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Rates of mental health challenges among children and youth are on the rise. Physical activity has been identified as a promising intervention to improve mental health outcomes for youth. This study aimed to investigate how mental health clinicians perceive and utilize physical activity as a mental health intervention for children and adolescents. Seventy-four Ontario mental health clinicians (psychologists, psychotherapists, and social workers) were surveyed about their perspectives and practices related to physical activity as part of mental health care for children and adolescents using a mixed-methods approach. Survey respondents were also asked about barriers to including physical activity in care. Although 100% of clinicians agreed that physical activity was beneficial to their own and to their clients' mental health, only 61% reported prescribing physical activity to their clients. Barriers to prescribing physical activity as a treatment option included lack of training, time, and resources. Clinicians who were more physically active themselves were more likely to view physical activity as beneficial for mental health and were less likely to view time as a barrier to discussing and prescribing physical activity in their practice. Many clinicians expressed a need for more training, knowledge, and resources. The results of this study suggest that with improved access to training and resources, clinicians will be well-positioned to leverage the benefits of physical activity for mental health in their practice.

Instability in early childhood education and care (ECEC) arrangements may have detrimental consequences on children's mental health. This study examined ECEC trajectories in the first 30 months of life for 373 children from low-income families in Toronto. We provide information about patterns of instability and reasons for instability. We also tested whether instability in ECEC was related to children's mental health using the Strengths and Difficulties Questionnaire. Five main profiles of ECEC stability were identified: (1) 8% in Home-Only, (2) 56.3% in Home-Center, (3) 8.0% in Home-Center-Home, (4) 5.9% in In-and-Out, and (5) 20.9% in Home-Multiple-Centers. Frequently mentioned reasons for change were a new baby in the family, availability of grandparents, quality of ECEC and family relocation. Families in these different profiles had similar demographic characteristics. Of the five profiles, children in the Home-Center-Home profile had a significantly higher likelihood of experiencing mental health problems compared to the Home-Center and Home-Multiple-Centers groups. These findings have important implications for future research, policy and practice related to ECEC availability.

Extensive research into wilderness therapy has not explored who benefits the most and who does not thrive in these programs. The present study examined demographic, clinical, and familial characteristics that distinguished adolescents who improve most in wilderness therapy programs from those who deteriorate. Using data collected by the National Association of Therapeutic Schools and Programs Practice Research Network, the study sample consisted of 5639 adolescents attending wilderness therapy programs which collected and contributed data to the Practice Research Network between 2017 and 2022. Measures included the Youth Outcome Questionnaire-Self Report and the McMaster Family Assessment Device, as well as demographic, familial, and clinical data collected by program staff. Using binary and univariate logistic regression, the study found individual and familial factors that predicted membership in the top 10% of adolescent participants in terms of mental health improvement from pre-to-post wilderness therapy and those factors which predicted membership in the bottom 10% in terms of poorer mental health from pre-to-post program. Considering the intensity, length, and financial resources associated with wilderness therapy program participation, these findings have important implications for wilderness therapy program staff professional development, communication of expectations to adolescents' parents/caregivers, and program admission decisions.

Because the COVID-19 pandemic has been implicated in increased mental health concerns for families of low income, we aimed to describe maternal perspectives about the pandemic's impact on their kindergartener's mental health during the 2020-2021 school year. We conducted 22 in-depth, semi-structured interviews with U.S. mothers with low income who had kindergarten-age children (50% male and 50% female). All participants were female, ranging in age from 24 to 44 years, and reported the following ethnic/racial identities: non-Hispanic Black or African American (41%), Hispanic of any race (36%) and non-Hispanic, White (23%). With a team comprising multiple researchers from varied disciplines (e.g., medicine, education and public health) our analytic process used an iterative approach for developing and revising codes and themes until we reached thematic saturation. Most mothers described negative impacts on social, behavioural and emotional aspects of mental health. Some described positive social impacts, including strengthened family relationships. Mothers described no positive changes to behavioural or emotional aspects of mental health. Maternal perspectives suggest the importance of prioritising access to screening and treating mental health needs to support children's kindergarten transition, mitigate pandemic impacts and plan for future disruptions.

Many training initiatives are underway to increase implementation of evidence-based practice (EBPs) in mental healthcare. However, little is known about what types of trainings and supports yield the highest reach and engagement. Supported by a tax-funded, countywide initiative to improve access to quality care for youths, the current mixed methods study evaluates mental health (MH) provider reach, or registering for the training initiative, and engagement, or participation in training activities, for several EBP training and implementation supports. MH providers were offered free 1) formal EBP workshops; 2) a biweekly learning community; 3) individual case consultation; and 4) confidential online clinical feedback system. To register, interested providers (N = 698) completed a web-based assessment measuring clinical practice information, organizational implementation climate, and EBP knowledge, attitudes, and practices. Thirteen providers, selected via purposeful sampling stratified by level of participation, completed semi-structured qualitative interviews. While the training initiative achieved high reach (66% of county agencies had a provider register), far fewer providers engaged substantially in training. Quantitative results indicated that providers whose professional discipline was not psychology, had higher baseline EBP knowledge, more extensive use of common evidence-based strategies, and less extensive use of other therapy strategies, engaged in more training. Rapid qualitative analysis of interviews expanded upon these findings and illuminated provider, organizational, system, practical, and training activity-specific barriers and facilitators to engagement. Findings suggest the importance of identifying strategies for improving provider engagement in training activities beyond workshops. Implications for future research and training initiatives are discussed.

This study explored predictors of community-based providers' adherence to MATCH, a modular cognitive behavioral therapy for children and adolescents. Provider-reported adherence to MATCH was measured using three increasingly strict criteria: (1) "session content" (whether the session covered MATCH content consistent with the client's target problem), (2) "session content and sequencing" (whether the session covered MATCH content in the expected sequence for the client's target problem), and (3) "session content, sequencing, and participant" (whether the session covered "MATCH content" in the expected sequence and with the expected participant(s) for the client's target problem). Session, client, provider, and organizational predictors of adherence to MATCH were assessed using multilevel modeling. Results revealed that nearly all providers delivered MATCH content that corresponded to the target problem, but only one-third of providers delivered MATCH "content" in the expected "sequence" and with the expected "participant" for the client's target problem. This difference underscores the need for nuanced adherence measurement to capture important implementation information that broad operationalizations of adherence miss. Regardless of the criteria used providers were most adherent to MATCH during sessions when clients presented with interfering comorbid mental health symptoms. This suggests that the design of MATCH, which offers flexibility and structured guidance to address comorbid mental health problems, may allow providers to personalize treatment to address interfering comorbidity symptoms while remaining adherent to evidence-based practices. Additional guidance for providers on managing other types of session interference (e.g., unexpected events) may improve treatment integrity in community settings.

International students in Australia risk financial insecurity and as a result, may make suboptimal health decisions. Limited research has explored the experiences of international students' health-related financial decision making. In-depth interviews were conducted with 31 international students to explore how financial situation influences their decisions in Australia. Data were thematically analysed. Findings highlight that limited income can impact overall wellbeing and health-related decision making. When making financial health-related decisions, participants prioritised urgent health needs and education. Participants who perceived their financial situation limited were less willing to spend money on mental health services, social activities, and food. This study suggests that students may consider the long-term financial benefits of studying abroad when making decisions, but they do not consider the long-term health implications of stress and wellbeing. Enabling students to improve their financial situation and lower their expenses could enhance wellbeing and facilitate health-related decision making.

English language learning students in China often feel challenged to learn English due to lack of motivation and confidence, pronunciation and grammar difference, lack of practice and people to communicate with etc., which affects students mental health. Adopting Big data and AI will help in overcoming these limitations as it provides personalized guidance to the students in all aspects. The paper has established an automatic early warning system to monitor the students' psychological state at any time period. The data is collected from 650 respondents from four different public universities in China. The data analysis has been done with the help of powerful SPSS software and the methodology which we used for determining sample size is, Random sampling. The study involves a qualitative assessment to identify participants' characteristics and categorize them to appropriate clusters. The findings of the research showed that the most obvious differences in mental health between students who used automatic warning and those who did not use automatic warning were: depression, anxiety, hostility, terror, and psychosis. The proportion of students who use early warning was less than those who did not use early warning. Research contributes to policymakers to emphasize the importance of incorporating mental health support and resources into educational policies. The novelty of the study seeks to provide a deeper understanding of how AI and big data can optimize mental health education for English students. With the support of AI and Big data there is a constant monitoring and improvement effect on English education students' mental health.

Autistic adults experience high rates of metal health difficulties and face significant barriers to accessing appropriate mental health care. Empirical research and recent professional guidelines emphasise the importance of modifying standard mental health interventions to best meet the needs of autistic adults. This systematic review explored mental health professionals' experiences of adapting mental health interventions for autistic adults. A systematic search was conducted on CINAHL, PsychINFO, PubMed, Scopus, and Web of Science in July 2022. The findings from 13 identified studies were synthesised using thematic synthesis. Three major analytical themes were generated, the unique experience of adapting interventions for autistic clients, factors which facilitate successful adaptations, and challenges to adapting interventions. Each theme contained a number of subsequent sub-themes. Professionals view the process of adapting interventions to be a highly individualised process. A range of personal traits, professional experiences, and systemic, service-based issues were identified in facilitating or challenging this individualised process. Further research regarding adaptations with different intervention models and increased supportive resources are required to enable professionals to successfully adapt interventions for autistic adult clients.

Long-term effects of the COVID-19 pandemic on autistic individuals and their families are recently emerging. This study investigated these effects in 40 mother-child dyads by measuring the behavioral problems of autistic individuals (via Aberrant Behavior Checklist) and their mothers' anxiety levels (via Beck Anxiety Inventory) during the pre-pandemic period, one month after, and one year after its onset. One year into the pandemic, aberrant behaviors of autistic individuals worsened only for those whose mothers had high anxiety levels. The continued negative impact of the COVID-19 pandemic on the behavior of autistic individuals is related to their mother's anxiety level, highlighting the need to support maternal mental health in families with individuals with autism.

Mothers of autistic children often report poor mental health outcomes. One established risk factor for these outcomes is the child having a medical home. This study examined possible mediating variables (coping, social support) in this relationship in 988 mothers of autistic children from the 2017/2018 National Survey of Children's Health (NSCH). The results of the multiple mediation model suggest the relationship between having a medical home and maternal mental health is largely explained by indirect associations with coping and social support. These findings suggest that clinical interventions for coping and social support provided by the medical home for mothers of autistic children may improve maternal mental health outcomes over and above implementation of a medical home.

Songwriting has been used in music therapy for decades to help address trauma, alleviate depression and build confidence in both children and adults. With components that great music education models point to--composition, agency, collaboration, and means for self-expression, songwriting seems to be a useful tool for music educators as well. Yet, songwriting is rarely found in a general music educators' curriculum in a substantial way. This study investigates the stories of eight students who engaged in a robust songwriting program in their elementary school years (children aged 6-12 -- referred to as middle childhood). The students share their experiences with songwriting in detail and leave us wondering why songwriting has not been incorporated as an integral part of music education curricula and how this can be changed.

Guided by the critical race theory and the social identity theory, the present study aimed to explore the impact that exposure to police brutality on social media has on Black college freshmen's perception of law enforcement and mental wellness. To explore this phenomenon, we conducted in-depth, semi-structured interviews with 20 Black college freshmen (age range: 18-20). Participant narratives were coded using a thematic analysis. Findings revealed that participants depicted police brutality on social media as racially driven, which yielded behavioral changes and negative psychological responses, such as sleep disturbances, anger, and fear. Further, the oversaturation of police violence in the media significantly altered the participants' views of the police and their practices. Our findings are consistent with previous literature concerned with the vicarious experiences of police brutality among youth and have implications for educators, counselors, and scholars.

This study examined the prevalence and correlates of psychopathology in gifted children (GC) and explored whether giftedness confers protection or risk for mental health problems. We used a comparative design to analyze a population-based sample of 100 GC and 100 controls matched by age and sex in Turkey. We assessed psychiatric diagnoses with the Development and Well-Being Assessment (DAWBA), a valid diagnostic tool for child and adolescent mental health, and measured resilience and temperament with standardized scales. GC and controls did not differ significantly in the frequency of psychiatric disorders. However, GC showed lower resilience and higher negative reactivity and activity than controls. Negative reactivity was a significant predictor of psychopathology in GC. Sex did not moderate the effects of giftedness on mental health outcomes, resilience, or temperament. Our findings suggest that GC may have increased vulnerability to stress and reduced coping skills. We highlight the need to identify and support GCs who experience mental health problems and face psychological challenges. Our results emphasize the importance of early intervention and prevention to enhance resilience and well-being in this population. Future research should investigate the underlying mechanisms and develop tailored strategies to support the mental health and well-being of GC.

The study investigated the role of relocating on the mental health, psychosocial stress, and social support of 159 first- and second-year Latinx college students. Findings revealed students who relocated for college had significantly higher self-reported sense of campus belonging, and social support compared to students who did not relocate. Implications for college readiness organizations and universities with commuter populations are discussed. Future directions to enhance the understanding of Latinx students' transitionary experiences are also reviewed.

Organizations, employees, and individuals suffer from adverse outcomes due to a lack of occupational health, impacting everything from organizational performance to psychological and physical health, and they are a prevalent phenomenon for various jobs, including teaching. The aims of the current study are two-fold: to determine the state of occupational health (i) and its structure among 470 Turkish teachers at all school levels, including 338 female teachers (71.9%) and 132 male teachers (28.1%), specifically in terms of stress, the depressed mood at work, and organizational commitment variables (ii). A structural model for occupational health is developed and examined through the AMOS 22 program. The findings of this study indicate that stress predicts a negative impact on organizational commitment (-0.42), whereas it has a positive effect on depressed mood at work (0.74). Additionally, organizational commitment is shown to have a negative impact on depressed mood at work (-0.15). Overall, policymakers, school administrators, and leaders should prioritize strategies to reduce stress, create a healthier work environment, and address the need for proactive efforts to promote a positive emotional climate that improves teacher occupational health. Additionally, further research should explore the other factors that enable to prevent and reduce depression mood at work.

School-based mental health professionals consistently report that they are either not prepared to support grieving students, or do not have time to integrate crisis intervention support into their hectic schedule. Given that inadequate school mental health services can increase a bereaved student's risk of developing emotional problems, it is critical that school psychologists increase their comfort in grief. This study surveyed 75 school psychologists in the Northwestern United States regarding their training and experience in grief support. A reflexive thematic analysis identified four themes related to the challenges and recommendations in grief support: lack of training, limited role of the school psychologist, lack of formalized grief response system, and lack of school and community resources. Furthermore, only 3% of participants reported taking the lead in providing grief support and 64% provide grief support fewer than five times a year. The majority (81%) reported that they had zero courses devoted to grief support during their graduate degree, with more participants (67%) obtaining grief training postdegree. Study limitations, areas for further research, and implications for schools and school psychologists are also discussed.

Student mental health needs continue to rise across the United States and many students and families rely on schools to provide services to meet these needs. Yet, an overwhelming number of available frameworks and approaches to school mental health (SMH) and overlapping terminology surrounding SMH supports like trauma-informed (TI) approaches, social and emotional learning (SEL), and others can lead to confusion and potentially less effective implementation of services and supports for students. In this paper, we aim to mitigate this confusion and offer a solution that integrates several of these approaches into a single complementary model with a special emphasis on the role of SEL. We first present an overview of commonly used SMH frameworks. Next, we present the Trauma-Informed Multi-Tiered Systems of Support Model (TI-SEL MTSS)--an adaptation of the TITI-SEL MTSS--to include and emphasize the specific role of SEL as a critical foundational layer within a multi-tiered system of support. The proposed adapted model maintains the key structure of a MTSS while highlighting the importance of embedding SEL pedagogy in daily teaching practices and all aspects of school life. A case study is used to illustrate how the proposed model adaptations can be used in practice and in tandem with TI and SMH services without being conflated as the same service as SEL. Practical implications for implementation are discussed.

Increases in school stress among adolescents are a growing concern. Although perfectionism and parental expectations have an important role in school stress, their joint influence has not been evaluated nor have analyses taken a multidimensional perspective of school stress into consideration. The aims of this study were to analyze the role of self-oriented perfectionism and parental expectations in school stress, and to explore their potential moderation effect in the associations between school stress and health complaints in adolescence. Sample consisted of 4,768 secondary-school students (52.1% girls; M = 13.74) aged 11 to 17 years (M = 13.74) from 54 high schools in Andalusia (Spain), and school stress was measured using ASQ-S questionnaire. Results show that high self-oriented perfectionism and parental expectations were significantly associated with higher levels of school stress. In addition, the three variables school stress, self-oriented perfectionism and parental expectations were significantly associated with health complaints, and self-oriented perfectionism moderated the relationship between stress of school-leisure conflict and health complaints. These findings should be taken into consideration for future research and the development of interventions aimed at reducing school stress among adolescent students.

This study examined how veteran social engagement predicted post-secondary school attainment. Nearly 10,000 post-9/11 veterans, who separated from military service in 2016, were surveyed on the programs/services they used over 4 years following separation. More than half of veterans had obtained a degree within 4 years of separation. A higher proportion of veterans of color and female veterans reported attending only some higher education than White non-Hispanic male veterans. Positive predictors of educational attainment included participating in veterans' centers and veteran-student organizations, while negative predictors included financial and mental health problems. Implications for veteran-serving programs of post-secondary institutions are discussed.

This study analyzes students' future preferences for online business courses based on responses from a spring 2021 student sample from a California public regional university. The timing of this research takes advantage of the COVID-19 "sudden disruption" that provided a unique opportunity to examine factors (including challenges specific to COVID-19) that affect student choices about course delivery modality. Academic background, remote-learning experiences, and mental health significantly impacted future course enrollment decisions. Study results provide insights for both university administrators and faculty who will need to plan curriculum in the challenging postpandemic higher education setting.

Doctoral students experience high rates of mental health distress and dropout; however, the mental health and wellness of engineering doctoral students is understudied. Studies of student persistence, wellness, and success often aggregate fields together, such as by studying all engineering students. Thus, little work has considered the experiences of biomedical engineering (BME) doctoral students, despite differences between doctoral BME research, course content, and career expectations compared with other engineering disciplines. In this qualitative interview case study, we explore stressors present in the BME graduate experience that are unique from engineering students in other disciplines. We analyzed a longitudinal interview study of doctoral engineering students across four timepoints within a single academic year, consisting of a subsample (n = 6) of doctoral students in a BME discipline, among a larger sample of engineering doctoral students (N = 55). BME students in the sample experienced some themes generated from a larger thematic analysis differently compared with other engineering disciplines. These differences are presented and discussed, grounded in a model of workplace stress. BME participants working in labs with biological samples expressed a lack of control over the timing and availability of materials for their research projects. BME participants also had more industry-focused career plans and described more commonly coming to BME graduate studies from other fields (e.g., another engineering major) and struggling with the scope and content of their introductory coursework. A common throughline for the stressors was the impact of the interdisciplinary nature of BME programs, to a greater extent compared with other engineering student experiences in our sample. We motivate changes for researchers, instructors, and policymakers which specifically target BME students and emphasize the importance of considering studies at various unit levels (university department level vs college level vs full institution) when considering interventions targeting student stress and wellness.

College students' mental health concerns have dramatically increased in prevalence and severity over the past decade, overwhelming the capacity of counseling centers to meet demand for services. In response, institutions of higher education (IHEs) increasingly emphasize prevention, education, and outreach efforts aimed at improving well-being. Although this focus has prompted an increase in research on student well-being, few studies have investigated the unique contributions of malleable psychosocial factors on student outcomes. This study aims to address this gap in the literature by examining the relative impact of an array of psychosocial factors--adaptive and maladaptive perfectionism, coping self-efficacy, social connectedness, perceived burdensomeness, grit, resilience, and meaning in life--on academic performance and distress and suicidality in a sample of 7505 students from 15 U.S. IHEs. Controlling for institutional selectivity and non-malleable aspects of students' identities and pre-college experiences, facets of perfectionism, grit, and emotion-focused coping self-efficacy were the psychosocial factors most strongly associated with GPA, and perceived burdensomeness, social connectedness, emotion-focused coping self-efficacy, and resilience were most strongly associated with distress and suicidality. Among non-malleable factors, race/ethnicity explained the most variance in GPA and gender identity explained the most variance in distress and suicidality. Results are discussed in light of persistent, identity-based disparities in academic achievement and suicide risk and the potential of psychosocial factors as intervention targets to improve academic performance and reduce suicide risk.

Increased reactivity to daily stressors is associated with mental health difficulties, which are common in autistic individuals. We investigated affective reactivity to daily-life stress, cognitive emotion regulation, and their link with co-occurring mental health symptoms in adolescents and young adults with autism. A 6-day ecological momentary assessment protocol was used to assess perceived daily-life stress (event-related, activity-related, and social stress) as well as negative affects in autistic (n = 39, age = 18.4) and non-autistic (n = 55, age = 18.1) participants. Co-occurring mental health difficulties, social functioning, and cognitive emotion regulation were assessed with questionnaires and clinical evaluations. Youth with autism showed higher levels of perceived stress related to their daily social context and activities, as well as an increased affective reactivity to activity-related stressors compared with non-autistic youth. Moreover, they reported using less adaptive and more non-adaptive emotion regulation, the latter increasing their affective response to daily stressors and possibly contributing to the severity of co-occurring mental health symptoms. Our findings demonstrate high perceived daily-life stress in autistic adolescents and young adults. To minimize the negative effects of stress and the development of mental health symptoms, interventions could focus on effective stress management and strategies that autistic young people use to manage their emotions.

BACKGROUND: Affirming spaces have been associated with improved mental health outcomes for lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) adolescents. METHODS: With data from adolescents currently enrolled in middle or high school across the United States, this study used topic modeling methods to examine students' reports of what they were looking for in LGBTQ-affirming schools and, separately, the association of LGBTQ-affirming schools with suicide risk reduction. RESULTS: Topic models demonstrated consistent themes in how students determined that their school was affirming, such as LGBTQ clubs, teachers requesting pronouns, pride flags, and accepting peers. Students of color uniquely looked for actionable responses in addressing LGBTQ issues. Transgender and nonbinary students required explicit mention of support for transgender issues. Quantitatively, LGBTQ students who reported that their school was LGBTQ-affirming had 20% lower odds of attempting suicide in the past year (adjusted odds ratio = 0.80). CONCLUSIONS: These findings suggest that schools must be safe for all youth and implementing policies that make LGBTQ students feel seen and supported in their identities is a protective factor for mental health. IMPLICATIONS: School policies must ensure that youth have access to supportive people, symbols of support, and LGBTQ clubs and that they are also salient to LGBTQ students of color and transgender and nonbinary students.

Systemic racism is pervasive in US society and disproportionately limits opportunities for education, work, and health for historically marginalized and minoritized racial and ethnic groups, making it an urgent issue of social justice. Because systemic racism is a social determinant of health prevalent across multiple social and institutional structures, it requires multilevel intervention approaches using effective designs and analytic methods to measure and evaluate outcomes. Racism is a fundamental cause of poor health outcomes, including mental health outcomes; thus, mental health services and programs that address racism and discrimination are key to promoting positive mental health of racial and ethnic minority youth. While multilevel interventions are well-suited for improving outcomes like youth mental health disparities, their evaluation poses unique methodological challenges, requiring specialized design and analytic approaches. There has been limited methodological guidance provided to researchers on how to test multilevel interventions using approaches that balance methodological rigor, practicality, and acceptability across stakeholder groups, especially within communities most affected by systemic racism. This paper addresses this gap by providing an example of how to rigorously evaluate a hypothetical, theoretically based, multilevel intervention promoting mental health equity in three US school systems using an anti-racist approach intervening at the macro- (i.e., school system), meso- (i.e., school), and micro- (i.e., family and student) levels to improve mental health in adolescents. We describe the design, sample size considerations, and analytic methods to comprehensively evaluate its effectiveness while exploring the extent to which the components interact synergistically to improve outcomes. The methodological approach proposed can be adapted to other multilevel interventions that include strategies addressing macro-, meso-, and micro-levels of influence.

It could be argued that autistic females, attending high school, have a distinct set of needs when compared to their male counterparts. The purpose of this review is to synthesise reported findings on what could be considered as effective for supporting the needs of autistic females in high school settings. The review adhered to PRISMA guidelines. Searches identified 12 papers that included direct perspectives of autistic females, their families and the professionals supporting them. Data were analysed using thematic synthesis. The findings indicate seven main themes for support related to: mental health; identification of specific needs and post-diagnostic support; friendship interventions and skills development; tiered support; relationships between home and school; transitions between levels of education; self, peer and staff advocacy, and sense of belonging. Social and emotional experiences of autistic females in high school are key areas to target in ensuring successful education. Findings are discussed in relation to integrated, inclusive practices that high schools may adopt to support this cohort of students. Implications for professional practice, policy and research are discussed, which will be of interest to educators and helping professionals alike.

School staff increasingly seek to implement evidence-based school mental health services to promote student mental health. However, barriers to accessing programming and support mean that implementing these programs is difficult. Popular strategies to address these challenges, like one time professional development, often fail to be effective or sustainable. This study used mixed methods to evaluate how a set of training activities--sequential online learning modules combined with interprofessional telementoring, following the extension for community healthcare outcomes (ECHO) model--influenced provision of school mental health services. School counselors, nurses, psychologists, and social workers (n = 46) participated in training activities, which included nine, cohort-based ECHO sessions and 12 modules. We used a concurrent mixed methods design in which quantitative (implementation data and pre-post surveys) and qualitative (posttraining focus groups with a subset of participants, n = 11) data were used to evaluate training. Quantitative results indicated statistically significant pre-post improvements in participants' clinical self-efficacy (d = 0.83) and knowledge of evidence-based practices (d = 0.37). Qualitative data corroborated quantitative results. Post training, focus groups described positive reactions, learning, and behavior change, particularly with respect to equitable service provision and interprofessional teaming. ECHO appeared to facilitate the application of evidence-based strategies to real-life practice and improved participants' understanding of effective coordination of services. Taken together, findings suggest that group-based telementoring may be a high-impact strategy for supporting the implementation of effective, culturally specific, and collaborative school mental health services.

Young people with developmental language disorder (DLD) often have poorer mental health compared to those without DLD. However, not all young people with DLD experience such difficulties. Two hundred and eighty-one young people at risk of DLD (45% Female; 53% White British) were identified from a UK based population-cohort. Main caregivers completed questionnaires about their early life (<5 years) and their mental health (at 14 years). Parent-child conflict was revealed to be an early risk factor for all mental health outcomes, at age 14. Additionally, harsh discipline and second-hand smoke predicted worse externalising problems, and gender differences predicted worse internalising problems. Further findings demonstrated that, as the number of risk factors increased, so did the severity of mental health difficulties.

Rates of depression in youth are continuing to increase at a steady rate, yet these youth often do not receive mental health services (Bertha & Balázs, 2013; Thomas et al., 2011). Schools are an ideal setting to connect youth to mental health services; however, many barriers exist with respect to schools having adequate resources and access to the appropriate levels of services (Duong et al., 2021; Owens & Peltier, 2002). Schools may collaborate with local community providers with available resources to address these gaps. The current article describes the pilot of a school-based mental health promotion program intended to reduce depression in youth by promoting access to care through referrals to community providers. Data were collected, via self-report measures, every 3 months for 12 months from students from three middle and high schools in North Texas. The students (N = 88) enrolled in this program experienced significant reductions in their depression symptoms at the end of 12 months. This program highlights the importance of school-community partnerships to promote access to care to address mental health concerns. The results from our pilot study demonstrate the feasibility and the potential of school-based programs in improving the mental health of youth in schools through community partnership.

Although care coordination (CC; i.e., the organization of care activities between professionals to facilitate appropriate service delivery; McDonald et al., 2007) has yet to be studied extensively within schools, preliminary research suggests coordinating school mental health supports can be beneficial (Francis et al., 2021) and that interprofessional and interagency collaboration is warranted to meet student needs (McClain et al., 2022). We examined the perceptions of school mental health providers (SMHPs) regarding importance, quality, and engagement with within-district transition CC practices within a multitiered system of support framework. Participants were 163 SMHPs who endorsed being involved in designing, providing, or implementing mental health services in a U.S. school district. The three scales used to measure engagement with CC practices were based on the "Care Coordination Measures Atlas" (McDonald et al., 2014) and were found to have promising preliminary psychometrics. Descriptive statistics indicated SMHPs endorsed CC as very important but perceived school and district personnel to view it as less important, reported their own quality of CC was slightly above that of their school and district, and regularly engaged in broad CC practices. Moreover, bivariate correlations indicated SMHP's personal views of CC importance were not associated with the quality of school and district CC, yet engagement in broad CC activities was associated with transition facilitation practices, and attitudes about CC were associated with engagement in broad CC activities. Implications of findings are discussed.

There is a need for increased collaboration between mental health providers who work with children and youth to increase continuity of care across settings. While schools can be an optimal location for mental health support, school psychologists often have to work with clinical providers given the increases in youth mental health needs and the shortage of school-based providers. This study used an online survey with a mixed-methods approach to understand the collaboration practices of school and clinical psychologists. A sample of 57 practitioners in the United States were asked to provide their perceptions of the roles of their interagency providers, their collaboration practices, and the benefits or barriers in the collaboration process. Findings indicated differences in providers' perceptions of the quality of assessments conducted and the importance of particular psychological practices to the roles of clinical and school psychologists. Content analysis of open-ended responses found that while providers acknowledge the benefits of collaboration there was distrust among providers. Implications for training programs and future research directions are discussed.

The COVID-19 pandemic influenced a paradigm shift in Philippine higher education. Educational institutions were challenged and impacted, compelling them to restrict physical interactions and transition to flexible learning modalities. This study investigates the impacts of COVID-19 on the education of private university students in the Davao Region, Southeastern Philippines. One hundred eighty-eight students participated in the survey via Google Forms, which was later analyzed using descriptive statistics. From them, a selected few were also invited to participate in qualitative inquiries to obtain an in-depth understanding of the problem under study. Although internet connectivity challenges emerge as a significant impediment, students prefer synchronous lectures and video conferences as learning modalities. Most of them are anxious, dealing with mental health and study habit issues. Interestingly, some respondents revealed that the pandemic positively impacted their lives. Students' adaptive and creative skills helped them cope with the challenges of the new learning modalities. The administrators and faculty members may benefit from these findings in formulating online learning policies and teaching-learning strategies. These findings are helpful baseline to ensure educational sustainability during and after the health crisis.

Schools have been identified as important settings for promoting adolescent mental health and well-being. Little is known about counselling practices in Ghanaian senior high schools (SHSs). This study explored counselling practices in 11 SHSs in Ghana's capital, Accra. We used convenience sampling methods to select 15 school counsellors and interviewed them about access to and utilisation of counselling in SHSs. We also explored common presenting concerns and service challenges. Data were analysed thematically and showed that most of the counsellors had a master's or doctoral degree in guidance and counselling. According to our participants, students access counselling to address school (academic and career), home (e.g. parents' problems and livelihood issues) and peer relations concerns. Other students access counselling for emotional (including suicidal ideations and self-harm), drug use and conduct issues. Counsellors provide academic advice, career guidance, financial and emotional support. Findings revealed that counsellors are facing several challenges including role conflict, work overload, deficient resources, as well as negative perceptions of counselling. Findings have implications for the government, policy makers, SHS administrators, school psychologists and counsellors and students.

Academic stress among adolescents can undermine academic achievement and harm mental health. Levels of academic stress vary considerably across countries and education systems, but little is known regarding the causes of this variation. In this paper, I develop a theoretical framework positing that stress will be lower in education systems that reduce the stakes attached to academic achievements, temper competition and high aspirations, and weaken the link between achievements and self-worth. I test observable implications of the framework by analysing if stress is influenced by the degree of external differentiation and vocational orientation of education systems, using harmonised survey data on pupils in more than 30 countries. The empirical analyses largely support the implications of the framework: pupils in more differentiated and vocationally orientated systems report significantly lower levels of stress, also in models adjusting for country fixed effects. Moreover, academic achievement is a less important predictor of stress in differentiated or vocational systems, possibly due to lower stakes attached to achievements. I end by proposing further predictions of the framework that can be tested in future research, and by discussing implications of the results with regard to possible trade-offs between different goals of education policy.

While transition from primary to secondary school is a positive experience for many young people, for others, it may be a difficult period of adjustment. Socioeconomic status (SES) may influence the likelihood of a positive or negative transition experience owing to differences in psychosocial (self-esteem, self-efficacy, social support) and flexible (cultural capital, financial support, power) resources to respond to the challenges presented by a new school environment. Welsh all-age schools do not have a typical primary to secondary school transition and offer an opportunity for comparative analysis to explore the impact of transition on young people. This analysis used multilevel and structural equation modelling to assess differences in mental health and bullying outcomes in year 7 (first year of secondary education) in young people in all-age schools compared with those in secondary schools. It also considered whether school connectedness might explain these differences. It found that school type did not significantly predict outcomes at a population level; however, there was evidence of an interaction between SES and school attended for some outcomes. Peer problems, conduct problems and bullying victimisation were lower for children with low SES when attending all-age schools. For children with high SES, the same outcomes tended to be more positive if the children attended secondary schools. There was no evidence that school connectedness mediated the relationship between school type and mental health or bullying outcomes. Findings provide tentative evidence that all-age schools may act to reduce health inequalities caused by SES.

This study used a longitudinal probability sample survey, "Understanding Society: COVID-19," to examine trajectories in adolescents' mental health, via the Strengths and Difficulties Questionnaire, at three timepoints during COVID-19 with a particular emphasis on vulnerable groups (i.e., young carers, adolescent girls, BAME--Black, Asian and minority ethnic, and adolescents in financially strained households). Generally, self-reports of emotional and total difficulties remained stable during the pandemic, although adolescents who had limited social support were far more likely to report severe emotional and total difficulties. Young people with pre-existing mental and physical health conditions appeared more resilient, whereas vulnerable young people were hit the hardest during the pandemic. Compared to their less vulnerable peers, young carers, adolescent girls, Black or mixed-race young people and adolescents in financially strained households were more likely to report reduced mental health during the pandemic. It is hoped that the findings will contribute to debates about the pandemic unveiling existing mental health inequalities in society, and to public policy in an era of perma-crises as we currently face a cost of living crisis where public services are under enormous strain to reach those who need them most.

The COVID-19 pandemic control measures substantially impacted the life of university students in the UK. While multiple studies investigated early stages of the pandemic, focusing on risk factors for depression and anxiety, fewer studies assessed later phases of the pandemic or examined positive protective factors for mental wellbeing. Our longitudinal study investigated changes and associations between COVID-19 experiences, lifestyle behaviours, social connectedness and mental wellbeing in the second year of the pandemic. The validated Warwick-Edinburgh Mental Wellbeing Scale was used to measure the primary outcome mental wellbeing. Self-reported data from 161 university students (18-35-year-old) in England was obtained. Data collection took place across two time points with contrasting COVID-19 epidemiological and countermeasure attributes. T1 occurred in the spring of 2021, during the tail end of the third national lockdown when indoor household mixing was prohibited and vaccination rates were low among 18-35 year olds. T2 took place 6 months later, in the autumn of 2021, when restrictions had ended and vaccination rates were high. Within-participant changes in students showed that mental wellbeing significantly improved over 6 months, suggesting positive adjustment. Fear of COVID-19 and engagement in COVID-19 protective behaviours significantly decreased as pandemic restrictions eased. Physical activity levels were high and did not change over time, while greenspace visits significantly diminished. Social support remained the same and group membership significantly increased over time. Hierarchal regressions revealed that social support was the most critical contributor to mental wellbeing. We discuss lessons for mental wellbeing promotion strategies: encouraging the use of greenspace as locations for distanced social interaction and physical activity in times of lockdown constraints.

School counselors support the academic, career, and social/emotional development of all students in their care, and one important method of delivery of a comprehensive school counseling program is the use of classroom instruction. In this exploratory, sequential mixed-methods study, we examined participant responses from nine focus groups regarding the school counselors' experiences with delivery of classroom lessons, in combination with a national survey of 247 practicing school counselors. Results underscored participants' desire to spend more time in classrooms and ongoing barriers to classroom access. We discuss implications for school counseling practice and school counselor education.

Objective: This study aimed to evaluate how health educators use emotional appeals on the social media site TikTok to promote well-being, engage audiences and reduce mental health stigma. Design/Method: Our research team conducted a quantitative content analysis of 400 TikTok videos centred on health education. We evaluated the frequency of mental health content compared with general health education content and associated views, engagement and use of emotional appeals. Results: Mental health content frequently appeared in #EduTok health videos and earned significantly greater reach than general health content. However, videos discussing mental health earned less engagement and relied less on emotional appeals. Mental health content mainly relied on affiliation, hope and sorrow message appeals, although the presence of these appeals did not significantly affect engagement. General health content utilised personal stories, expert credentials and emotional appeals more frequently than mental health content. Conclusion: Evidence from this research suggests that mental health educational content underperforms general health videos and underutilises emotional appeals on TikTok. Health educators must critically analyse and adjust message strategies to enhance audience reception, taking note of success across health topics. We discuss the implications for how practitioners can use TikTok to reduce stigma and promote positive mental health with emotionally engaging content, especially among young audiences.

Having an affirming and inclusive school environment is pertinent to the well-being of LGBTQ+ students of color. However, research indicates that existing school policies and protections are insufficient to support this population. The present study investigates how LGBTQ+ individuals of color perceived their K-12 experiences related to their intersectional identity and their interactions with school counselors. In a focus group of three LGBTQ+ college students of color, participants recounted how they navigated their identities during their K-12 schooling. The analysis yielded five themes related to the participants' identities: (a) isolation, (b) delayed identity development, (c) peer pressure and aggression, (d) teachers' bias and (micro)aggressions, and (e) heteronormative curriculum and extracurricular activities. Regarding the students' experiences with school counselors, three themes emerged: (a) school counselors were too busy to talk, (b) uncertainty about who was an ally, and (c) unsureness of confidentiality. Findings underscored the unique challenges LGBTQ+ students of color encounter related to receiving support and engaging in identity development. We discuss implications and recommendations for school counselors and school systems.

Life Course Theory contends that school transitions can interrupt academic and wellbeing trajectories, depending on child, family, and school factors. Hierarchical regression analyses examined how autistic traits were associated with school transition outcomes. Autistic traits explained 12% of the variance in Quality of Life (QOL), 24% of the variance in mental health and 9% of the variance in school belonging. When autistic traits were accounted for, gender was a significant predictor of changes in QOL whereas changes in school belonging were predicted by cognitive functioning, parent education, school attendance and school refusal. Changes in mental health after transition were mostly predicted by family factors including family structure, family functioning and parent education but were also significantly predicted by sleep problems.

The current study was a secondary analysis of cross-sectional data collected in New Zealand. Parents (n = 291) of an autistic child completed an online survey that included temporal/demographic questions relating to the parent and child, and parent ratings of the child's core ASD symptoms, their parenting stress, and psychological well-being. Child and parent ages were related to ASD core symptoms, parenting stress, and psychological well-being, the parent-child age gap was not. Diagnostic delay was only positively associated with parent depression and negatively associated with child communication impairment. Findings indicated that temporal variables can be predictive of parent well-being and child autism symptoms. The findings suggest that focusing interventions on communication abilities may have positive impacts parental mental health.

Mobile app-based meditation is an effective self-care solution for depression, but limited evidence exists for the long-term benefits among autistic adults, who are at increased risk of experiencing depression. The primary goal of this study was to examine the feasibility and effectiveness of incorporating habit training into an app-based meditation intervention to maintain reductions in depressive symptoms among autistic adults. Participants were randomized to an App Only (who only received access to the meditation app), App + Habit Training (who received the meditation app and instructions for anchoring their app-based meditation to an existing routine), or a waitlist control group. All participants completed questionnaires at baseline, post-intervention, and 6 months post-intervention, and responded to SMS ecological momentary assessments regarding their meditation practice during the 8-week intervention and an 8-week follow-up period. The results show that the App + Habit Training group reported significantly more days with meditation per week during and after the intervention (p < 0.05) and also experienced a larger decrease in depression symptoms post-intervention and 6 months later (p < 0.05) relative to the control group. These findings demonstrate that app-based meditation habits are an effective self-care solution for autistic adults with depression, and anchoring is a promising strategy for establishing other healthy habits among autistic adults.

As mental health concerns coupled with inadequate supports have been described as reaching crisis proportions in autistic people, there is a pressing need for accessible and effective support systems. While self-compassion has shown various benefits in the general population, its application in supporting autistic individuals remains limited. This study investigated the experiences of 39 autistic adults who participated in an autism-specific online self-compassion program. The program included a series of five modules which incorporated psychoeducation, meditation, and self-reflective exercises that were completed over a 5-week period. Qualitative data was collected through weekly check-ins and a post-program survey, which underwent thematic analysis through the lens of an autistic researcher resulting in four key themes: the positive impact of self-compassion, challenges faced during the program, recognizing self-compassion as a journey, and the value of program adaptations. These findings shed light on the experiences of autistic adults engaging with self-compassion interventions, highlighting both the benefits and barriers they encountered. The study underscores the importance of developing tailored interventions that consider the unique needs and perspectives of autistic individuals to promote improved mental health outcomes and foster inclusivity.

This brief article summarizes five trends and issues discussed during a moderated panel and round table discussion at the Association for Experiential Education (AEE) Symposium on Experiential Education Research (SEER) in November 2023. The aim of this session was to expand on prior documented trends and disseminate current experiential and outdoor education (EOE) trends, issues, and related research. These are only a few of the many EOE trends and issues but they represent both meta trends/issues and program-specific trends. This session was designed for scholars and practitioners who teach, provide program administration, and/or conduct research and evaluation efforts for EOE and related disciplines. Topics included cultural representation in the outdoors, trauma and mental health trends, safety II: a new view of risk management, nature and outdoor programming, and whether college outdoor orientation leaders should be paid. We hope that you, the reader, are inspired to consider what trends and issues are impacting your work and explore areas for future research.

Some autistic people use strategies to hide autistic behaviour and appear more neurotypical. Previous research has linked this 'social camouflaging' with mental health difficulties. This review synthesised qualitative research to explore the relationship between camouflaging and mental health. Thirteen studies were systematically identified, appraised and synthesised using meta-ethnography. Four third-order concepts were developed, describing camouflaging as an attempt to cope with stressful social contexts which impact mental health. Many autistic people experienced unintended negative consequences of their camouflaging that increased stress. Potential mechanisms for the relationship between camouflaging and mental health related to the qualities of the strategies that were used. Camouflaging strategies that were superficially 'successful' involved high levels of self-monitoring, were highly cognitively demanding or highly habitual and appeared more linked to poor mental health. This should be investigated in future research and has potential implications for how clinicians support autistic people with mental health difficulties.

Background: The COVID-19 pandemic has changed many facets of outdoor adventure and experiential education (OAEE) programs. Using past literature, four variables represent important student outcome variables associated with OAEE programs. Purpose: This study examined the effects of participation in an OAEE program on levels of anxiety, depression, hope, and resilience. Methods: This study used online data collection software with a 30-item inventory to measure the selected variables. Using a retrospective predesign, data were collected and analyzed using repeated measure t-tests. Findings: Results suggest that OAEE programs can effectively enhance an individual's ability to cope with anxiety and hopelessness while enhancing their levels of resilience.