Objectives Adolescents have many anxieties,

Japan is facing a markedly high incidence of adolescent suicide. This study examines the relationship between depression and self-rated health, which is a significant factor driving people towards suicide, highlighting the importance of children’s assessments of their health. In this cross-sectional study, an original questionnaire combining text and illustrations was administered to 6421 elementary, junior, and senior high-school students and an effective way of using the questionnaire was proposed. To assess children’s self-rated health, the survey questions were classified into two domains: physical and mental health. The questions were further classified based on symptom duration. Depression assessment was based on the Depression Self-Rating Scale for Children. To provide a basis for the effective use of the self-rated health assessment tool, the respondents were classified into three groups based on physical/mental conditions together with the duration of those conditions, and comparisons were subsequently made. The groups were Favourable Health, Temporarily Poor Health, and Persistently Poor Health, and the results were analysed using an ANOVA. Self-rated health levels decreased, and depressive conditions worsened with age. Although most children led physically and mentally healthy school lives, the mean Depression Self-Rating Scale score was significantly higher for the Persistently Poor Health group than the other two, and the Temporarily Poor Health group scored significantly higher than the Favourable Health group for both physical and mental health (all p < 0.001). As the Temporarily and Persistently Poor Health groups in the domains of physical and mental health are more likely to be depressed, it is important to monitor the health of children in educational settings. In this study, completing this questionnaire was shown to help children understand themselves objectively and help the adults around them comprehend their condition quicker. It is especially important to promptly develop systems for appropriate and organic collaboration between educational settings and medical or welfare services.

Suicide among school-age children is a serious issue in Japan, exacerbated by the coronavirus disease 2019 pandemic. Collaboration and cooperation between schools—where children spend much of their time—and medical/welfare services are indispensable. However, teachers are overworked, and intensified stress levels have led to high absenteeism. We propose the effective use of the Observe–Orient–Decide–Act (OODA) loop for timely collaboration and cooperation between schools and medical institutions to manage high-risk children as a measure to prevent suicide. We administered questionnaires to 205 teachers who worked with children, nurses, welfare professionals, and school counsellors in schools and related facilities; 171 respondents with valid responses were included. We examined their self-rated health, attitudes towards the OODA loop, levels of depressive symptoms, satisfaction/dissatisfaction with the current status of collaboration and cooperation, and reasons for this. When we compared those satisfied/dissatisfied with the current status of collaboration and cooperation, we found no significant differences in the level of depressive symptoms, but the self-rated health of the latter was poorer. We identified three factors in the attitude survey on the OODA loop—flexible and independent situational assessment, group monitoring and sharing, and self-monitoring—and those who were dissatisfied showed lower scores for all items. We classified the reasons into three categories—details of collaboration and cooperation, methods of collaboration and cooperation, and organisations for collaboration and cooperation—revealing marked differences. The level of satisfaction with the current status of collaboration and cooperation was correlated with the level of mental health. Satisfied participants were more positive about adopting OODA perspectives. Raising awareness of the OODA concept among teaching personnel, creating an organisational structure, establishing systems for appropriate and organic collaboration between schools and medical/welfare institutions, and reviews by external institutions are necessary to effectively use the OODA loop.

Background Japan is facing a markedly high incidence of adolescent suicide. This study examines the relationship between depression and self-rated health, which is a significant factor driving people toward suicide, highlighting the importance of children’s assessments of their health. Methods In this cross-sectional study, an original questionnaire combining text and illustrations was administered to 6,421 elementary, junior, and senior high school students. To assess children’s self-rated health, we classified the survey questions into two domains: physical and mental health. We further classified the questions based on symptom duration. Depression assessment was based on the Depression Self-Rating Scale for Children. To provide a basis for the effective use of the self-rated health assessment tool, we classified the respondents into three groups based on physical/mental conditions together with the duration of those conditions and made comparisons. The groups were Favorable Health, Temporarily Poor Health, and Persistently Poor Health, and the results were analyzed using an ANOVA. Results Self-rated health levels decreased, and depressive conditions worsened with age. Although most children led physically and mentally healthy school lives, the mean Depression Self-Rating Scale score was significantly higher for the Persistently Poor Health group than the other two, and the Temporarily Poor Health group scored significantly higher than the Favorable Health group for both physical and mental health (all p < 0.001). Conclusions As the Temporarily and Persistently Poor Health groups in the domains of physical and mental health are more likely to be depressed, timely cooperation between schools and medical institutions is imperative to prevent depression.