Schools are an accessible and acceptable mental health service setting and have been identified as a front-line partner in identifying mental health concerns in youth. However, little is known about the services counselors regularly provide to students, particularly students with depression risk. This study used the Services as Usual (SAU) condition from a randomized controlled trial of a school-based depression prevention program to explore mental health services for middle and high school students with elevated depression symptoms, per validated self-report and diagnostic interview measures. Counselors with varying experience levels and training backgrounds from 17 schools submitted session logs describing meetings with students, the Therapy Procedures Checklist–Family Revised to capture techniques used most frequently with students, and the Evidence-Based Practice Attitude Scale to assess views towards adopting evidence-based programming. Counselors reported on other mental/behavioral health services students received through their school and students reported on service use outside of school-provided supports. Results suggest that over half of youth randomized to SAU did not meet with counselors during the 3-month intervention window. Meetings that occurred were often infrequent, impromptu, and brief. Despite the enrolled population, counselors rarely endorsed depression as a topic during meetings. Counselors, on average, reported positive attitudes toward evidence-based practices and endorsed utilizing techniques that ranged from problem-solving to insight-oriented approaches. This exploratory study suggests that students identified as having elevated depression symptoms may not consistently access mental health support through their school counselors. We discuss the relevance of the findings to evidence-based implementation of services in schools.
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.
