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Suicide rates among children and adolescents have continued to rise over the past decade indicating the need for school-based suicide prevention programs. School nurses (SNs) are well positioned to assist in assessment, early identification, and intervention of at-risk students. This integrative review aimed to (1) critically examine the role of the SN in school-based suicide interventions, (2) explore potential barriers preventing the SN from participating in suicide interventions, and (3) recommend strategies to build capacity for principles of school nursing practice in suicide intervention. The National Association of School Nurses' Framework for 21st Century School Nursing Practice was used to categorize interventions and outcomes related to suicide prevention. Findings demonstrate a lack of reported nursing interventions directly linked to student outcomes and suggest obscurity in the role of the SN. Recommendations for future research and strategies to build capacity for principles of school nursing practice are provided.

Suicide rates among Black youth have risen faster than any other racial/ethnic group in the past two decades. Black youth residing in rural areas are subject to systemic challenges such as minimal access to mental healthcare providers, generational poverty and oppressive social structures that lead to racial discrimination. Racial discrimination places rural Black youth at increased risk for anxiety, depression, and suicide. Protective factors have been found to mitigate the negative impact of racial discrimination on mental health, but there is limited research covering suicidality and Black youth. This scoping review explores what is known about the role of protective factors in moderating the association between racism/discrimination and suicide risk among Black youth in the United States. Findings were mixed regarding the influence of protective factors in moderating the effects of racial discrimination on suicide risk and more exploration among Black youth in impoverished rural areas is warranted. [ABSTRACT FROM AUTHOR]

Qualitative data analysis is recognized as a threshold concept in research education and can be conceptually challenging for doctoral students. While retreats are common approaches to support dissertation writing, we propose an unconventional approach for doctoral education with the use of retreats for qualitative data analysis. Analytic autoethnography was used to examine what features of an off-campus retreat supported data analysis of dissertation research, With the use of a focused agenda, the retreat space offered opportunities for icebreakers to stimulate synthesis thinking, student-led analytic activities, and reflective writing. Data were collected from documents, analytic artifacts, photographs, and reflective journals. We identified three themes pertaining to retreat features to support qualitative analytic work: Analytic Immersion, Analytic Support, and Analytic Reflection. Findings suggest that retreat spaces can be used to support doctoral students navigating the challenges of knowledge acquisition associated with qualitative data analysis. We recommend four key considerations when designing a qualitative analysis retreat: (1) create a space for analytic immersion; (2) design activities to cultivate student agency; (3) situate faculty for optimal student mentoring and support; and (4) allocate time and space reflective practice. This paper contributes to the ongoing conversation of threshold concepts in doctoral education and offers a new approach for supporting students during data analysis. [ABSTRACT FROM AUTHOR]

School connectedness is associated with a broad range of positive academic and mental health outcomes. A dimension of school connectedness, student– teacher connectedness, is related to improved academic progress and may be an important protective factor against risk-taking behaviors, particularly for low-income students and for those with limited parental support. The purpose of this qualitative secondary data analysis was to explore teacher perceptions of parental involvement in a low-income, rural middle school serving a diverse student population and the influence on student–teacher connectedness. Data were taken from transcripts from five focus groups comprised of middle school teachers, administrators, and clinicians (n = 26). Thematic analysis included first and second cycle coding followed by developing Venn diagrams to depict categories and patterns before reaching consensus on themes. Three themes were identified: (1) parental support of students; (2) parental modeling for students; and (3) parental interaction with teachers. Overall, teachers perceived a lack of parental involvement in this low-income diverse middle school which led to missed connections between students and teachers. This disconnect may be the result of multiple factors, including perceived low levels of parental support for students, differing expectations between parents and teachers, and perceived poor quality interactions between parents and teachers. When formulating strategies to enhance student–teacher connectedness, consideration should be given to the extent and importance of the role of parental involvement. [ABSTRACT FROM AUTHOR]

School nurses are well-positioned to assess, identify, and refer children and adolescents who are at risk of suicide. This multiple-case study examined the personal, behavioral, and environmental factors that influence the role of the school nurse in youth suicide prevention and intervention. Purposive sampling was used to recruit two school nurses who were identified as unique cases. Data from interviews, surveys, and documents generated a cross-case analysis. Findings indicate that school-level exclusive practices, such as a lack of communication and collaboration, greatly influence the role and reach of school nurses. Further, dilemmas arising from environmental barriers hinder school nurse capacity to promote student safety and affect moral distress levels. Leveraging data to demonstrate the pivotal role of school nurses to support mental health equity and reduce disparities in youth suicide is crucial to developing inclusive and responsive suicide prevention programs., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The rising rate of youth suicide in rural Eastern North Carolina reflects the national trend. Although school nurses have been regarded as the gateway professional for mental health services, their role in suicide prevention is not well understood. The purpose of this study was to explore school nursing practice regarding suicide prevention of school-aged children in one vulnerable region of the United States. Focus groups and surveys were collected from 35 school nurses in six school districts. Findings indicate that suicide protocols inclusive of the school nurse can facilitate their role in suicide prevention. Variation of school nursing practice existed between and within districts. These variations in school nursing practice highlight the need for school districts within the state and across the country to examine their policies and practices for mental health equity. Barriers such as higher caseloads, role disconnect, and lack of specialized training contributed to variations in practice.