A program to educate school nurses about mental health interventions.

Concerned with the increasing incidence of mental health problems in children and adolescents and the impact of these problems on students' school success and predisposition to self- and other-directed violence, the Multnomah Education Service District Department of School Health Services determined to become proactive by providing preventive interventions for students experiencing actual or potential mental health problems. An educational program was designed to assist school nurses in the identification of potential mental health problems. In addition, information about appropriate interventions for students at risk for aggression, violence, and other mental health pathology was presented. The program involved education on mental health assessment and intervention, as well as expert psychiatric clinical support for the development of student support groups. School nurses were then challenged to develop practice improvement projects incorporating this knowledge for a group of students in their work setting. This introductory article describes the project's general rationale and implementation process. The four articles following in this issue of The Journal of School Nursing describe the goals, implementation, and outcomes of the practice improvement projects developed for early intervention with students exhibiting attention disorders, school absenteeism, social withdrawal, and depression.     

Mental Health and Academic Achievement: Role of School Nurses

PURPOSE: This article discusses how school nurses promote mental health and subsequent academic achievement by screening and referral for children demonstrating mental health problems. Nursing interventions are discussed at the individual, systems, and community levels. CONCLUSION: Mental health problems can affect school performance and academic achievement. When mental health problems are not recognized, students may be unable to reach their academic potential. School nurses are in a key position to provide interventions to address mental health and academic achievement. PRACTICE IMPLICATIONS: The role of school nurses and examples of mental health collaborative activities are provided.     

The Impact of Mental Health Nursing Module,Clinical Practice and an Anti-Stigma Program on Nursing Students' Attitudes toward Mental Illness: A Quasi-Experimental Study

BackgroundIt is important to support nursing students during their education in developing positive attitudes toward people with mental illness.ObjectivesTo examine the impact of mental health nursing module, clinical practice, and anti-stigma program on the attitudes of nursing students toward mental illness.DesignThe study was a single group pretest and posttest quasi-experimental design.SettingsThis study was conducted in a nursing school in the west of Turkey.ParticipantsThe sample of the study consisted of 64 undergraduate nursing students.MethodsThe data were collected through the Beliefs Toward Mental Illness Scale and Social Distance Scale.ResultsThe mean scores of the dangerousness subscale significantly decreased after mental health nursing module, clinical practice and anti-stigma program. The results revealed significant positive differences in the mean scores of the social distance scale after the theory, clinical practice, and anti-stigma program were completed.ConclusionsThe mental health nursing curriculum should be focused on replacing stereotypes with accurate information. Anti-stigma programs should be included in standard mental health nursing courses.     

Psychosocial health information in free text notes of Swedish children’s health records

Background: High‐quality documentation of children’s health is an important priority in health care given trends of declining mental health and reduced well‐being in children. There is a lack of information concerning psychosocial health in the standardized part of the national health record in the Child Health Service and the School Health Service in Sweden. Further, little is known if the free text notes in the health record, besides information on physical health, also include information on children’s psychosocial health. The aim of this study was to describe what is recorded concerning children’s health and development in free text notes. Methods: The study was based on a retrospective analysis of text using an inductive approach for qualitative analyses of content. Results: The analysis of the free text notes in the health records yielded seven categories: development, family, health problems, living habits, medical issues, preschool/school and leisure, and well‐being. The categories mainly covered psychosocial aspects of health and were not only about health and development problems of the child but also what was covered during the visits. The information was unevenly distributed across the ages. A stronger focus on the youngest age groups within a family and preschool setting is needed. There was novel information in the free text notes such as pain, general health, emotions, mother’s mental health and leisure activities, which was not covered in the standardized part of the health records. Conclusion: The free text notes mainly reflected a psychosocial perspective on health. The findings of this study suggest that requesting more information on children’s psychosocial health in the standardized part of the health records could contribute to more comprehensive and informative health records in the Child health Service and the School Health Service in Sweden.     

Identifying the mental health needs of preschool children.

The city of Chicago offers publicly funded preschool education to 20,000 3- and 4-year-olds through its State Pre-Kindergarten program. The students attend some 300 schools, and their health needs are monitored by 11 nurses and 8 aides. In the last several years, the nursing coordinator recognized the need to improve the mental health assessment skills of the school nurses. To that end, a relationship was developed with a child psychiatric nurse who had expertise in assessing young children's behaviors, particularly in the context of the classroom milieu. The collaboration of the school nurse and mental health nurse-consultant was structured as one-on-one sessions, each focusing on a particular child. A case is presented to illustrate the assessment method and accompanying suggestions for early intervention strategies. The case also points out how school nurses can structure assessments of at-risk children that lead to classroom-based interventions.     

Children's mental health and school success.

An integrative review of literature was undertaken to examine the impact of children's mental health on their school success. The literature confirmed a confluence of problems associated with school performance and child and adolescent mental health. Poor academic functioning and inconsistent school attendance were identified as early signs of emerging or existing mental health problems during childhood and adolescence. Among the goals of school nursing is to provide a process for identification and resolution of students' health needs as they affect educational achievement. Thus, it is within the scope of practice and goals of school nursing to also address children's mental health needs, as they affect school performance. This review of literature supports the conclusion that school nursing is well positioned to respond to the need for mental health promotion, illness prevention, and early intervention related to children's mental health.     

A World Wide Web-based health resource. Survey of Missouri school nurses to determine priority health information resources for SchoolhealthLink.

Two hundred ninety-two school nurses in Missouri participated in a mailed survey to aid in the design of SchoolhealthLink, a World Wide Web (WWW)-based information service for Missouri school nurses and children. The nurses identified specific health information resources likely to benefit school nurses and school children and prioritized these resources. The school nurses assigned high priority to 11 types of health information resources: individualized health care plans, emergency care plans, communicable disease control plans, acute illness, injuries, communicable diseases, hotline numbers, medications in schools, immunization protocols and standards, community-based health care resources, and Department of Elementary and Secondary Education regulations that affect school nurse practice. The four most common health problems school nurses identified were asthma, attention deficit disorder, diabetes, and head lice. SchoolhealthLink will provide a one-stop WWW-based resource for school nurses and school children.     

民族院校大学生心理健康现状调查及心理护理干预

目的对民族院校大学生进行心理健康现状调查,探讨护理干预对心理健康存在隐患的学生的心理健康影响。方法采用分层随机抽样法抽取300名少数民族大学新生进行心理筛查。采用中国大学生心理健康量表（CCSMHS）进行测量,对心理健康存在隐患的学生采用症状自评量表（SCL-90）进行再次评估和护理干预,并与国内大学生常模比较,观察心理护理前后该组学生SCL-90各因子的变化。结果经CCSMHS筛查出的阳性学生36名,占总人数的12％;民族大学新生在CCSMHS躯体化、焦虑、自卑、强迫和冲动等因子得分均高于常模,差异具有统计学意义（P〈0．05）。对于筛查阳性的学生经SCL-90测量,结果表明,在心理护理前,该组学生在躯体化、抑郁、焦虑和精神病倾向因子得分高于常模,差异具有统计学意义（t分别为-0．11287,-0．09539,-0．12324,-0．08119,-0．04136,P〈0．05）;心理护理前后,在躯体化、抑郁、焦虑、敌对、恐怖、偏执和精神病倾向方面均有显著地改善,差异具有统计学意义（t分别为-0．15869,0．00163,0．02937,0．03914,0．01304,0．00979,0．01061,P〈0．05）;心理护理后与全国常模比较,除了焦虑方面外,其他因子均无统计学差异（t=-0．01277,P〈0．05）。结论通过应用不同的心理护理手段进行心理干预教育,能够改善少数民族大学新生的心理健康状况。     

The family-focused mental health practice questionnaire

It is estimated that 1 in 5 children have a parent with a mental illness, and studies have shown that such children are more likely to develop mental health problems when compared with their peers. Research has demonstrated the benefits of mental health clinician family-sensitive practice to both parents and their children; however, a measure of clinician practice is not available. The psychometric properties of a questionnaire measuring family-focused practice in the psychiatric setting are reported here. There were 307 public adult mental health worker participants, predominantly from the nursing profession and working full time. Principal component analysis highlighted 14 subscales that summarize 49 items reflecting organizational and worker factors, such as skill/knowledge about the impact of parental mental illness on children and worker confidence. Subscales are discussed in relation to the literature and psychiatric policy. The measure appears a useful tool for evaluation, benchmarking for training and organizational improvement, and ultimately, for increasing quality services to parents, families, and particularly children associated with psychiatric services.     

Mental health placements in a general health setting: no substitute for the real thing!

Aim. To determine effectiveness of clinical placements in non‐mental health facilities in producing improvement in attitudes toward people with a mental illness and toward mental health nursing in nursing students. Background. Clinical placements in mental health settings have favourably impacted students’ attitudes and confidence in mental health settings. Placement shortages have created discussion about using non‐mental health settings to gain this experience, as mental illness is common in all health settings. To date, no research findings support or refute the efficacy of non‐mental health settings in influencing confidence and attitudes. Design. A within‐subject design was used. Participants provided self‐report data soon after the beginning and at the conclusion of the mental health component. Methods. A questionnaire was administered to a cohort of undergraduate nursing students (n = 66) to measure attitudes, preparedness for practice and interest in mental health nursing as a career, using a pre‐ and post‐test design. Results. Only 25% of participants completed clinical experience in a mental health facility. Minor improvement in attitudes, confidence and appreciating the nursing role in mental health were identified, but the impact on attitudes was considerably less favourable than when clinical experience was undertaken in a mental health facility. Conclusion. Participants who completed clinical experience in a non‐mental health facility did not demonstrate more favourable views about mental health nursing. Relevance to clinical practice. Clinical placements in mental health are essential preparation for undergraduate students to maximise improvement in attitudes to the care of people diagnosed with a mental illness and to mental health nursing.     

A student health advocate program.

School nurses are in a unique position to influence health education in the school system. However, it is likely that school nurses have varying opportunity, due to staffing patterns, to effectively use their health education background to reach large numbers of students. This article explores the benefits of providing a school nurse-facilitated student health advocate program. The student health advocate program is a creative approach, designed to access a greater audience of students for health education and health promotion activities. It also cites research supporting the choice of peer education as a health education/health promotion strategy. The initiation of a student health advocate program, the role of the school nurse, student activities, program evaluation, and nursing implications are discussed. Positive benefits accrued for both the student health advocate and the mentored student.     

A systematic review: Students with mental health problems—A growing problem

Storrie K, Ahern K, Tuckett A. International Journal of Nursing Practice 2010; 16 : 1–6
A systematic review: Students with mental health problems—A growing problem
The number of university students with a serious mental illness has risen significantly over the past few years. A systematic review was conducted that addressed emotional and or mental health problems of university students worldwide. In total, 572 articles were identified, of which 11 met inclusion criteria. Issues identified included types of problems experienced by students, how staff dealt with these students, barriers to seeking help, tools that facilitated help-seeking and epidemiological trends in the university student population. Recommendations include (i) providing better links between the university and external mental health providers, and (ii) increasing students' awareness of existing support services within and external to the university. As it is unrealistic to expect all academic staff to have the expertise required to deal with students with emotional problems, it is also recommended that (iii) policies and personnel with expertise in mental health are available to provide guidance for staff.     

At-risk children: a demographic analysis of the children of clients attending mental health community clinics

Children of parents with mental illness have an increased risk of psychological problems. The aim of this study was to identify the demographic characteristics of dependent children of adults presenting at mental health clinics in Western Australia. A survey of clients who attended the clinics indicated that half reported having had children. Of these, 21% had a primary diagnosis of schizophrenia. Although schizophrenia was the most common illness, there were almost seven times more children living with a parent with a primary diagnosis of depression than schizophrenia. Recommendations include that children of clients with mental illness be included as part of a wider client focus.     

父母离异对中学生心理健康状况的影响

目的分析父母离异对中学生心理健康状况的影响。方法使用症状自评量表(SCL-90)、自编的基本资料问卷,按随机分层整群抽取,对南宁市2700例中学生采用问卷调查方式做了心理健康状况的调查。结果南宁市父母离异中学生心理问题发生率20.1%,无父母离异中学生心理问题发生率13.8%,两者差异有统计学意义(P0.01)。父母离异中学生SCL-90检测各项因子得分均高于无父母离异中学生SCL-90检测各项因子得分,两者比较差异有统计学意义(P0.01)。结论父母离异严重影响中学生心理健康状况,应得到广泛重视。     

To your health: implementation of a wellness program for treatment staff and persons with mental illness

Persons with mental illness often have poor access to both health promotion and primary care services. Consequently, they are at greater risk for earlier mortality, and comorbid health problems that ultimately impact their community rehabilitation. The "To Your Health" program is a health promotion program, based on the states of change model that was implemented as part of a clubhouse rehabilitation program. The program used personal wellness profiles, health assessments, and personal goal setting to assess the relative wellness of clients and staff in order to increase their awareness of health-promoting behaviors. Additionally opportunities were provided to engage individuals in making changes through participation in activities that provided opportunities to try out new behaviors and to set goals that integrated changes into their lives. The initial findings are reported along with the rationale for the involvement of clients and staff, and the role of health promotion in community rehabilitation of persons with mental illness.     

Nursing students’ attitudes and experiences with mental illness: A cross-sectional study

Almost half (46%) of people will experience a mental health issue in their lifetime and all nurses need mental health knowledge and skills regardless of their area of specialization. Little is known, however, about student attitudes toward people with mental illness on entry to pre-registration nursing programs. The aims were to investigate Australian pre-registration nursing students’ attitudes toward, and prior experience with, people with mental illness on program commencement. This cross-sectional study used the Community Attitudes Toward Mental Illness (CAMI) scale with pre-registration nursing students, and questions on students’ prior experience with mental illness (self, family, friends). There were n = 311 (271 female/40 male) first year, first semester Bachelor of Nursing students at a national Australian university. Students reported prior experience with mental illness with family (49.5%/n = 154) and friends (61.4%/n = 191). Self-reported (36.3% /n = 113) mental illness, particularly anxiety and depression, significantly exceeded national averages. Most students held accepting attitudes toward people with mental illness, except for perceptions of dangerousness. This study provides new findings on nursing student attitudes and experience with people with mental illness on program entry. The high self-reported prevalence of anxiety and depression at program entry indicates a pressing need for early intervention and mental wellbeing strategies for students from commencement of their tertiary education. Fear-reducing education which challenges perceptions of dangerousness in relation to people with mental illness, and supportive mental health clinical placements during their program, may help improve students’ attitudes and reduce fear and mental health stigma.     

中专在校护生心理健康现状的调查分析

目的 了解中专护生心理健康的现状.为心理健康教育提供有针对性的指导.方法 应用心理健康诊断测验量表(MHT量表)对642名在校护生以问卷方式进行心理健康状况调查,并进行相关性分析.结果 有严重心理问题(≥65分)的学生占0.78%,有较严重心理问题(<65分且≥56分)的学生占4.52%.各年级学生在学习焦虑、过敏倾向、身体症状焦虑3方面有明显的差异,P<0.05.结论 中专护生心理健康总体状况良好,但还是有较多的人存在学习焦虑、过敏倾向和身体症状焦虑,且各年级存在差异.中专护校应进一步加强对学生的心理健康教育,并争取家长的密切配合,对有心理障碍的护生给予相应的干预措施,以提高中专护生的整体心理健康水平.