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Poor mental health among U.S. adolescents has reach epidemic proportions, with those from the Middle East and North African region exhibiting increased risk for distress and suicide ideation. This mixed-methods study analyzes quantitative data from first- and second-generation Arab adolescents (n = 171) and qualitative data from a participatory study conducted with 11 adolescents of the same population to understand the role of cultural resources in coping. Drawing on the Intersectional Theory of Cultural Repertoires in Health, we show that: 1) cultural resources underlie meaning-making throughout coping; 2) coping strategies are inseparable from the influence of peer and familial relationships, as dictated through the social norms and other cultural resources; 3) collectively held repertoires of coping can promote belonging, affirm identity, and protect against discrimination; and 4) the outcomes of coping strategies, and the culturally informed meaning individuals make of these outcomes, influence their future coping behaviors., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: A growing literature points to the critical role schools can play in promoting improved psychosocial wellbeing and resilience among first- and second-generation Arab immigrant and refugee adolescents, but few evaluations have examined the effectiveness of culturally adapted, school-based interventions., Methods: We conducted a pilot evaluation of a culturally adapted social and emotional learning and life skills program, Forward with Peers (FwP), and examined its potential effectiveness for this population. FwP was evaluated across three high schools in the Detroit Metropolitan Area. Within each school, one Arabic class was randomly assigned to receive FwP programming and another served as a control. The pilot evaluation sought to examine changes in several mental health and psychosocial outcomes of interest., Findings: Improvements in overall perceived social support (P = 0.045) and perceived social support from someone special in one's life (0.042) were statistically significant in the treatment as compared to the control group. Comparative improvements were also marginally significant for resilience (P = 0.095) and perceived social support from family (P = 0.074)., Conclusions: Findings highlight the potential of FwP and support the growing interest in establishing efficacy of school-based, culturally appropriate SEL programming to improve psychosocial wellbeing among Arab refugee and immigrant adolescents. FwP's demonstrated improvements in resilience and social support have the potential to prevent mental health disorders and bolster coping mechanisms to minimize adverse consequences in this vulnerable population. Employing a strengths-based approach, FwP offers an alternative intervention to traditional treatment-oriented supports for the proliferation of mental health disorders within this vulnerable population., (© 2024. The Author(s).)

Purpose: Nearly 20% of U.S. adolescents have considered suicide. Yet, gaps remain in understanding correlates of resilience and suicide risk, especially among populations born outside the United States who may face unique migration- and acculturation-related stressors. This study adds to the literature by exploring correlates of suicide ideation among a diverse population., Methods: This study analyzes quantitative data (N = 357) from the Study of Adolescent Lives after Migration to America, in Detroit and Harrisonburg. More than 40% of the sample was born outside the United States, with the majority born in the Middle East and North Africa. Path analysis was used to model dual outcomes of resilience and suicide ideation using measures of hope, school belonging, stressful life events, and being born outside the United States., Results: Suicide ideation and resilience were negatively correlated (ß = -.236[.069]; p < .001). Adolescents with greater hope (ß = .367; p < .001) and school belonging (ß = .407; p < .001) reported higher resilience, while lower levels of school belonging correlated with higher levels of suicide ideation (ß = -.248; p = .009). More stressful life events were associated with suicide ideation (ß = .243; p < .001), while fewer were correlated with resilience (ß = -.106; p = .003). Being born outside the United States was associated with suicide ideation (ß = .186; P-.015), with this finding driven by those from the Middle East and North Africa region, who faced significantly increased risk of suicide ideation (ß = .169; p = .036)., Conclusions: Findings suggest that adolescents born in the Middle East and North Africa region may represent a vulnerable group needing targeted and culturally responsive interventions to destigmatize mental health and psychosocial well-being, boost existing sources of resilience, and encourage help-seeking behaviors., (Copyright © 2021 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Introduction: There is substantial evidence linking stressful life events (SLEs) in childhood to poor mental health later in life, but few studies explore how various types of SLEs differentially impact mental health. The purpose of this study is to assess associations between SLEs and psychosocial outcomes in a diverse adolescent population in the USA and to examine whether and how these relationships are gendered., Methods: The sample comprises 181 high school students ages 13-21 years in Harrisonburg, Virginia. This study analyzed associations between 12 SLEs and eight psychosocial outcomes using ordinary least-squares and logistic regressions. Relationships were estimated for the full sample and for males and females, separately., Results: For boys, having ever been forced to leave one's family was associated with declines in resilience (B = - 4.646; 95% CI (- 8.79, - 0.50)) and increases in externalizing symptoms (B = 0.392; 95% CI (0.15, 0.63)). Furthermore, boys who experienced a drastic change in their family reported lower levels of school belonging (B = - 9.272; 95% CI (- 17.45, - 1.09)). For girls, having ever been forced to leave one's family was associated with decreases in depressive (B = - 0.961; 95% CI (- 1.88, - 0.05)) and anxiety symptomology (B = - 0.868; 95% CI (- 1.68, - 0.06)). Overall, students who experienced a life-threatening emergency exhibited greater depressive (B = 0.445; 95% CI (0.15, 0.74)) and anxiety symptoms (B = 0.287; 95% CI (0.05, 0.52)), and depressive symptomology was also associated with having ever been physically hurt by someone (B = 0.224; 95% CI (0.01, 0.44))., Conclusions: Findings provide insights into how exposures might engender different mental health processes and outcomes, and how these processes may manifest differently across gender., Competing Interests: Competing interests The authors declare that they have no competing interests.

Background: A growing literature has drawn attention to the central role that schools play in supporting the adjustment of resettled refugee youth and promoting their mental health and psychosocial wellbeing. In particular, the recent proliferation of school-based social and emotional learning (SEL) initiatives presents an opportunity to strengthen supports for resettled adolescents. This participatory research study aims to understand how high school students resettled from countries in the Middle East and North Africa region are experiencing the challenges and opportunities of acculturation and the ways in which they believe schools can better support them in this process., Methods: We analyzed primary data collected during focus group discussions as part of the SALaMA study. During these discussions, we used participatory ranking methodology to elicit adolescents' suggestions on how high schools can better support students both academically and psychosocially after resettlement. Fourteen focus group discussions were held with male (n = 38) and female (n = 31) adolescents aged 14-20 years, who were selected purposively across six public high schools in Harrisonburg, Virginia, Austin, Texas, and Detroit, Michigan. Participants offered suggestions and then ranked them in order of importance using consensus ranking., Results: Thematic analysis of the PRM results across sites produced a wealth of suggestions centered around three broad themes, namely: skills related to navigating social and academic challenges, culturally responsive teaching, and socially and culturally equitable learning environments., Conclusions: Findings reported illustrate limitations of the conventional, universal SEL model and shed light on how schools can adapt transformative SEL strategies to serve their students better, especially newcomers from conflict-affected countries., (© 2021. The Author(s).)

Young refugees resettled to the U.S. from the Middle East and North Africa (MENA) region face significant acculturative stressors, including language barriers, unfamiliar norms and practices, new institutional environments, and discrimination. While schools may ease newcomer adjustment and inclusion, they also risk exacerbating acculturative stress and social exclusion. This study seeks to understand the opportunities and challenges that schoolwide social and emotional learning (SEL) efforts may present for supporting refugee incorporation, belonging, and wellbeing. We completed semi-structured interviews with a purposive sample of 40 educators and other service providers in Austin, Texas, Harrisonburg, Virginia, and Detroit Metropolitan Area, Michigan as part of the SALaMA project. We conducted a thematic analysis with transcripts from these interviews guided by the framework of culturally responsive pedagogy. The findings revealed that students and providers struggled with acculturative stressors and structural barriers to meaningful engagement. Schoolwide SEL also provided several mechanisms through which schools could facilitate newcomer adjustment and belonging, which included promoting adult SEL competencies that center equity and inclusion, cultivating more meaningfully inclusive school climates, and engaging families through school liaisons from the newcomer community. We discuss the implications of these findings for systemwide efforts to deliver culturally responsive SEL, emphasize the importance of distinguishing between cultural and structural sources of inequality, and consider how these lessons extend across sectors and disciplinary traditions., Competing Interests: The authors have declared that no competing interests exist.

Introduction: Few studies have assessed the impact of displacement, resettlement, and discrimination on well-being outcomes for adolescent refugees resettled within the U.S. Conducted in three charter schools in the intergenerational Arab enclave of the Detroit Metropolitan Area, this mixed-methods study assessed the mental health and psychosocial support for both U.S.- and foreign-born adolescents from the Middle East and North Africa region. Methods: A quantitative survey was used to collect data on 176 students. Key outcomes included hope, prosocial behaviors, resilience, depressive, anxiety, externalizing symptoms, stressful life events, perceived social support, and sense of school belonging. Differences in outcomes between U.S.- and foreign-born students were compared using T -tests. Regression analysis explored whether outcomes were gendered and correlated with years in the U.S. for foreign-born students. Qualitative data collection included key informant interviews with school staff and community service providers, student focus group discussions, and caregiver interviews. Interview transcripts were analyzed using thematic analysis and the constant comparative method. Results: No statistically significant differences between the foreign-born and U.S.-born groups were observed. However, analysis revealed that resilience decreased for male students with time spent in the U.S. Qualitative themes illuminated these results; shared cultural heritage allowed newcomer students to access relevant language and psychosocial support, while inter- and intra-group peer relationships strengthened students' dual language skills and identity formation. However, shifting gender expectations and role hierarchies for newcomer students revealed boys' increased stressors in the family domain and girls' better accessed support in the school context. Conclusion: The existence of an immigrant paradox in this enclave setting was not supported. Instead, findings highlight the reciprocal value of peer-based mentorships and friendships between U.S.- and foreign-born students with similar cultural backgrounds, the importance of social and emotional curricula and cultural competency training within schools, and the gendered effects of acculturation., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Seff, Gillespie, Bennouna, Hassan, Robinson, Wessells, Allaf and Stark.)

Background: Families resettling to the U.S. from conflict-affected countries in the Middle East and North Africa (MENA) face countless challenges. These families must cope with experiences of armed conflict and forced migration while also assimilating to a new society. According to the 'immigrant paradox,' time spent in a new country can compound the effects of migration and assimilation challenges and lead to deteriorated mental health. This study aims to assess the psychosocial wellbeing of MENA-born or first-generation adolescents attending school in the Detroit metropolitan area (DMA) to understand how schools, families, and communities play a role in supporting these adolescents' wellbeing., Methods: The quantitative component of this mixed methods study will involve a self-administered survey with a sample of students whose responses will be linked to academic records and behavioral assessments. The survey will utilize validated instruments to measure depressive and anxiety symptoms (Hopkins Symptom Checklist-37A), hope (Children's Hope Scale), resilience (Child and Youth Resilience Measure-12), externalizing and prosocial behavior (Hopkins Symptom Checklist-37A, Strengths and Difficulties Questionnaire), school belonging (Psychological Sense of School Membership), and peer relationships (Multidimensional Scale of Perceived Social Support). Differences in outcomes will be analyzed across two strata: students born in the MENA region and first-generation students whose parents immigrated to the US from the MENA region. The qualitative component will involve semi-structured key informant interviews with parents, school administrators, educators, and mental health providers, and focus group discussions (FGDs) with a purposive sample of adolescents born - or whose parents were born - in the MENA region. The FGDs will include a participatory ranking activity where participants will be asked to free-list and rank ideas about how schools can better support students like them. Thematic content analysis will be conducted to identify common themes., Discussion: This study will contribute evidence about the wellbeing of adolescents who come from - or whose parents come from - conflict-affected countries currently living in the U.S. Findings can be used to inform program and policy development to enable schools and their community partners to serve this population more effectively.

Background: Youth resettling to the U.S. from conflict-affected countries in the Middle East and North Africa (MENA) face countless challenges. As they cope with their experiences of armed conflict and forced migration, these girls and boys must also adjust to the language and social norms of their new society, often encountering prejudice and discrimination along the way. Previous studies indicate that schools can play a central role in facilitating this adjustment while also promoting mental health and psychosocial wellbeing. This qualitative study aims to understand the lived experiences of MENA newcomers resettled in Austin, Texas and Harrisonburg, Virginia and to assess how schools, families, and communities support their mental and psychosocial wellbeing., Methods: We held six focus group discussions across the two cities with a total of 30 youths (13-23 years) from Iraq, Syria, and Sudan. We also conducted semi-structured interviews with 30 caregivers and 27 key informants, including teachers, administrators, service providers, and personnel from community-based organizations., Results: Guided by Bioecological Theory, our thematic analysis identifies several means by which various actors work together to support resettled adolescents. We highlight promising efforts that seek to enhance these supports, including sheltered instruction, school-parent collaboration, peer support programming, social and emotional learning initiatives, and integrated mental health centers., Conclusion: While this study underscores the resilience of newcomers and the value of local support systems, it also reflects the importance of investment in schools, mental health systems, and resettlement programs that can enable newcomers to achieve their full potential., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s). 2019.)

As communities around the world continue to receive record-setting numbers of newcomers fleeing armed conflict, schools play a central role in supporting these families through the challenges of adjustment. Policymakers and educators in several high-income countries have begun to invest in efforts to support these young forced migrants not only academically, but also socially and emotionally. This study reviews the published and grey literature on 20 school-based programs aimed at improving the mental health and psychosocial wellbeing of adolescent forced migrants in high-income countries from 2000 to 2019. This review seeks to inform a more comprehensive and detailed understanding of the types of program options available to schools, while also identifying gaps in the current literature related to factors influencing program implementation. We find several common approaches and challenges to supporting adolescent forced migrants, as well as their families, communities, schools, and service providers. The reviewed programs faced recurring challenges related to intercultural exchange, gaining access to communities, promoting care-seeking, school capacity limitations, and sustainability. The lessons learned from these programs indicate that several steps can be taken to mitigate these challenges, including adapting services to individuals and their contexts, taking a multi-layered approach that addresses multiple levels of young people's social ecologies, and building trusting, collaborative partnerships with schools, communities, and students., (Copyright © 2019 Elsevier Ltd. All rights reserved.)