to review all available evidence regarding multilevel factors that facilitate or pose a challenge to the provision of School Mental Health Programs (SMHP) using teachers as providers. The current review aims to map extracted evidence under the Consolidated Framework for Implementation Research (CFIR) domains to support future implementation research on school-based mental health services. The scoping review included experimental, qualitative studies, and systematic reviews involving teacher-led mental health programs conducted in the school setting to improve the socio-emotional well-being of children and adolescents irrespective of time and geographical limitations. All (published and unpublished) evidence in English from Pubmed, Cochrane database of systematic reviews and clinical trials, Scopus, and Science Direct was searched using keywords and Boolean combinations and extracted using study designs, place of study, year of publication, sample size, and target population. A qualitative analysis of implementation facilitators and barriers cited by the studies was carried out and mapped on CFIR. This review identified barriers and facilitators of implementation across school-based mental health Programs in 29 studies. The major emerging themes were those related to the inner setting of the organization, the process of implementation, and the characteristics of individuals involved in implementation. These included the availability of structural characteristics, positive school culture, organizational readiness, committed leadership, and beliefs of the providers. Findings highlight the need for early assessment of contextual factors acting as barriers and facilitators and careful execution following realistic planning and stakeholders' engagement to ensure the success of SMHP.

Evaluating and Advancing the Evidence Base for School Mental Health Programs.

Evaluating and Advancing the Evidence Base for School Mental Health Programs.

Prevalence, Best Practice Use, and Member Engagement on School Mental Health Teams.

School mental health (SMH) teams have been widely recommended to support multi-tiered mental health program implementation in schools. Available research suggests emerging best practices that promote effective SMH teaming and indicates the importance of having team members who are highly engaged (e.g., actively involved, retained on the team). Despite evidence that these factors improve team functioning, there is limited knowledge of SMH team prevalence, best practice use, and factors impacting member engagement among a diverse sample of elementary schools. This study surveyed a cross-sectional sample of elementary principals (n = 314) across the United States whose schools implement multi-tiered SMH programs. Most principals (89%, n = 280) reported using teams to organize these programs. Schools in urban/suburban communities, with 300 or more students, or with specific school funding for SMH activities were more likely to have SMH teams. Only one-third of principals reported that their team members participated in related training. Other SMH team best practices were commonly reported (by two-thirds or more teams). Results of a linear regression model indicate that larger teams (six or more members) and teams with access to resources had significantly higher member engagement scores. The study's findings provide recommendations for practice and future research directions.

Public health unit engagement in school mental health programs and adolescent mental health during the COVID-19 pandemic: COMPASS, 2018-2022.

Public health unit (PHU) engagement in schools is important for promoting wellness in students. We aimed to investigate if PHU engagement with schools may have provided protection against the risk of depression and anxiety in students during the COVID-19 pandemic. We used longitudinal data from the Cannabis, Obesity, Mental health, Physical activity, Alcohol use, Smoking and Sedentary behaviour survey between the 2018/19 and 2020/21 academic years. Multilevel models were used to assess the association between PHU engagement with school mental health programs prior to the COVID-19 pandemic and depressive (Center for Epidemiologic Studies Depression scale Revised) and anxiety symptoms (Generalized Anxiety Disorder scale) during the COVID-19 pandemic. The sample included 23894 students across 104 secondary schools in British Columbia, Alberta, Ontario and Quebec. In confounder-adjusted models, PHU engagement before the pandemic was not associated with student depressive symptoms (B=-0.01, 95% CI=-0.04, 0.02), but was protective against anxiety symptoms (B=-0.03, -0.06, 0.001) during the COVID-19 pandemic. The results highlight that PHU engagement with mental health programming in schools was protective against anxiety for students during the COVID-19 pandemic. The findings support the importance of PHU engagement for improving student mental health and pandemic recovery.

The effectiveness of the WHO school mental health package in promoting mental health literacy among secondary school teachers in Qatar: a randomized controlled trial

Teachers’ mental health literacy (MHL) is fundamental for recognizing and assisting students with mental disorders. The aim of this study was to assess the effectiveness of the World Health Organization School Mental Health Program (WHO-SMHP) in promoting MHL among secondary schools’ teachers in Qatar. We conducted a two-arm randomized control trial. Teachers working in governmental secondary schools were eligible for selection. A total of 16 schools (8 intervention, 8 control) randomly selected and stratified by gender then randomly assigned (1:1). Participants and study team were aware of group assignment. Assessment of teachers’ MHL was at day 0, 3 then 3 months afterward. Bivariat analysis and Generalized Estimating Equations were used in analysis. The primary outcome was teachers MHL. Secondary outcome was the influence of sociodemographic characteristics on the level of MHL. Between October 30, 2018 and March 21, 2019, we randomly assigned 195 teachers from 16 schools to attend training workshop on WHO-SMHP (n = 95) or usual practice (n = 100). Compared with controls, teachers from intervention group demonstrated a significant improvement in the level of MHL at day three (mean difference = 19.1, 95% CI = 17.0–21.2, Cohen’s d = 2.63; p < 0.001).) and after three months (mean difference 16.61, 95% CI = 13.96–19.26, Cohen’s d = 1.86; p < 001). There were no significant differences related to influence of other variables on MHL. To our knowledge, this is the first trial to prove the effectiveness of the (WHO-SMHP) in promoting teachers MHL, which can be successfully implemented in a wider scale.

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.