Co-existing symptoms and risk factors among African school children with hyperactivity-inattention symptoms in Kinshasa, Congo

The aims of the study were to explore hyperactivity–inattention (HI) symptoms and co-existing symptoms of emotional and behavioural problems among African school children and their relationship with health status, socio-demographic factors, and school performance. Method: A case–control approach was used. The Strengths and Difficulties Questionnaire (SDQ) was used to explore the co-existing emotional and behavioural symptoms and a semi-structured interview with parents to explore the socio-demographic variables. The sample included 357 school children at the age of 7–9 years: 183 children were defined as cases, defined by abnormal scores on the SDQ-HI scale and 174 randomly selected children among those with normal scores on the SDQ-HI were defined as controls. No age and gender differences were noticed between the two groups. Results: A younger maternal age at childbirth, and poor school performances were more frequent among cases than controls. Three quarter of the hyperactive-inattentive children had co-existing symptoms according to SDQ, the most common being conduct problems. Conclusion: As in other cultures, co-existence of HI symptoms and emotional and behavioural problems was found in this African setting. Further validation of behavioural screening instruments in African children is called for.     

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.     

An examination of sleep health,lifestyle and mental health in junior high school students

The factors that influence sleep health and mental health in junior high school students' lifestyles was examined. The proportion of students who replied that they feel bad in the morning, and who do not have breakfast was significantly higher in poor sleepers. The proportion of students who regularly take exercise was significantly lower among poor sleepers. Compared with good sleepers, poor sleepers had a higher number of illnesses and their General Health Questionnaire score was worse. The study's results suggest that sleep health is closely related to both physical and mental health, and that habits such as exercise, and regular sleeping and eating, are important for maintaining and improving students' sleep health.     

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.     

珠江三角洲某校高中生心理健康状况调查与管理

目的 调查珠江三角洲（简称“珠三角”）某高级中学学生的心理健康状况,分析比较不同性别、年级、文理分科及成绩排名的学生心理健康状况,推进学生心理健康个体化管理。方法 于2019年11月7日-18日采用中国中学生心理健康量表（MSSMHS）对珠三角某中学全校1 917名高中学生的心理健康状况进行测评,比较该校高中生心理健康状况与常模的差异,分析性别、年级、学习成绩等因素与心理健康的相关性。结果 高中生心理异常检出率为31.4%,各因子异常检出率前三者依次为学习压力感（55.3%）、情绪波动性（52.6%）、焦虑（51.6%）,而心理不平衡的异常检出率最低（21.7%）。其中,女生心理异常检出率高于男生（29.2% vs. 33.5%）,文科生心理异常检出率高于理科学生（31.1% vs. 27.5%）,学习成绩排名一般的学生心理异常检出率最高（43.3%）,高一年级学生心理异常检出率最高（36.4%）。结论 珠三角某中学高中生心理健康状况不容乐观,需重点关注高一年级学生、女生以及成绩一般的学生。     

An evaluation of an interdisciplinary rural school mental health programme in Appalachia

School mental health (SMH) programmes serve as a necessary niche within rural communities and aim to bring accessible care to youth who may otherwise go without mental health services. The following study evaluated the impact of mental health treatment provided by the Assessment, Support, and Counseling (ASC) Center, an SMH health initiative located within a high school in rural western North Carolina during the 2011–2012 school year. Participants were high school students between 14 and 18 years of age, predominately Caucasian (91.3%) and female (65.5%). Treatment was evaluated based on score change on the Youth Outcome Questionnaire using the reliable change index (RCI; Jacobson & Truax, 1991) to track changes in symptomatology. Following ASC Center treatment, 63% of the clinical sample was deemed to have improved or recovered based on the RCI. While the study did not use an experimental design (with associated cautions regarding interpretation of findings), the results suggest that a moderate dosage of cognitive-behavioural therapy provided to adolescents in the context of a rural SMH programme is associated with reliable change for the majority of youth who take part in the treatment.     

Student perceptions of the acceptability and utility of standardized and idiographic assessment in school mental health

Evidence-based assessment (EBA) comprises the use of research and theory to select methods and processes that have demonstrated reliability, validity and clinical usefulness for prescribed populations. EBA can lead to positive clinical change, and recent work has suggested that it is perceived to be useful by school mental health providers. However, virtually nothing is known about student perceptions of assessment use. Semi-structured interviews were conducted with 31 ethnically diverse middle and high school students (71% female) receiving mental health services in school-based health centers. Findings indicated that the majority of students found assessments to be useful, and perceived three primary functions of assessments: structuring the therapy session, increasing students’ self-awareness and improving communication with the provider. Barriers to acceptability were also found for a minority of respondents. Some students found the nature of standardized assessments to be confining, and others expressed that they wanted more feedback from their counselors about their responses. Idiographic assessments demonstrated especially high acceptability in this sample, with students reporting that tracking idiographic outcomes increased self-awareness, spurred problem-solving and helped them to reach behavioral goals. Implications for school mental health service improvements are discussed.     

Norms for mental health services in South Africa

Background In the aftermath of apartheid, South Africa has inherited a fragmented, under-resourced and inequitable public sector mental health service. Attempts are being made to reform mental health services, in keeping with new health policy, which proposes the downscaling of psychiatric institutions and the development of community-based services. This study set out to develop a set of service norms for the care of people with severe psychiatric conditions (SPC) in South Africa, to assist the implementation of the new policy. Methods A national situation analysis of current public sector mental health services was conducted. A model was developed for estimating the mental health service resource needs of people with SPC. Following consultation with provincial stakeholders, a set of service norms were developed taking into account national indicators from the situation analysis (as a baseline level) and proposals of the model (as a target level). Results The study recommends an increase in the number of acute psychiatric beds in general hospitals; development of community-based residential care; redistribution of staff from hospital to community services, particularly in rural areas; and the development of information systems to monitor the transitions to community-based care. Conclusions The norms proposals presented in this study express mental health service needs in terms of quantifiable service resource and utilisation levels. In doing so, the study attempts to make explicit the assumptions and values on which planning is based.     

Connecting students to mental health care: pilot findings from an engagement program for school nurses

Schools function as the major provider of mental health services (MHS) for youth, but can struggle with engaging them in services. School nurses are well-positioned to facilitate referrals for MHS. This pilot study examined the feasibility, acceptability, and preliminary efficacy of an engagement protocol (EP) designed to enhance school nurses' utilization of evidence-based engagement practices when referring youth to MHS. Participants were six school nurses and 25 adolescents in a large, urban school district. School nurses reported positive attitudes toward the EP, suggesting that they found it feasible and acceptable. Though there were small increases in school nurses' use of engagement practices and in adolescents' readiness for services following training, due to limited sample size, differences were not statistically significant. Still, pilot results suggest preliminary efficacy of training school nurses to strategically implement evidence-based engagement practices to increase adolescents' engagement in MHS.     

Learning disabilities among Nairobi school children

Four hundred and forty-one school children studying in local primary schools were referred during 1980-1981 to the Psychological Assessment Clinic in Nairobi (Kenya) for poor academic performance. The most frequent cause for the learning difficulties of these children was mental retardation. In one third, emotional disorders were responsible for their learning difficulties. Currently, even mentally retarded children are admitted into the existing educational system and are unable to cope. Recommendations for the future are made.     

Background,experience of abuse,and mental health among adolescents in out-of-home care: a cross-sectional study of a Swedish high school national sample

Purpose: To compare experiences for adverse events, especially sexual abuse, and mental health in a group of high school students in out-of-home care with a representative sample of peers of the same age and similar educational attainment living with their parents.

Materials and methods: A sample of 5839 students in the third year of Swedish high school, corresponding to a response rate of 59.7%, answered a study specific questionnaire. Data from 41 students living in out-of-home care were compared with data from peers not in out-of-home care in a cross-sectional analyze.

Results: Students in out-of-home care had more often an immigrant background and a non-heterosexual orientation, had more often experienced physical and penetrative sexual abuse, and more often sought healthcare for mental problems. Disclosure of sexual abuse was less common, and acts of persuasion or adults' use of their social position was more common among students in out-of-home care.

Conclusions: Even where the protective factor ‘senior educational attainment’ is present, risks for abuse and poor mental health are evident for adolescents in out-of-home care. Disclosure of adversity, when it has occurred, ought to be higher among these adolescents with regular contact with social services, but our findings indicate tendencies for the opposite. We therefore suggest routines to be established to screen for adverse life events and mental health actively, along with general and systematic assessments of adversity and mental health during care.     

Promoting mental health at school: short-term effectiveness of a popular school-based resiliency programme

Schools are increasingly seen as promising environments for initiatives to prevent mental disorders and to protect and promote mental health. This pilot study examined whether a school-based resiliency programme, Bounce Back, increased protective factors associated with resilience. Thirty-nine children aged 8–10 years (M = 9.17, SD = 0.58) from two schools in Melbourne, Australia, were allocated to the Bounce Back intervention (N = 17) or comparison (N = 22) group. Partial support for the effectiveness of the programme was found. Children's optimism and self-efficacy in the intervention group increased significantly with a large effect size from pre- to post-intervention. These changes were maintained at the 3-month follow-up; however, changes in perceived access to supportive relationships and emotional regulation were not detected. This pilot study represents an important step in the validation of one of the most widely used programmes in Australian schools, and provides some support for its continued use.     

Developing mental health services in Nigeria

This grass-roots level mental health awareness programme considerably increased use of community-based mental health services in a part of Nigeria where knowledge about treatability of mental illness was limited. The benefits of the programme were sustained for a significant period after the initial awareness programme. In order for attitude changes to be reinforced, similar awareness programmes must be repeated at regular intervals.     

Factors associated with behavioral problems and cognitive impairment in children with epilepsy of Kinshasa,Democratic Republic of the Congo

BackgroundBehavioral problems and cognitive impairment are common in children with epilepsy (CWE). In sub-Saharan Africa, little is known about these comorbidities particularly their relationships with socioeconomic features. The goal of this study was to identify clinical and socioeconomic factors associated with behavioral problems and cognitive impairment in CWE of Kinshasa (Democratic Republic of the Congo).MethodsThis cross-sectional hospital-based study had included 104 CWE aged 6 to 17 years. Behavioral problems were assessed by the child behavior checklist. The Wechsler nonverbal scale of ability was used to assess cognitive impairment.ResultsAt least one behavioral problem was found in 34.6% of CWE. Internalized problems were increasing with father’s age (p = 0.034). Externalized problems were increasing with the decreased of mother’s age (p = 0.009) and with a previous antiepileptic treatment (p = 0.032). Total behavioral problems were increasing with a previous antiepileptic treatment (p = 0.029). Cognitive impairment was present in 73.3% of CWE. It was more common in boys (p = 0.013), and it was increasing with a low household daily expenses (p = 0.034), with a previous antiepileptic treatment (p = 0.041), with an early onset of epileptic seizures (p = 0.042), and with a high frequency of epileptic seizures (p = 0.011).ConclusionBehavioral problems and cognitive impairment are common in CWE. Multivariate analysis has shown that behavioral problems were associated with socioeconomic features only. Contrariwise, cognitive impairment was associated with both socioeconomic factors and clinical features. There is a need of more studies to improve knowledge of these comorbidities in the sub-Saharan Africa context.     

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。     

Associations among acculturation stress,mental health literacy,and mental health of married immigrant women in Korea

Approximately one in 12 marriages in Korea is an international marriage between a Korean man and a foreign woman. Women immigrating by international marriage have often reported that they experience difficulties adapting to their Korean family and culture. This study was conducted to provide basic information for developing mental health programs for immigrant women in Korea by investigating their acculturation stress, mental health literacy, and mental health. A sample of 209 immigrant women completed scales measuring these three constructs, which correlation analyses revealed to be significantly interrelated. Immigrant women’s acculturation stress was significantly related to number of marriages, husbands’ number of marriages, original country, reason for marriage, and occupation. Mental health was significantly associated with women’s original country, reason for marriage, education, and house income. Mental health literacy was significantly related to nationality. This research provides an important evidence base for developing multicultural education, services, and programs.