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Educator leaders play a vital role in fostering educators' and students' mental health and wellbeing. Through qualitative research, this paper provides insights from eight education leaders working in State Schools in Malta on their perceptions of, and experiences in, the promotion and support of mental health and wellbeing among educators and students. The objective of the study is to examine how mental health and wellbeing are being promoted, addressed, and supported in schools. Eight semi-structured interviews were conducted with education leaders followed by a reflexive thematic analysis. Four themes emerged from the data, namely school philosophy, ethos, and leadership; mental health and wellbeing in schools; loss and grief; and COVID-19 and its impact on mental health and wellbeing in schools The findings suggest the need for more proactive and supportive considerations of mental health and wellbeing in schools in Malta, along with the implementation and evaluation of mental health and wellbeing whole-school projects in schools.

In this article, we draw on a narrative inquiry into the experiences of children, youth, and families waiting for mental health support during the COVID-19 pandemic in Western Canada. We foreground two youths' experiences (Gillian, who self-identifies as transgender, and Malek, who self-identifies as racialized) to highlight the complex barriers and supports each encountered while attempting to secure appropriate care as they navigated moments of crisis within their worlds of home, school, and communities. By inquiring into their mental health stories, we foreground the unique ways these youth enacted counterstories to disrupt hegemonic constructions of their identities, build agency, and support their wellbeing.

Little is known about OCD in people with learning disabilities (LD) in general and in terms of current and professional support. In this study, we examined caregivers' perceived challenges and strategies practiced in institutionalized settings in managing OCD in people with LD and derived implications for research and practice. We studied individual cases of people with LD (n = 7). Each case included group discussions (n = 28) and semistructured interviews with caregivers (n = 20). We used qualitative content analysis to analyze the data. Our findings reveal the following challenges for caregivers: recognizing and classifying ambiguous behaviors, recognizing emotional well-being and needs through nonverbal signals, finding and applying effective strategies, being unqualified regarding additional needs, managing inappropriate institutionalized conditions, and lacking external specialization. We identified five strategies for dealing with compulsive behavior: tolerating and allowing, accepting and supporting, involving, limiting the compulsive act, and stopping the act. Collaboration among psychiatric, therapeutic, and caregivers in institutionalized settings is critical for early identification and support of OCD. Challenges arise from caregivers' lack of training on the additional needs of people with LD and OCD, highlighting the urgent need for disorder-specific guidelines for identification and support.

4-H academics responded to the COVID pandemic by rapidly adapting CDC and other resources for virtual delivery. A statewide epidemiology project was taught to 48 youth with the goal of minimizing fears and confusion, increasing prevention measures, leveraging current topics for education, and bolstering the social-emotional health of youth participants. Results indicated that youth enjoyed the project and adopted behaviors to reduce the spread of infectious diseases, such as increased mask-wearing.

Research demonstrates that young people value mental health support that is tailored to their needs and preferences, rather than a "one size fits all" offer, which is often not equitably accessible (National Children's Bureau, 2021). Understanding young people's lived experiences across different sociocultural contexts is important. The aim of this research was to conduct an international qualitative study on the views of young people with lived experience and professionals, on proposed aspects of personalised support for anxiety and/or depression. Participatory action focus groups were conducted with N = 120 young people with lived experience of anxiety and/or depression (14-24 years) and with N = 63 professionals in Brazil, India, Kenya, Pakistan, Portugal, South Africa, Turkey, and the United Kingdom. Data were analysed using the rigorous and accelerated data reduction (RADaR) technique. Overall, although some country-specific differences were found in terms of what aspects of support young people found to be most important, individual preferences were considered stronger, furthering the view that support should be personalised to the needs of the individual young person. Young people experiencing anxiety and/or depression should be able to choose for themselves which aspects of support they would prefer in their own care and support plans, with families and mental health professionals providing guidance where appropriate, rather than removing the young person from the decision-making process altogether. It should also be ensured that the aspects of personalised support can be understood by young people and professionals from different contexts, including marginalised and minoritised groups and communities.

The mental health treatment gap remains wide across the world despite mental illness being a significant cause of disability globally. Both end-user and healthcare provider perspectives are critical to understanding barriers to mental healthcare and developing interventions. However, the views of providers are relatively understudied. In this review, we synthesized findings from current literature regarding providers' perspectives on barriers to mental healthcare in Canada. We searched Medline, PsycINFO, Embase, and CINAHL for eligible Canadian studies published since 2000. Analysis and quality assessment were conducted on the included studies. Of 4,773 reports screened, 29 moderate-high quality studies were reviewed. Five themes of barriers emerged: health systems availability and complexity (reported in 72% of the studies), work conditions (55%), training/education (52%), patient accessibility (41%), and identity-based sensitivity (17%). Common barriers included lack of resources, fragmented services, and gaps in continuing education. Interestingly, clinicians often cited confusion in determining the ideal service for patients due to an overwhelming number of potential services without clear descriptions. These five domains of barriers present a synthesized review of areas of improvement for mental healthcare spanning both patients and clinicians. Canadian mental health systems face a need to improve capacity, clinician training, and in particular service navigability and collaboration.

Background: Youth with intellectual disabilities experiencing homelessness are invisible within multiple service sectors. We know little about their experiences of homelessness, or the impacts of such on the social and physical health and well-being. Methods: We used quantitative and qualitative methods to measure prevalence and learn from key informants and homeless youth with intellectual disabilities about factors leading to and sustaining homelessness, and the implications of such on their social, physical, and mental health and well-being. The project involved seven co-researchers with intellectual disabilities and experience of youth homelessness in research design, data collection, analysis, and dissemination. We created Forum Theatre scenes that creatively represent the findings of the project. In this paper we share one of those scenes, as well as the recommendations three co-researchers with intellectual disabilities have for improving support to homeless youth with intellectual disabilities. Findings: Lack of awareness of and about homeless youth with intellectual disabilities, combined with siloed ways of working by involved sectors, results in significant disadvantage and health inequities for youth. Also revealed was the likelihood this would continue given existing obstacles to accessing appropriate housing and supports to exit homelessness. Conclusion: Services providers, policy makers and representatives of the involved sectors need to recognize and acknowledge homeless youth with intellectual disabilities and take responsibility for learning and working together to develop integrated and responsive approaches to effectively supporting them.

School nurses have reported stress and worry caring for young people experiencing mental health problems, but why this occurs and how they respond has not been well-explored. In this study researchers generated a substantive theory of the experiences of secondary school nurses who encountered young people with mental health problems using the original method of grounded theory. Thirty-one Western Australian school nurse participants reported that students presented with complex mental and social health needs that were not easily resolved. This was conceptualized as an "untenable burden". Participants countered this by engaging in the three-stage process of "tactical prioritizing". During an initial period of "strategic assimilation" into the school and broader community, participants referred students to external service providers. This was frequently inadequate, and participants found themselves grappling with unmet student mental health needs. Participants responded by implementing nursing strategies for "optimizing outcomes" in the lives of young people, while simultaneously engaging in "managing self" to support their own well-being.

The objectives of this article are to examine the epidemiology of suicide for Black college men; social determinants of mental health, mental health inequities, and suicide prevention for Black college men; role of mental health utilization for Black college men; role of culture in addressing mental health needs for Black college men; racial trauma and mental health for Black college men; role of socio-economic barriers for Black college men; mental health needs of Black college men amid the COVID-19 pandemic; mental health needs of African and Caribbean college men; mental health needs of Black gay, bisexual, queer, and trans+ college men; and implications for colleges and universities in addressing the mental health needs of Black college men.

The growing number of autistic adults challenges the limited adult service system. While data on service use and barriers are available, there is limited information from the individual's perspective on which services are most helpful in adulthood and how service use is connected to community participation outcomes. Forty autistic adults participated in a study combining global positioning system community participation measures with survey and interview data on service use, including which services are most helpful in adulthood, barriers to services, and service needs. Participation outcomes were analyzed relative to demographics, number and types of services received in the past 2 years, and current mental health service use. Participants received an average of two services in the past 2 years, most frequently mental health and employment services. Individuals currently seeing a mental health counselor were more likely to be working full-time and visit more community locations compared to those who were not seeing a counselor. Participants reported mental health services as the most helpful service received in adulthood followed by employment services. While an emphasis is often placed on employment services in the transition to adulthood, findings suggest a need for integrated mental health and employment services for autistic adults. [This paper was presented at the Conference on Rehabilitation Education (NCRE/CSAV/RSA) Annual Meeting, 16 September 2022.]

Background: People with intellectual and developmental disabilities are among the most underserved in an inequitable healthcare system. Methods: Using Arksey and O'Malley's methodology and a social determinants of health framework, we conducted a scoping review of literature on the state of practice in education of healthcare professionals in the health and healthcare needs of this population. Results: Searches found 4948 articles, with 182 included in the final review. Themes identified included gaps of not being informed by workforce needs, continued use of the medical model of care, not addressing intersectionality with racial/ethnic and other discriminations, and lack of involvement of the population in developing/evaluating programs and promising trends of development of competency-based interprofessional programs with experiential learning. Conclusion: We provide recommendations for best practices in a concerted effort to educate a healthcare workforce equipped with the knowledge and skills to address the health needs of this population.

Using a content analysis methodology, we examined 15 peer-reviewed articles published between 2009 and 2019 that used qualitative and mixed methods approaches to explore how college and university students experience food insecurity. Concerningly, there was limited variety in the methods employed across these articles and more discussion of methodology was needed. Despite this, our analysis of student statements in these articles yielded three common themes: (1) co-occurring basic needs; (2) academic, physical, psychological, and social effects of food insecurity; and (3) institutional satisfaction and/or critique. We include implications for research and practice.Context and implicationsRationale for the studyFew qualitative studies centre students' food insecurity experiences in the United States. We examined available research to unearth commonalities across student narratives while connecting food insecurity to broader social class inequality in higher education.Why the new findings matterOur findings underscore the urgent need for additional qualitative food insecurity scholarship that foregrounds student voices. Future researchers examining food insecurity should consider: (a) the nuances of on-campus food insecurity, (b) the impact of food insecurity on student success, and (c) the linkages between food insecurity and social class in higher education.Implications for policy makersCampus leaders and policy makers can help address campus food insecurity by building holistic wraparound systems to support the multi-faceted needs of students facing food insecurity. To do this, policy makers and leaders must begin to understand food insecurity as more than a statistic and acknowledge the human experiences of those it affects.

Young adult refugees have suboptimal primary care use, including having a regular provider and engaging with a regular source of care for primary and preventive healthcare needs. Our purpose was to understand how young adult refugees (ages 18-29 years) resettled to the United States understand and experience primary care. We conducted 23 semi-structured interviews with young adult refugees and explored their ideas about and experiences of key characteristics of primary care. Emergent themes were synthesized. Young adult refugees reported a lack of an understanding of the idea of primary care. However, they also described the lack of accepted key components of primary care, such as being the first contact and providing continuity, coordination and comprehensiveness. The importance of developing an ability to ask questions, get answers and feel empowered was a facilitator of primary care successes. Young refugees lack access to healthcare that exemplifies quality primary care. Improving understanding of the primary care model and its value as well as increasing access and ease of engagement could improve primary care engagement for young adult refugees.

Unsafe and violent schools are a widespread problem in South Africa. This paper argues that Adverse Childhood Experiences (ACEs) contribute to this phenomenon. While various individual and community-level interventions to address ACEs have been reported on, the contribution of safe parks towards preventing school violence has not yet been explored. To support schools in dealing with violence, the Adopt-a-School Foundation introduced a pilot project at eight schools in Botshabelo in the Free State Province. The programme included psychosocial support services, establishing safe parks, and ensuring community involvement. The goal was to improve school communities by creating environments that are empowering, academically effective, gender sensitive and free from violence. Although there are safe parks in communities around South Africa, they are an uncommon sight at schools. This paper reports on the quantitative study conducted on safe parks' contribution to making schools safer and less violent. Results show that safe park activities improve community well-being, including reduced gangsterism, enhanced learner safety, and decreased disciplinary problems. It is recommended that safe parks continue to provide psychosocial services to children at schools and that their programmes be expanded to include more services.

Background: In 2012, the South African government initiated the Integrated School Health Policy (ISHP) to serve as a national guideline on providing school health and support services from key stakeholders such as the Department of Health (DoH), Department of Basic Education (DBE) and Department of Social Development (DSD). However, despite the ISHP regulations, publications report that teachers in underresourced government schools are not sufficiently equipped to address their learners' psychosocial challenges. Aim: This study aimed to assess which psychosocial interventions implemented at the schools the school teachers are aware of. Setting: A total of 50 school teachers from five under-resourced primary schools in Gauteng school communities of Meadowlands, Ivory Park, Alexandra and Doornkop-Soweto completed a feedback questionnaire designed by the investigators. Methods: This descriptive study follows a quantitative descriptive design. A comparative descriptive analysis between schools using frequencies, percentages and graphs was used to analyse the results. Results: Results indicate that a school teachers' ability to support their learners varies per school and is based on their school's compliance to training their teachers on the school safety protocols and is not affected much by external training. Schools that follow the ISPH regulations on teachers' training of protocols, better equip their teachers to observe psychosocial challenges their learners face. Conclusion: Despite the availability of guidelines, this study observes a gap in educators' observations of mental health concerns or external stakeholders responsible for nonphysical assistance. Contribution: Findings of this study provide feedback to all relevant stakeholders to assist in their future recommendations planning. One recommendation the authors of this study suggest may be that further studies explore if the lack of mental health observations is a result of poor teachers-student relations or a need for school teachers to be educated on learner mental health risk factors.

The present study explored where and how college students sought assistance and information for themselves and their family or friends who may have needed behavioral health and substance abuse disorder assistance. Two hundred and fifty-nine college students responded to the questionnaire at one of the 50 largest public higher education institutions in the Southeastern United States. Findings confirm that help-seeking is a multifaceted process involving social and professional support. Participants indicated that they would seek assistance earlier than they had and also make personal changes in their lives to address well-being. These findings can guide higher education administrators, faculty members, counseling staff on campuses, funders, and policymakers in designing and developing accessible and user-friendly programs and services for increasing student success on campuses.

China's elderly population is on the rise, and there is a growing need for improved education for professionals in geriatric health care and management. "Age-Friendly Interior Design" is a mandatory component of the curriculum for students majoring in aged care and management. Problem-Based Learning (PBL) has been introduced as an innovative teaching model. The study aims to achieve several objectives: 1) To compare the knowledge, skills, and interests of students after using Problem-Based Learning (PBL) against predefined criteria. 2) To compare the knowledge, skills, and interests of students after using the Traditional Teaching Method against predefined criteria, and 3) To compare the knowledge, skills, and interests of students after using Problem-Based Learning (PBL) and the Traditional Teaching Method. This research engaged students pursuing degrees in geriatric nursing and management at a university in Sichuan, China. It encompassed both a control group consisting of 42 students and an experimental group with 48 students. The findings indicated that both PBL and traditional teaching methods had a positive impact on enhancing students' knowledge, skills, and interests to some extent. Problem-based learning (PBL) was more effective in improving these aspects than traditional methods with a significance level of 0.05.

The purpose of this qualitative study was to identify and prioritize the mental health needs of rural communities in Texas Public Health Region 11 utilizing the Delphi method. Rural individuals face unique challenges when attempting to receive treatment for serious mental illness and mental health care. Stigma, a lack of privacy when seeking treatment, a shortage of mental health workforce professionals, a lack of culturally competent care, affordability, and transportation are all factors that complicate the need for treatment. This study utilized the Delphi method to engage rural community members in identifying and addressing critical issues related to mental healthcare delivery in their county. The sample for this study was selected from the population which comprise Texas Public Health Region 11 communities that were identified as rural communities within Health Professional Shortage Areas (HPSA) using an exponential nondiscriminatory snowball sampling method. Knowledge gained from the study will help to address challenges and critical issues in mental healthcare delivery in rural communities, such as workforce shortages, access issues, anonymity, stigma, integration of mental health services into primary care, and suicide prevention. The study's implications for refining, developing, and increasing rural mental health research, and implications for practice for mental health treatment providers in rural communities are discussed.

This conceptual paper introduces the Mindful Interactions (MI) tool designed to enable university teaching academics to promote student mental health and in so doing, impact positively on academic outcomes. The MI tool is comprised of three elements: "understandings" to provide theoretical guidance which inform pedagogy, "practices" to provide strategies for translating theory into practice, and "guiding principles" which provide a catalyst for critical reflexion, challenge existing beliefs, and create a shared vision from which to work. Relationships are at its core, acknowledging that university students report teacher-student relationships as key to their mental health. Issues related to university student mental health, of which psychological distress is an important component, have been well documented and exacerbated since the onset of COVID-19, increasing demands on universities to meet student mental health needs. It is contended in this paper that understanding the causes of psychological distress, particularly in relation to Adverse Childhood Experiences, offers an alternative lens through which to view student mental health. This lens suggests additional ways of thinking about how university teaching academics and universities might proactively respond to student mental health needs. Cultural Historical Activity Theory informed the theoretical framework for the study, whilst two 'approaches' (the 'Three Pillars of Trauma-informed Care' and 'Trust Based Relational Intervention') along with associated trauma literature underpinned the development of the MI tool.

Home care poverty is the inability of older people to access adequate home care services and their unmet needs for home care. With the increasing number of older adults (60 years old and above) with disability in China, the Chinese government pays more and more attention to home care. In this case, it is of great significance to explore whether older adults with the disability face home care poverty and its influencing factors. The Chinese Longitudinal Healthy Longevity Survey (CLHLS) data in 2018 were utilized. SPSS 22.0 was used as a data analysis tool to conduct descriptive statistics and multiple logistic regression analysis on the sample (n = 1932). The study found that in 2018, 48.0% of older adults with disability faced home care poverty. Multiple logistic regression results showed that degree of disability, age, rural and non-eastern regions, income poverty, family caregiver, and reluctant caregivers were positive factors that increased the risk of home care poverty in disabled older adults (p < 0.05). But care duration, care expenditure, social pensions insurance, community daily life care and community medical services are the positive factors to eliminate the home care poverty for older adults with disability (p < 0.05). In order to solve the problem of home care poverty of older adults with disability, based on the research conclusions, the study proposed to establish a long-term care insurance system, formulate supportive policies for family caregivers or their families, and establish a wide variety of community care services.

Background: The Australian Commission on Safety and Quality in Health Care recommends the development of reasonable adjustments to Comprehensive Care Standard to better suit the needs of people with intellectual disability. Method: An audit of adults with Down syndrome attending a mainstream internal medicine outpatient clinic was undertaken to describe their biopsychosocial profile, identify previously developed reasonable adjustments to clinical service and to consider their alignment with comprehensive care. Results: Of 54 adults, 31 (57%) male, average age 36 years (17.5-68 years), there were multiple syndromal and non-syndromal co-morbidities, 10 deaths (9 expected), from dementia. All had some degree of intellectual disability with all requiring disability supports to assist in their healthcare and an active health-disability interface in most cases. Conclusions: Reasonable adjustments to usual clinical content, process, knowledge, and organisation were identified, which appeared to facilitate application of comprehensive care. These were predominantly influenced by intellectual disability, disability supports, and the health-disability interface rather than the disease profile.

Proper treatment of developmental disabilities requires health workers to have adequate knowledge of etiology and referral procedures. There is a dearth of research on knowledge of developmental disabilities among health workers in Ghana. The purpose of this study was to document knowledge about developmental disorders, causes, and referral procedures among health workers. Researchers used a successive free-listing method to interview 37 health workers. Developmental disabilities which present with physical symptoms were the most salient disorders identified among health workers, while learning disabilities and attention deficit disorder were largely overlooked. The most commonly listed developmental disabilities were cerebral palsy, Down syndrome, and autism spectrum disorder. Respondents had limited knowledge about the causes of and referral resources for developmental disabilities. Results show the need for continuing medical education, public awareness, and enhanced resources to support the identification and care of children with developmental disabilities in Ghana.

The transition from early intervention to preschool is a major early milestone for children with multiple disabilities and their families and the first of many transitions they will experience across the lifespan. However due to the low-incidence nature of multiple disabilities, this group has been largely left out of the literature surrounding this transition. Thus, in this paper we review the existing literature in order to better understand the barriers families face during the transition from EI to preschool, and how this transition could be improved for parents of children with complex physical, medical and educational needs. Several challenges experienced by families as well as beneficial systems of support are presented. Implications for practice and further research examining the specific needs of families of children with multiple disabilities during transition are discussed.

The AV1 robotic device has a growing evidence base, both internationally and in the UK, for supporting pupils with physical/emotional health needs. The device allows pupils to access their school lessons remotely through telepresence technology. Previous papers have highlighted the growing relevance to the education field, although, to date, there is no published UK academic research. In consideration of this, the purpose of the present paper was to explore the views of school staff who have trialled the AV1 device in the UK. Semi-structured interviews were held with 10 staff members from different school settings before data were analysed thematically. Key themes related to potential for impact, opportunities/challenges, and wider socio-economic considerations. Implications are considered in relation to (1) future research and professional practice, and (2) the introduction of a proposed implementation framework to support practitioners when trialling the AV1.

We studied the associations between childhood-identified learning disabilities and adult-age mental health and whether adult-age reading and math skills, coping styles, or resilience influenced the associations. The participants were 159 Finnish adults (60.4% males). Of them, 48 (30%) had a reading disability (RD), 22 (14%) had a math disability (MD), 21 (13%) had RD + MD identified in childhood, and 68 (43%) were population-based controls, matched based on gender, age, and place of residence. At ages 20-40 (M[subscript age] = 29), they reported their mental health, coping styles, and resilience, and their reading and math skills were assessed. The hierarchical regression analyses, predicting mental health with RD, MD, and their interaction while controlling for gender and age, indicated that childhood MD predicted the occurrence of more mental health problems in adulthood, but this was not observed in the case of RD. The RDxMD positive interaction effect reflected better mental health in both the RD and the RD + MD groups than in the MD group. Controlling for adult-age reading and math skills had no effect on the association between MD and mental health outcomes while controlling for resilience and coping styles diminished the impact of MD. Strong resilience without the use of an emotion-oriented coping may thus alleviate the association between MD and mental health. As childhood MD can have long-term associations with mental health problems, these issues need to be addressed in school, at work, and in healthcare. Based on our findings, strengthening effective coping and resilience may be one avenue of support.

Objective: Over the past three decades, cultural competence has been widely promoted in the health disciplines, including in health education and promotion, as a tool to address health disparities and promote health equity among diverse populations. Cultural intelligence (CQ), or the individual's capability to adjust to cultural situations based on multiple factors including cognitive, metacognitive, motivational and behavioural characteristics, can be another useful tool when addressing the needs of diverse groups. The goal of this study was to assess the level of CQ among health education specialists and its relationship with cultural competence skills (CCS) among members of this group. Design: Five hundred and forty randomly selected health education specialists in the USA completed an online survey. The survey included questions to assess CQ, CCS and demographic information. Descriptive statistics and analysis of variance were used to analyse the data. Results: Results from the study showed that there was a significant variation in CQ among health education specialists based on race/ethnicity, education, the percentage of cultural/racial/ethnic diverse people they serve, and participation in professional development training. There was also a positive correlation between CQ and CCS, and between each of the CQ capabilities and CCS. Finally, both CQ metacognitive and cognitive capabilities were significant predictors of the overall CCS score. Conclusion: Findings from this study showed that CQ is associated with CCS among health education specialists. The results of the study suggest that health education specialists should consider CQ a useful tool with which to increase CCS.

A cohort of pediatric patients with gender dysphoria was studied to determine differences in gender-affirming care by patient characteristics. This study found that patients were diagnosed, on average, between 13 and 15 years of age. Patients who were assigned male sex at birth were more likely to be diagnosed at a younger age and receive puberty blockers as their first treatment, while those assigned female sex at birth were more likely to be diagnosed at an older age and start gender-affirming hormone therapy first. Patients who identified as female were more likely to receive any gender-affirming treatment than male-identifying or nonbinary patients. These findings characterize some of the many factors that impact the timing and type of care gender diverse patients receive. These data further our understanding of the pediatric gender diverse population and of their medical gender-affirming care needs.

Social determinants of health are conditions, such as physical and social environments, which contribute to health outcomes. People with disabilities face more health inequities than their nondisabled peers, including disparities in social determinants of health. Although research indicates people with disabilities face a number of disparities compared to their nondisabled peers, less research has focused on disparities in social determinants of health among people with disabilities as a group. The aim of this study was to explore disparities in social determinants of health among people with disabilities. To do so, we analysed Personal Outcome Measures® interviews from 1,473 people with disabilities in the United States to examine correlates of social determinants of health. Findings revealed a number of characteristics that were correlated with lower social determinants of health among people with disabilities: gender; race; primary communication method; disability type; impairment severity; residence type; and organisational supports in place. Many of our findings link to larger structural systems and oppressions. Working on an individual scale to provide better services and supports to individual people with disabilities, although important, is not enough. People with disabilities will not have health equity until structural issues, such as racism, sexism, and ableism, are addressed.

Objective: Community colleges have historically reported high levels of student mental health needs, with low levels of available face to face services. Ways of meeting this mental health staffing challenge is an area of import for each institution. The COVID-19 pandemic exacerbated this situation. The objective of this analysis is to examine the impact of the pandemic on college students, with particular attention to community college student mental health issues and to illuminate a possible strategy to respond the expanded staffing needs faced by this sector of higher education. Method: This work is based on a review of studies reporting the pandemic's impact on community college student mental health, and needed mental health staffing. Two case studies, one urban and one rural, are presented here to highlight needed community college-university partnerships focused on increasing mental health professionals for community colleges. Results: The case studies illuminated commonalities between urban-rural settings, as well as challenges. Based on the literature review and case studies a generic model for responding to this critical mental health staffing need is presented. Contributions: This work challenges the notion that traditional staffing arrangements are the only patterns available to expand needed mental health professionals needed in community colleges. Studies of alternative staffing arrangement, evaluation, impact, and student satisfaction are warranted.

With gendered organization theory and n = 201 Historically Black Colleges and Universities women faculty, the following is addressed: RQ1: Which Historically Black Colleges and University women faculty, those at schools with or without an anti-bullying policy, are more likely to report workplace bullying? RQ2: What is the relationship between workplace bullying intensity and time spent strategizing against bullying, health problems, and organizational distrust for Historically Black Colleges and University women faculty? RQ3: How does workplace bullying affect the experiences of Historically Black Colleges and University women faculty? The mixed methods findings confirm the need for preventative structural changes policies to empower women.

Background: Adolescents and young adults (AYA) with chronic conditions should acquire self-management skills as part of their healthcare transition (HCT) from pediatric to adult-focused care. HCT/self-management skills have the potential to help mitigate health disparities among minority AYA with chronic conditions. This study investigated school nurses' practices promoting HCT/self-management skills in urban public schools. Methods: Seventy-nine nurses from three urban school districts in Massachusetts completed a survey of 32 Likert-type questions on HCT/self-management skills, eight demographic questions, and five open-ended practice questions assessing how often they have asked students with chronic conditions about HCT/self-management skills, based on the UNC TR[subscript x]ANSITION Index[TM]. Results: Among the 79 school nurses who participated (response rate 76%), 67% never or rarely assessed students' knowledge of HCT/self-management, and 90% would use a tool that promotes/measures HCT/self-management skills. Conclusion: In our study sample, most school nurses acknowledged the importance of assessing HCT/self-management skills. The majority favored using a tool to promote these skills.

Objective: Assess administrative responsibilities and experiential effects of emotional support animal (ESA) and service animal (SA) policies on college campuses. Participants: Students at two four-year universities participated in an emotional support animals and service animals survey. Selected students and professional personnel participated in interviews and focus groups. Methods: This mixed-methods study included quantitative survey data from 1,363 students, qualitative individual interviews (3) and a focus group (1) regarding emotional support animal (ESA) and service animal (SA). Results: Seventy-one students reported having ESAs, 18 had SAs. Barriers for ESAs on campus included no ESAs outside of dorms, while SA-owners reported fewer barriers. University administrators followed federal guidelines for SAs but lacked clear guidelines for ESAs. Qualitative themes included lack of awareness, education, support for SA, and ESA accommodations. Conclusions: ESA and SA accommodations continue to rise, on university campuses. Clear guidelines and implementation processes are imperative for future improvements.

Academic and research libraries historically lack intentional engagement with Black, Indigenous and People of Color (BIPOC) communities. This scoping review examines how academic and research library literature address social justice issues by engaging BIPOC with science, technology, engineering, mathematics, and/or medicine (STEMM) disciplines in North America. The review included published and unpublished literature by all types of library workers from varying education levels and used resources found within education databases and sources known as "grey literature." Findings identified a prevalence of BIPOC engagement via health topics with off-campus communities in comparison to limited interaction with BIPOC college and university students. A variety of engagement strategies and activities are discussed as unique opportunities and avenues for libraries to address issues related to social justice, diversity, equity, inclusion, and belonging.

Structural inequities influence young parents' access to health care, housing, transportation, social support, education, and income. The current study adds to the extant literature by providing data directly obtained in collaboration with young parents to understand how structural violence affects the health and well-being of their families, ultimately resulting in community-driven policy recommendations developed in collaboration with the state health department. We engaged a diverse sample of young people--considered as community researchers in the project--including Black, Latinx, and/or LGBTQ+ pregnant and parenting young parents in a participatory action research (PAR) project in the spring of 2022 to explore their health and material needs while living in Springfield, Massachusetts. Together with young parents, we used participatory arts-based methods to conduct community and identity building, define research questions and photo prompts, conduct data collection (photos), engage in group thematic analysis, and take action at the state policy level. We also conducted individual semi-structured life-history interviews with the young parents. Participatory community-led findings indicate an urgent need for systemic change to increase access to safe and affordable housing; living-wage jobs; safe, high-quality, and affordable child care; and to bolster social support and disabilities services for young parents and their families. This participatory study funded by a state health department demonstrates that participatory community-driven data can have the power to mobilize community members and policy makers for social change if prioritized at the state and local levels. Additional practice-based implications include prioritizing participatory mentorship programs intended to aid young parents in navigating the complex systems that are vital to their survival.

University counseling centers (UCCs) are an important resource for sexual and gender minority (SM/GM) students as they navigate their college experience. This study investigated the mental health needs of SM/GM collegiate clients in 2020-2021 as compared to the mental health needs of SM/GM collegiate clients in 2012-2015. The analyses also specifically explored the current mental health needs of asexual, pansexual, and gender non-binary collegiate clients. Data were from the Center for Collegiate Mental Health 2012-2015 and 2020-2021 academic years. Results indicate SM/GM identifying collegiate clients in 2020-2021 are younger, more racially diverse, reporting more mental health needs, and utilizing services at UCCs at double or triple the rate as compared to 2012-2015. In 2020-2021, all SM/GM clients had more mental health needs than their non-marginalized peers. Asexual and non-binary clients were demographically similar to their peers, while nearly half of the pansexual clients were racial minority identifying, were more often first-generation, and were younger than their peers. Asexual clients showed acute mental health needs as compared to the other SM groups, whereas pansexual and non-binary students had higher levels of reported symptoms than their respective comparison groups. Implications for UCCs including specialized inclusive services and intentional campus relationships are discussed.

The influence of the global health crisis and systemic racism on the return to campus are enormous. With differing experiences, opinions, and ideas about what is needed, individuals are challenged to understand their own and others' lived experiences in 2020. Campuses should be prepared for the emotional healing and systemic changes needed in higher education. It is important for campus leaders to recognize that campuses will be places of collective trauma. Moving forward, according to the authors, campuses are likely to see more urgent concerns about food and housing insecurity, and physical, mental, and emotional health needs. Addressing these concerns will require significant levels of community and psychological support. In considering the current context, it is important for practitioners to communicate with students both immediate and long-term plans for diversity, equity, and inclusion (DEI) efforts and COVID-19 precautions, while acknowledging areas of uncertainty. It is critical for leaders to be aware of the emotional pulse of the campus and how trauma has manifested among various communities on campus. Leaders should be aware that emotions shift over time, and new strategies may need to be developed in order to navigate emerging emotions.

The purpose of this study was to examine associations between caseload, social determinants, health needs, students meeting grade-level English and Math standards, and attendance. Data from the Washington State Open Data Portal and Report Card were combined with District Health Assessment data from 264 school districts. Analyses of variance and linear stepwise regression analyses were conducted. Key findings indicate significant differences in English and Math outcomes by caseloads, with higher caseload districts have lower percentages of students meeting English and Math standards, but not attendance. Caseload is a significant predictor of students meeting English and Math standards, after controlling for social determinants and district health needs. Findings point to the complexity of school nursing work and builds a foundation to guide future nursing research. Large prospective studies that allow for comprehensive measurement of structure, process and outcomes variables are needed to advance school nursing research.

The aim of this study was to closely examine the experiences of non-Indigenous academics in marking a single assessment task designed to promote cultural safety practice in a health professional programme. In recognition of institutional racism and significant health and wellbeing disparity in Indigenous wellbeing, "cultural safety" is recognised as essential knowledge across professions in tertiary education. An assessment task was designed to support students' written critical reflection to promote their cultural safety practice. A collaborative autoethnography by four academics critically reflected on the tensions in marking this reflective assignment as non-Indigenous educators. Thematic analysis was conducted on transcriptions of the authors' discussions and a framework was developed in response to repeating sites of tension. "The Indigenous allyship assessment framework: sharing the load" was framed around the central theme of Navigating the Unsettling. It specifically draws attention to navigating the "Personal (Heightened Responsibility" and "Partial Knowledge)," "Pedagogical (Judge the Meaningful" and "Feedback Conversations)" and "Persons and Processes (systems) (Efficiency Culture" and "Cost of Marking)" tensions. Our conclusion was that non-Indigenous educators need to consciously navigate unsettling challenges to do justice to assessment tasks to promote cultural safety.