上海市中学生对心理卫生问题的知晓度调查

目的 了解并比较上海初中生与高中生对心理卫生问题的知晓情况。方法 采用儿童心理卫生知晓问卷和长处与困难问卷（SDQ）对737名中学生进行了研究。结果 初中生在同伴交往和社会行为方面问题多于高中生组。高中生在情绪、注意力上问题多于初中生。高中生对严重心理卫生问题的识别力高于初中生。初中生和高中生对服药和与人谈论来解决心理问题的方法都不认可,尤其是高中生。都认为家庭对心理卫生问题的影响很大,初中生更相信他们的父母能发现并帮助他们解决心理问题,而高中组中则相反。结论 上海初中生和高中生对心理卫生问题的知晓情况存在差别。     

Transformation of children's mental health services: the role of school mental health

The New Freedom Commission has called for a transformation in the delivery of mental health services in this country. The commission's report and recommendations have highlighted the role of school mental health services in transforming mental health care for children and adolescents. This article examines the intersection of school mental health programs and the commission's recommendations in order to highlight the role of school mental health in the transformation of the child and adolescent mental health system. Schools are uniquely positioned to play a central role in improving access to child mental health services and in supporting mental health and wellness as well as academic functioning of youths. The New Freedom Commission report articulated several goals related to school mental health: reducing stigma, preventing suicide, improving screening and treating co-occurring disorders, and expanding school mental health programs. The authors suggest strategies for change, including demonstrating relevance to schools, developing consensus among stakeholders, enhancing community mental health-school connections, building quality assessment and improvement, and considering the organizational context of schools.     

中学生心理卫生状况调查及相关因素分析

目的：研究中学生心理健康水平及影响因素。方法：以群体分层抽样法，共抽取受试样本2066例。采用症状自评量表（SCL-90）、艾森克个性问卷（EPQ）、青少年心理卫生调查表（自编），对宝鸡市12所中学初一至高三的六个年级的中学生进行问卷调查。结果：表明约9％的中学生有心理健康问题。中学生心理健康问题依次为强迫、人际关系敏感、敌对、偏执、抑郁、焦虑等。偏相关分析发现中学生心理健康水平与神经质、精神质、年级、学习任务、性别等呈正相关。结论：中学生心理健康值得高度重视；神经质与精神质的个性倾向、年级、学习任务等是影响中学生心理健康的重要因素。     

School Mental Health and Foster Care: A Logical Partnership

School mental health is increasingly recognized as an effective framework of care for enhancing access to high quality mental health services for school age youth. This article discusses the potential role that school mental health can play in helping to address the mental health needs of children and adolescents in foster care, a group with elevated risk for mental health and educational problems when compared to other children and adolescents living in high risk environments. A full continuum of school mental health services, from prevention to intervention, offers opportunities to reach these youth before academic and emotional-behavioral problems escalate. Benefits and challenges to providing services to youth in foster care through school mental health are discussed and next steps toward developing a training curriculum that addresses core competencies needed for effective school-mental health-foster care integration are addressed.     

Establishing and Maintaining Important Relationships in School Mental Health Research

For this article, we investigated a complicated (and hypothesized, little-studied) area in school mental health research: namely how researchers establish and maintain successful relationships with key stakeholders in school settings. We identified key stakeholders that school mental health researchers have to consider when engaging in school-based research. Parents, youth, teachers, school leadership, school mental health professionals, district-level leaders, and community mental health partners are each specific stakeholders who may have differing (or even competing) agendas than that of the research team. In addition, professionals within these groups may have concerns or even suspicions about the researchers’ involvement in their school. To better understand these complex relational issues, we conducted a survey of leading school mental health researchers based on a convenience sample of researchers who attended a national school mental health research summit in October 2012. The survey data revealed that successful school mental health researchers have to continually work at creating and maintaining good relationships with school stakeholders, and consider these relationships crucial to conducting this research. In this article, we will describe barriers to recruitment and implementation and methods of overcoming the challenges identified in several case studies of school-based research in published articles and from our survey data. We present this information and propose a preliminary best practice model to developing and maintaining relationships with school professionals in SMH research.     

Towards School Mental Health in Nigeria: Baseline Knowledge and Attitudes of Elementary School Teachers

There is a shortage of child and adolescent mental health (CAMH) professionals all over the world, and this shortage is especially critical in most parts of the developing world. Schools have been identified as ideal settings to reach needy children in the community, and training teachers in CAMH issues can help improve early identification and appropriate referrals of children with mental health problems. As part of a needs assessment for developing a training programme, selected Nigerian elementary school teachers were asked to complete confidential questionnaires to determine their perceptions of mental health problems in school children. Teachers indicated that they had no previous CAMH training. Baseline assessments revealed that teachers' knowledge of CAMH was deficient, and attitudes to children with mental health problems revealed intolerance. Incorporation of CAMH care into teacher education curricula is a critical next step towards integrating school teachers as mental health collaborators in school mental health programmes in Nigeria.     

重点中学学生心理健康状况及影响因素分析

目的研究重点中学在校学生心理健康状况及其影响因素。方法对某市4所重点中学的1937名在校初中、高中生，应用中学生心理健康调查表、父母养育方式量表进行调查。结果41．71％的学生存在程度不同的心理健康问题，主要表现为：学习压力、情绪不平衡、适应不良、强迫症状。心理健康问题与母亲拒绝否认、同伴关系、母亲过分干涉、过度保护等诸多因素有关。结论重点中学学生心理健康问题发生率较高，应引起教育界和社会的关注。     

Stakeholders' perspectives on the recommendations of the President's New Freedom Commission on Mental Health

OBJECTIVE: The purpose of this study was to understand stakeholder perspectives on school mental health and the mental health system as they relate to the goals identified by the President's New Freedom Commission on Mental Health. METHODS: A total of 11 focus groups were held in Maryland, Ohio, and New Mexico with groups of parents, youths, school- and community-based providers and staff, and child and school mental health advocates and leaders. Across the three sites, 105 individuals participated in the focus groups. RESULTS: The stakeholders provided several important recommendations to advance the field of mental health. They included addressing stigma, implementing culturally competent care, providing mental health training to school staff, and increasing collaboration between community providers. CONCLUSIONS: Obtaining the views of key stakeholders is critical to transforming the mental health system and expanding the focus on mental health in schools.     

女子中学学生心理健康状况的调查

目的调查女子中学学生心理卫生状况.方法抽取寄宿制女子中学和普通中学各一所,采用精神症状自评量表（SCL-90）对学生进行测评,并对结果进行比较.结果两所学校女生的心理卫生状况均较差,问题学生检出率分别为15.45%和13.83%,以初一和初四多见而严重.表现形式亦不尽相同,女子中学表现在人际关系敏感、敌意、恐怖及精神病性等方面,普通中学女生表现在躯体化、强迫症状、抑郁及焦虑等因子方面,这些在初中三年级时差别开始明显.结论两所学校学生总体心理卫生状况均较差,有心理问题学生的总检出率相当,心理问题的表现形式却不十分一致.     

Qualitative analysis of key informant interviews about adolescent stigma surrounding use of school mental health services

Given the increased access to mental health services that schools provide, there has been a growing consensus among mental health professionals for the delivery of services for youth in schools. Building the capacity of schools to provide evidence-based socio-emotional supports across a continuum of care has been prioritized in recent decades. However, despite policy changes to implement more mental health services in schools, these services still remain widely underutilized by adolescents experiencing mental health problems. Understanding the factors impacting students’ decisions to seek help or use resources provided in a school setting is crucial for actually increasing utilization of care. Yet, little is known about the role of stigma in students’ underutilization of school mental health services. The current study examined stigma about mental health and services in schools through a qualitative analysis of 15 school personnel and student interviews at three high schools in South Carolina. Thematic analysis of interviews indicated that students have a negative outlook of mental health services because of fear of being stereotyped or embarrassed as a result of receiving school counseling. Data from this exploratory study directly contribute to the field of education by providing a model for professionals to implement strategies to eliminate the stigma that causes underutilization of school mental health services.     

School nurses' perceived prevalence and competence to address student mental health problems

Due to under-identification of student mental health problems and limited specialty mental health providers in schools, school nurses are often faced with identifying and addressing student mental health needs. This exploratory study assessed prevalence and types of student mental health problems encountered by school nurses, as well as their prior training, perceived competence and levels of comfort addressing such problems. Data collected at a 2010 National Association of School Nurses conference from 78 school nurses suggest that in their view, 31% of students present with mental health concerns as their ‘primary’ presenting issue. School nurses reported moderate levels of comfort identifying specific problem areas, but limited comfort in mental health intervention and pre-service training to identify, assess, make referrals and/or intervene. Perceived competence identifying mental health concerns overall was predictive of perceived competence to make referrals. Implications and recommendations for professional development are presented.     

A national initiative to advance school mental health performance measurement in the US

Standardized health performance measurement has increasingly become an imperative for assuring quality standards in national health care systems. As compared to somatic health performance measures, behavioral health performance measures are less developed. There currently is no national standardized performance measurement system for monitoring comprehensive school mental health in the USA. Drawing upon related initiatives in the school mental health field and national performance standards for behavioral health care in non-school settings, the current study describes the identification, development, and refinement of quality and sustainability performance measures for comprehensive school mental health. A three-phase method involving literature review and expert consensus, nominal group decision-making, and a modified Delphi process resulted in the development of two performance assessments, which include 12 domains and 67 indicators. Future directions for national performance measurement among school mental health systems to drive improvement in quality and sustainability are considered.     

Supporting Mental Health and Wellness among Private School Students: A Survey of Catholic Elementary and Secondary Schools

Little systematic inquiry has focused on school-based mental health services in the Catholic education sector, which educates more than two million children annually in the United States. More than 400 Catholic elementary and secondary schools were surveyed to inform a baseline environmental scan measuring how Catholic schools nationally are serving children's mental health needs. The article sheds light on patterns of mental health staffing and resource provision, student psychosocial and mental health issues, mental health service provision, and barriers to and challenges of mental health service provision. The findings are contextualized by comparison with estimates of public school mental health service provision, consideration of funding issues pertinent to the private school sector, and the continuing need for strategic assessment and action planning to support student mental health.     

Longitudinal Determinants of School-Based Mental Health Service Use for Girls and Boys with Externalizing Behavior Problems

Studies suggest that girls with externalizing problems (ExtP) who receive school-based mental health services may have more severe impairments than boys. In addition, girls with ExtP who receive mental health treatments have been found do so for shorter durations, but this remains to be confirmed among children receiving school-based mental health services. This study sought to (1) examine gender differences in students’ characteristics and problem severity at study inception and in mental health service use at school at 12-, 24- and 36-month follow-up and (2) investigate longitudinal child, family and school determinants of service use among girls and boys. Participants were 370 elementary school students (149 girls) receiving school-based mental health services for ExtP. Child, family and school determinants of mental health services at school were examined ecologically from parent and teacher reports at study inception and follow-up points. Proportionally more girls than boys presented clinical ExtP and fewer retained services at each follow-up point. Multilevel generalized estimating equations models indicated that, among girls, conflict with teacher, affiliation with deviant peers and poor academic functioning significantly increased the likelihood of mental health service use over time but that ExtP severity was the most robust independent predictor. A broader set of determinants emerged for boys, including ExtP severity, internalizing problems and affiliation with deviant peers. These results suggest that adults may be more sensitive to boys’ difficulties than to girls’ and that girls who receive school mental health services typically present more severe impairments.     

Examining Bidirectional Associations Between School Engagement and Mental Health for Youth in Child Welfare

Children in contact with the child welfare system (CWS) represent a vulnerable population that is at an increased risk of poor mental health and academic outcomes. Although the majority of research has focused on the academic benefits of school engagement, studies have also found a negative association between school engagement and youth mental health outcomes. Surprisingly limited research, however, has considered the possibility of a bidirectional relationship between school engagement and youth mental health, and even fewer studies have examined this relationship in high-risk populations, such as children in contact with the CWS. The present study addresses this issue by utilizing longitudinal data from a national sample of 2633 children in contact with the CWS, the National Survey of Child and Adolescent Well-Being (NSCAW I), to examine the possible bidirectional relationship between school engagement and mental health symptoms. Data were collected from this sample (mean age = 10.04; 52.3% female) over three time points (18 months apart). Structural equation modeling results indicated that students’ mental health (externalizing/internalizing symptoms) predicted subsequent school engagement levels. School engagement, on the other hand, was not a predictor of mental health symptoms at later time points. Findings point to the existence of a unidirectional relationship from mental health symptoms to school engagement for children in contact with the CWS. Directions for future mental health interventions for this population are discussed.     

Building an International Network for Mental Health in Schools

World-wide, there is increasing recognition of gaps and limitations in mental health systems for children and adolescents. With this increased recognition has come increased momentum to develop a comprehensive range of mental health promotion and intervention programs in schools, a setting offering unmatched opportunities to reach students, families and others. A national technical assistance center focusing on advancing school mental health programs in the United States, with national and international collaborators, has been developing a network of people from diverse countries who share an interest in school mental health. In this article, we review factors behind the increasing world-wide interest in school mental health, and describe the development of the International Network for Mental Health in Schools. Opportunities to become involved in this network at upcoming international meetings are discussed.     

Linking Mental Health and After School Systems for Children in Urban Poverty: Preventing Problems,Promoting Possibilities

The current mental health system is failing to meet the extensive needs of children living in urban poverty. After school programs, whose mission includes children’s socialization, peer relations, and adaptive functioning, are uniquely positioned to support and promote children’s healthy development. We propose that public sector mental health resources can be reallocated to support after school settings, and we offer specific examples and recommendations from an ongoing federally funded program of research to illustrate how mental health consultation can support publicly funded after school programs. In light of the increase in resources of urban, poor communities, consultation to publicly funded after school programs can contribute to the mental health goals of keeping children safe and supervised, promoting their healthy development through academically and socially enriching activities, and identifying children in need of more intensive mental health services. An erratum to this article can be found at     

Persistently Dangerous Communities and Schools in the United States: How Might School Mental Health Help?

With increasing pressure on schools in the United States to address violence and school safety, school mental health (SMH) programs and services are well positioned to assist school administrators, teachers, and other school staff to prevent and/or reduce inappropriate and violent student behavior in schools. It is a struggle for persistently dangerous schools to provide educational environments that are safe and supportive for all students, and their academic achievement is threatened. The process of identifying and reforming these schools is explored briefly, followed by the ways in which school mental health strategies and programs can reduce suspensions and expulsions. Finally, opportunities are highlighted in which school mental health professionals can work with school administrators to produce effective change to promote safe schools and communities.     

Relationships Between Perceived School Climate and Adolescent Mental Health Across Genders

The current study explored the relationship between school climate perceptions and self-reported mental health among 415 high school students. Mental health was defined comprehensively via indicators of positive functioning (life satisfaction) and psychopathology (internalizing and externalizing problems). Regression analyses indicated that students’ perceptions of six dimensions of school climate (sharing of resources, order and discipline, parent involvement, school building appearance, student interpersonal relations, and student–teacher relations) accounted for a total of 15–22 % of the variance in indicators of their mental health, above and beyond between-school differences in outcomes. Bivariate links emerged between positive perceptions of each school climate dimension and better mental health. Parent involvement was the most consistent unique predictor of mental health. Worse perceptions of the peer interpersonal relations, equal sharing of school resources, and physical appearance of one’s school building uniquely predicted greater psychopathology (externalizing and internalizing problems, respectively), whereas teacher–student relations were particularly associated with wellness (among girls only). Across indicators, school climate was more highly associated with girls’ mental health. Directions for future research and implications for educators are discussed.     

Brief report: Association between psychological sense of school membership and mental health among early adolescents

Mental health problems among adolescents are prevalent and are associated with important difficulties for a normal development during this period and later in life. Understanding better the risk factors associated with mental health problems may help to design and implement more effective preventive interventions. Several personal and family risk factors have been identified in their relationship to mental health; however, much less is known about the influence of school-related factors. One of these school factors is school belonging or the psychological sense of school membership. This is a well-known protective factor to develop good academic commitment, but it has been scarcely studied in its relationship to mental health. We explored this association in a sample of early adolescents and found that students who reported having a high level of school membership had lower mental health problems, even after controlling for several personal and family factors.