Adolescent mental health problems are prevalent in school settings, highlighting the need for efficient tools that can capture both psychological distress and positive functioning. The dual-factor model conceptualizes mental health as the coexistence of these two dimensions; however, integrated measures suitable for school-based screening remain limited. The present study developed and validated the Adolescent Mental Health Scale (AMHS) based on the dual-factor framework. Participants were adolescents recruited from secondary schools in Guangdong Province, China. Item analysis and exploratory factor analysis were conducted in Sample 1 (N = 608; Mage = 15.02 years, SD = 1.39; 51.3
Youth mental health (MH) needs have intensified in the United States since the COVID-19 pandemic, with rural youth experiencing disproportionately high suicide rates and persistent barriers to MH care. Because schools often serve as a primary access point for identifying and addressing MH concerns, school mental health professionals (SMHPs) serve a critical role, especially in rural contexts. Unfortunately, however, many receive limited preparation for the practical realities of rural school MH (SMH) practice. This study sought to understand how SMHPs working in rural schools in one southeastern state navigate the challenges they encounter in delivering youth MH care. Secondary data collected from 15 semi-structured interviews were analyzed using a constructivist grounded theory approach. Findings highlighted four interconnected categories of navigation strategies: (1) orienting through identity and mindset, (2) building relational foundations, (3) educating oneself and others, and (4) delivering services and navigating systems. These findings position rural SMHPs as strategic navigators who legitimize and sustain their work through internal grounding, relational processes, knowledge translation, and adaptive service delivery. Implications are discussed for school and district practices that support rural SMH, graduate training and professional preparation of SMHPs, and future research on SMHP navigation strategies in rural school contexts.
This study aimed to develop and implement the RealBody+ intervention program to improve psychological factors related to body image (i.e., internalization of appearance ideals, social appearance anxiety, and disordered eating symptoms) among school-aged youth. The program sought to integrate body expression activities with education on healthy habits, positive body image, self-esteem, and awareness of online gendered body stereotypes. A quasi-experimental design with non-equivalent groups was conducted involving 250 Spanish students (113 boys and 137 girls, aged 11–17) from Secondary Education and the first year of Baccalaureate. Over seven one-hour sessions within Physical Education classes, the experimental group (n = 121) participated in body expression activities combined with exercises to raise awareness of online gendered body stereotypes. The active control group (n = 129) attended informational lectures. Assessments were conducted before and after the intervention to measure internalization of gender-specific body ideals (thinness for girls and muscularity for boys), social appearance anxiety, and eating disorder symptoms. At baseline, girls reported higher media pressure than boys, and both genders primarily exercised to modify appearance. Following the intervention, both the experimental group and the active control group showed significant improvements in the measured variables, with no significant group × time interaction effects. The RealBody+ program was associated with improvements in psychological aspects of body perception, including reduced internalization of gendered body ideals, social appearance anxiety, and eating disorder symptoms. However, these changes were comparable across both the experimental and active control groups, suggesting that both approaches may be similarly effective in promoting positive outcomes in school settings.
Schools are a primary access point for youth mental health services, yet most lack the sustained funding, infrastructure, and partnerships needed to build comprehensive and equitable systems of care. State policy offers a mechanism to address these limitations, but there is limited guidance on how it can effectively support the development of infrastructure and partnerships at scale. This descriptive implementation paper introduces the Maryland Consortium on Coordinated Community Supports (Consortium), a statewide initiative established through the Blueprint for Maryland’s Future Act, which allocates 100 million annually to expand school-community mental health partnerships across all 24 Maryland jurisdictions. Grounded in the Collective Impact Model, the Consortium offers funding, evidence-based training, and implementation support to community behavioral health agencies and their school partners. We describe (a) the state policy mechanism that created and sustained the Consortium, (b) how the policy was operationalized through the Collective Impact Model, (c) early findings, and (d) practical implementation lessons. In Year 1, the Consortium funded over 100 partnerships across Maryland, trained 1,218 providers in 18 evidence-based programs, and supported mental health services for 136,945 students statewide. Overall, the Consortium provides a practical example of how legislative investment can be translated into sustainable school-community mental health partnerships through ongoing collaboration, learning, and refinement.
Teachers provide crucial support to the psychosocial, emotional, and academic development of students affected by trauma; however, such support can come at a cost to teachers’ health and attrition. The present study aimed to identify secondary traumatic stress (STS) levels of Australian teachers and investigate the relationships between trauma-informed care (TIC) training, years of general teaching experience, amount of experience teaching students affected by trauma, and five components of attitudes towards TIC with teachers’ STS. Australian teachers (N = 124) were recruited to an online survey via snowball sampling on social media and email. Participants were predominantly women (86.3
Student self-harm and suicide are persistent and complex challenges in schools. Educators are often the first point of contact for students experiencing these behaviours, yet many report feeling ill-equipped to respond effectively. This mixed-methods systematic review aims to examine educator perspectives on, experiences of and attitudes towards, student self-harm and suicide. Five electronic databases were searched for peer-reviewed articles in English from January 2000 to May 2025 reporting on educators’ perspectives towards student self-harm and suicide. 54 articles were included in the narrative synthesis and assessed for quality using the Mixed Methods Appraisal Tool. Educators held varied perspectives on their role in supporting student self-harm and suicide. While some viewed themselves as gatekeepers, others viewed supporting self-harm and suicide as beyond their professional scope. Some educators perceived self-harm and suicide as genuine signals of underlying distress, while others perceived these behaviours as attention-seeking and happening for trivial reasons such as peer pressure and boredom. Educators consistently reported feeling ill-equipped and identified lacking appropriate knowledge, training and guidance as key barriers to responding and supporting students. Preferred supports included targeted training with scenario-based learning, online modules, and peer discussion opportunities. Practical resources such as crisis plans, flowcharts, and clear guidelines were also identified as essential. Overall, this synthesis of educator perspectives highlights the need for interventions that provide educators with the skills, confidence, and resources to respond effectively to student self-harm and suicide. Trial Registration: This systematic review was prospectively registered in PROSPERO (CRD420251043232; https://www.crd.york.ac.uk/PROSPERO/view/CRD420251043232 ) on 29 May 2025, and is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement (Page et al., 2021). The completed PRISMA checklist is available in Supplementary File 1.
The Cities Mentor Project (CMP) was developed to address academic and socio-emotional stressors experienced by youth in low-income, urban communities. This multisite, randomized, no-treatment–controlled, parallel-group pilot feasibility trial included 35 sixth-grade students who identified as African American (16 intervention; 19 control) and were enrolled in schools located in Englewood on the southwest side of Chicago, Illinois, USA. Data were collected at three time points using standardized measures of socio-emotional functioning and academic achievement. The CMP intervention comprised three components: participation in protective community settings, mentoring relationships, and coping skills training. Between-group analyses did not reveal significant differences in socio-emotional or behavioral outcomes; however, significant between-group effects were observed for reading achievement. Within-group dosage analyses indicated that intervention participants who received greater exposure to combined program components and spent more time in protective settings demonstrated better socio-emotional functioning. Parents also reported higher adaptive skills and fewer behavioral problems among youth receiving higher intervention dosage, and greater mentoring exposure was associated with higher mathematics grades. Findings support the feasibility of CMP and suggest that intervention dosage may be an important determinant of academic and socio-emotional outcomes for youth in low-income urban contexts enrolled in a mentorship intervention. Moreover, findings assert the need for further study of CMP.
Rising rates of anxiety, depression, and suicidality among adolescents underscore the need for school-based mental health literacy (MHL) interventions. This study documents the collaborative development and implementation of a five-session MHL curriculum delivered through a university-community partnership in afterschool settings at three urban high schools. Sixty-nine predominantly low-income, racially diverse students participated in the afterschool curriculum co-developed through collaborative needs assessment. Using secondary analysis of program evaluation data, we examined session-level pre–post survey items and students’ written reflections. The primary contribution of this study lies in documenting the partnership and implementation processes that shaped curriculum delivery. Shared decision-making, structured consultation, and iterative feedback between university and community partners informed contextually responsive adaptations while preserving core learning objectives. Findings suggest that afterschool settings can serve as viable entry points for MHL programming when supported by collaborative infrastructure.
Drawing from the perspective of transfer theory, this study explored the relationship between the perceived descriptive norms for bullying intervention (PDN-BI) and adolescent future prosocial risky behavior (PRB), as well as the moderating role of social-emotional competence. Two waves of data were collected from 1,308 junior high school students (aged 11–15, M = 13.06, SD = 0.62) in China at one-year intervals. The findings revealed a U-shaped relationship between PDN-BI at Time 1 and adolescent PRB at Time 2. The findings also indicated the moderating role of social-emotional competence in the U-shaped relationship, including turning point and steepness. This study supports the spillover effects of PDN-BI’s influence, challenges the traditional linear relationship results between descriptive norms and prosocial behavior, and provides new insights into how social identity theory and the bystander effect theory operate within the domain of PRB. Moreover, the findings offer new ideas for interventions to enhance adolescent PRB.
Research suggests that youth with attention-deficit/hyperactivity disorder (ADHD) are at elevated risk for chronic absenteeism from school, with long term consequences including educational underachievement, increased mental illness, and economic difficulties later in life. However, limited research has examined whether theoretical models of absenteeism risk derived largely from non-ADHD populations generalize to youth with ADHD, and data-driven methods to identify those at greatest risk remain underdeveloped. Machine learning approaches may complement traditional theory-driven analyses by evaluating whether established risk factors replicate in this population while accounting for complex interactions among predictors. Using data from a clinical sample of youth with ADHD, the current study applied machine learning methods to develop an algorithm capable of classifying youth with patterns of school absenteeism and identifying the most influential problem areas for classification. Parents/caregivers of 194 clinically-referred youth with ADHD (Mage: 10.7 years; SDage = 2.98; 21.1
Evidence regarding the long-term efficacy and optimal dosage of school-based Cognitive Behavioral Therapy (CBT) remains equivocal. Prior meta-analyses have frequently overlooked the non-independence of effect sizes inherent in school-based research. This study employed multilevel modeling to rigorously re-assess outcomes for internalizing symptoms and, crucially, psychological resilience. Methods: A systematic search of five databases until November 28, 2025, identified 49 randomized and quasi-randomized controlled trials (N = 12,702; 164 effect sizes). Variance was partitioned using a three-level random-effects model to separate sampling (Level 1), within-study (Level 2), and between-study (Level 3) components. Restricted cubic splines (RCS) were utilized to model non-linear dose–response relationships, and evidence certainty was appraised via the GRADE framework. Results: Three-level analysis demonstrated that school-based CBT significantly reduced depressive (Hedges’ g = 0.29) and anxiety symptoms (g = 0.30), while yielding a substantial improvement in resilience (g = 0.88). Crucially, sensitivity analysis using follow-up score differences confirmed the robustness of these findings, albeit with slightly more conservative estimates (Depression g = 0.27; Anxiety g = 0.26; Resilience g = 0.66). Therapeutic gains for depression and anxiety were sustained beyond the six-month follow-up. Between-study characteristics (Level 3) accounted for 74.59
Research has begun to explore the role of schooling in mental health promotion for children from refugee and asylum seeking backgrounds. Most of this research has been conducted in countries of permanent resettlement, with a lack of knowledge regarding these experiences within countries of first/temporary asylum. This study explored the schooling and educational experiences of refugee and asylum seeking children in Malaysia, where these children are not legally recognised and they are reliant on volunteer- and community-run schools that are typically underfunded and under-resourced. The research questions focussed on student perceptions of school-based factors that foster positive and negative mental health and wellbeing. This study explores the experiences of 173 refugee and asylum seeking students within Malaysia (age ranging from 10 to 20 years old, M = 14.64, SD = 2.17) who completed a face-to-face battery of questionnaires in English, with language support available to those requiring assistance. Multiple regression analyses revealed that factors such as social support, a sense of safety, positive physical environments, parental involvement in schooling, and the presence of mental health support were associated with positive mental health and wellbeing. Given the dominant role that schools play in the daily lives of children, they may represent important settings for interventions seeking to support mental health.
Research consistently demonstrates that children with internalizing problems (IP) face distinct challenges in academic settings as well as in social interactions with teachers and peers. Consequently, investigating IP within the school context is crucial. Despite the existence of a variety of assessment approaches, few studies have compared them in school-based IP research. This scoping review, therefore, examined the consistency of the conceptualizations of IP and the research topics addressed within school-based studies on IP. Studies were identified through a systematic literature search of ERIC, Psyndex/PsycINFO, and PubMed. In addition, we reviewed frequently used instruments by analyzing the items used to operationalize IP in terms of symptoms and consideration of the school context. A total of 61 studies were included. Our findings indicate that definitions of IP predominantly included anxiety and depression. However, approximately one-third of the analyzed studies did not provide an explicit definition. The majority of studies focused primarily on social outcomes, particularly examining interactions with peers. The analyzed studies differed widely in terms of the instruments used and the informant perspectives considered. Across instruments, interpersonal problems, negative self-image, and specific anxiety were the symptoms most frequently included, but large variability between instruments raises the question whether assessment of IP is always comparable in different studies. Furthermore, only a few of the analyzed instruments adequately considered the school context within their items. This heterogeneity poses significant challenges for comparing study results and underscores the necessity for more standardized approaches to support early identification and intervention in schools.
Studies have shown that working with trauma-exposed students can have negative impacts on teachers’ wellbeing. This study aimed to explore teachers’ experiences and how they can be supported when working with students exposed to trauma. Using Delphi methodology, 794 participants, including teachers, school leaders, trauma researchers, and mental health professionals completed a survey on their perceptions regarding the experiences and support needs of teachers when working with students exposed to trauma. Two hundred and twenty of these participants then completed a second survey and 206 completed a third survey. After the third survey, 231 of the 278 statements reached consensus, including individualised support through self-care training and mental health services, and structural support through school policies, cross-sector collaboration, training for school leaders, and greater resources for students exposed to trauma. Findings reveal that teachers face significant professional and personal challenges when supporting students exposed to trauma, and highlight the need for trauma-informed programs that are practical and reflect the day-to-day challenges. This study advances understanding of teachers’ experiences and support needs, providing a robust foundation for future development of trauma-informed programs aimed at supporting teacher wellbeing.
We are developing the ESSY Whole Child Screener, which aims to strengthen educator interpretation and use of universal screening data through an efficient yet comprehensive assessment across child-focused domains and contextual factors that can affect a student’s school success. In this study, we investigated the potential for treatment utility and usability of the ESSY Whole Child Screener data report in comparison to existing universal screener reports of social, emotional, and behavioral domains. Focus groups were conducted with nine school-based data teams, in which they were asked to interpret and discuss the data reports of fictional students. Although the reports appeared to be four different students, each case was presented twice—once using the ESSY data report and once using the school’s existing screening report. We used narrative analysis to investigate the strengths, concerns, hypotheses, and next steps discussed in response to each report. Findings suggested that, in comparison to their existing data reports, when using the ESSY data report: (1) Educators’ first impressions included more contextual considerations; (2) A greater number of teams identified student strengths; (3) Teams noted contextual influences in addition to within-child concerns; (4) Hypotheses were less clinically diagnostic; and (5) Teams engaged in more immediate and comprehensive intervention planning. Teams perceived the ESSY data report to be highly usable, and data suggested the potential utility of an optional interpretation guide. We discuss potential implications for current school-based screening practices and next steps in piloting the ESSY Whole Child Screener.
Bullying has been studied for several decades, but its measurement remains a debated issue. The two main questions are whether measures should include a definition or specific behaviors and whether self- or peer-reports should be used. However, empirical data about the convergence of the different measures and their unique associations with students’ psychosocial adjustment are lacking. This was the main goal of this study. A sample of 475 primary students completed the three most common types of bullying measures (self-reported behavior-based, self-reported definition-based, and peer-reported definition-based), and psychosocial adjustment indicators (prosocial behaviors, conduct problems, hyperactivity, emotional symptoms, peer problems, social acceptance, and social rejection). Results indicated that these three types of measures converge to some extent. Our model also revealed that self-reported behavior-based measures were more strongly associated with several students’ psychosocial adjustment indicators. Overall, our findings support the idea that researchers and practitioners should select the type of measure that best fits their specific goals and constraints.
This study aims to examine how perceived parental bonding (through the dimensions of care and overprotection) relates to students’ intentions to use school counselling services, with biological sex as a psychosocial mediator. Data were analyzed using structural equation modeling with a maximum likelihood estimator to test direct and indirect relationships among variables. The findings indicate that parental overprotection has a direct and significant effect on students’ intentions to consult school counselling services, whereas the care dimension does not show a significant direct effect. However, both parental bonding dimensions exert indirect effects through biological sex, indicating that caregiving experiences are interpreted differently within biological sex role frameworks and shape students’ readiness to seek help. These findings affirm that the intention to consult is influenced not only by the level of problems experienced by students, but also by relational background and biological sex construction. Practically, these results underscore the importance for school counselors of considering caregiving experiences and biological sex dynamics in assessment, service approaches, and school counselling outreach strategies so that services are more responsive to students’ needs.
With increasing attention given to student recognition, its relationship with students’ well-being has remained underexplored. This longitudinal study investigated not only the parallel development process between student recognition and psychological wellbeing over time but also examined how teacher–student relationship contributes to with this co-developmental process over time. Using data from a three-wave survey of 314 secondary school students, latent growth models were applied to examine the longitudinal trajectories of student recognition and wellbeing separately. Subsequently, parallel process latent growth models were employed to capture the interrelations between the two constructs and to test how the teacher–student relationship influences their growth patterns over time. Results revealed that both student recognition and well-being experienced significant increases over time. The parallel latent growth models indicated that the intercepts and slopes of recognition and well-being were positively correlated, and the initial level of recognition significantly predicted the rate of change in well-being, highlighting the facilitating role of student recognition in promoting students’ well-being development. Moreover, teacher–student relationship was positively associated with the intercept and slope of student recognition, as well as the intercept of wellbeing, suggesting the critical role of teacher–student relationship in fostering both student recognition and well-being.
Attention-deficit/hyperactivity disorder (ADHD) is a commonly diagnosed mental health disorder, yet little is known about the priorities for funding, services, and research held by educators and ADHD coaches, particularly in Canada. This study, as part of a larger project surveying individuals with ADHD and those who support them in Canada, sought to develop a list of priorities held by educators and ADHD coaches (Total N = 122) for ongoing attention using the Delphi method for gaining consensus across multiple survey iterations. Results from the three waves of data collection suggest that our educator and ADHD coach participants working with children, adolescents, and emerging adults have wide ranging concerns. The most critical issues are with access to care, reduction of stigma in professional settings (e.g., healthcare and schools), adequate funding to support the availability of services, and increasing knowledge and awareness about ADHD, as well as the need for dedicated research attention for socio-emotional functioning in the context of ADHD and ADHD in girls and women. From this study, it is clear that although progress has been made in ADHD services and research, there are substantial unmet needs identified by individuals with ADHD and those who support them.
Adolescent suicide is a public health issue in Latin America, and particularly in Chile. School-based programs have been described as effective mechanisms for suicide prevention. However, less is known about participants’ perceptions during these programs, which is essential for their applicability and adherence. This study investigated the perceptions of students, parents, and teachers regarding the implementation of the RADAR program in a vulnerable school in Puente Alto, Chile. This program aims to prevent suicidal behavior in adolescents by creating a community network that identifies and refers them to specialized care. A codebook TA was used to explore participants lived experiences with the RADAR program. Three focus groups were conducted with students, parents, and teachers at a high-vulnerability school. The information was transcribed, coded, and analyzed using a thematic analysis to identify the program’s perceptions, benefits, and challenges through the lens of CFIR. Teachers, parents, and students had positive perceptions of the RADAR program. Participants valued access to mental health professionals. Teachers and students appreciated that the program fosters open discussion about mental health. However, challenges, including low levels of understanding of mental health and stigma between classmates and families, insufficient communication with teachers about the program, and barriers to specialized care in the public system, were described by participants. This study highlights the need for parental involvement, enhanced communication, mental health education, and effective public policies to improve access to public mental health services. All the findings emphasize the critical importance of adapted suicide prevention programs and foster collaboration between families, educational institutions, and the healthcare system.
