Feeling Unsafe at School and Associated Mental Health Difficulties among Children and Adolescents: A Systematic Review

Mori, Yuko; Tiiri, Elina; Khanal, Prakash; Khakurel, Jayden; Mishina, Kaisa; Sourander, André

doi:10.3390/children8030232

Cited by 23 publications

(24 citation statements)

References 94 publications

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“…Whereas school nurse scope of practice includes mental health services for students, previous work has noted a lack of appropriate training, and large caseloads of students 19 . A scoping review suggests that identification of mental health needs and school‐based interventions are currently central activities of school nurses, 19 and in one program, school nurse use of validated screening tools for depression and anxiety resulted in improved identification, care coordination, and referral for students, 20 which may be particularly compelling considering recent findings in a systematic review that found perceived safety is associated with mental health challenges, including suicidal behavior 21 …”

Section: Conflict Of Interestmentioning

confidence: 99%

Implementing facilitative leadership to develop a school nurse research agenda in western North Carolina

Baur

Carpenter²,

Driscoll

et al. 2022

Journal of School Health

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T he National Association of School Nurses' (NASN) framework for 21st century school nursing practice centers care for students within the context of the students' family and school. School nurses have complex and multi-dimensional roles, 1 including prevention, early identification and intervention to address health concerns, chronic disease management, and care coordination including referrals to care. 2,3 Additional principles include leadership, quality improvement, and community public health. 4 However, school nurses are not frequently involved in school-based research and setting research priorities, 5 or have only been involved in research as students. 6 One exception is a collaboration of the National Center for School Health and the National Nursing Coalition for School Health which developed a research agenda using a Delphi study two decades ago. 7 Despite this exception there remain numerous opportunities for nurse-led research to promote evidence-based care and demonstrate the value of school nursing. 8 Amidst a long-standing call to build capacity for nurse-led research, 4,7,9 efforts to expand school nurse involvement in research have been sparse. 10,11 NASN encourages rigorous research in student health and has prioritized the expansion of school nurses' role in research. 4 The NASN position statement builds on early work identifying school nurse research priorities to document their impacts on student health and

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Section: Conflict Of Interestmentioning

confidence: 99%

Implementing facilitative leadership to develop a school nurse research agenda in western North Carolina

Baur

Carpenter²,

Driscoll

et al. 2022

Journal of School Health

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show abstract

“…Substance use is associated with suicidality in adolescents ( 10 ), including illicit drugs ( 13 , 14 ), marijuana ( 14 , 15 ), alcohol ( 13 , 15 ), and tobacco ( 13 , 15 ). Psychosocial stressors and adverse childhood experiences also are associated with suicidality, including cyberbullying ( 16 – 18 ); not feeling safe at school ( 19 ); and sexual abuse, physical abuse, emotional abuse, and neglect ( 20 – 23 ).…”

Section: Introductionmentioning

confidence: 99%

Association Between Concussions and Suicidality in High School Students in the United States

Iverson

Karr

2022

Front. Neurol.

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ImportancePrior research has shown a statistically significant association between sustaining a concussion and suicidality in adolescents, but this prior research controlled for relatively few variables predictive of suicidality.ObjectiveTo examine whether sustaining a concussion remained a significant predictor of suicidality after controlling for relevant covariates (e.g., sexual abuse/assault, bullying, substance use, depression), hypothesizing that the relationship between concussion and suicidality would become non-significant after controlling for these variables.DesignThis study involved secondary data analysis of the 2019 Youth Risk Behavior Surveillance (YRBS) System, a national cross-sectional study of adolescents. Analyses were stratified by gender.SettingA national sampling of U.S. high school students.ParticipantsEleven thousand two hundred sixty-two students in the YRBS database, including 5,483 boys and 5,779 girls.Exposure(s)Participants included in the analyses reported whether, in the last year, they experienced a concussion and/or suicidality.Main Outcomes and MeasuresThe main outcome was suicidality (i.e., ideation, planning, attempt), which was predicted by concussion in an unadjusted analysis and by concussion along with other risk factors in a multivariable analysis.ResultsThe final sample included 11,262 participants with available data on concussion and suicidality in the last year (14–18 years-old; 51.3% girls; 49.0% White). Per unadjusted odds ratios with 95% confidence intervals, there was a relationship between concussion and suicidal ideation [girls: OR = 1.46 (1.24, 1.73); boys: OR = 1.69 (1.41, 2.03)], planning (girls: OR = 1.39 [1.16, 1.66]; boys: OR = 1.76 [1.44, 2.14]), and attempt [girls: OR = 1.70 (1.32, 2.19); boys: OR = 3.13, (2.37, 4.15)]. These relationships became mostly non-significant after controlling for relevant risk factors for suicidality. The adjusted odds ratios showed no relationship between concussion and suicidal ideation [girls: OR = 1.11 (0.86, 1.44); boys: OR = 1.24 (0.92, 1.69)] or planning (girls: OR = 1.07 [0.82, 1.40]; boys: OR = 1.12 [0.82, 1.55]); but a significant relationship with suicide attempts in boys [OR = 1.98 (1.28, 3.04)], but not girls [OR = 1.05 (0.74, 1.49)].Conclusions and RelevanceThere was an association between concussion and suicidality in U.S. high school students; however, after controlling for other variables (e.g., depression, sexual abuse/assault, illicit drug use), there was no association between concussion and suicidality aside from a significant relationship between concussion and attempts in boys.

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“…Perceived school safety has mainly been studied in western countries. A recent systematic review of 43 studies showed the mean occurrence of unsafe school environments was ~19% and ranged from 6.1 to 69.1% ( 2 ). Feeling safe at school has been reported to be associated with various predictors, including bullying and youth violence ( 3 , 4 ), lower academic achievements ( 5 ) and better relationships with teachers ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

“…According to the systematic review, most of the studies on perceived school safety were published between 2016 and 2020, indicating an increasing research interest in this topic ( 2 ). However, very few cross-national studies have been conducted and all of these only compared perceived school safety between two countries ( 11 – 13 ).…”

Section: Introductionmentioning

confidence: 99%

Feeling Unsafe at School Among Adolescents in 13 Asian and European Countries: Occurrence and Associated Factors

et al. 2022

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BackgroundResearch on perceived school safety has been largely limited to studies conducted in Western countries and there has been a lack of large-scale cross-national studies on the topic.MethodsThe present study examined the occurrence of adolescents who felt unsafe at school and the associated factors of perceived school safety in 13 Asian and European countries. The data were based on 21,688 adolescents aged 13-15 (11,028 girls, 10,660 boys) who completed self-administered surveys between 2011 and 2017. Logistic regression analyses were used to estimate odds ratios and 95% confidence intervals.FindingsThe number of adolescents who felt unsafe at school varied widely across countries, with a mean occurrence of 31.4% for the total sample: 31.3% for girls, and 31.1% for boys. The findings revealed strong independent associations between feeling unsafe and individual and school-related factors, such as being bullied, emotional and behavioral problems and feeling that teachers did not care. The study also found large variations in perceived school safety between schools in many countries.ConclusionThe findings emphasize the need to create safe educational environments for all students, based on positive relationships with teachers and peers. School-based interventions to prevent bullying and promote mental health should be a natural part of school safety promotion.

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Feeling Unsafe at School and Associated Mental Health Difficulties among Children and Adolescents: A Systematic Review

Cited by 23 publications

References 94 publications

Implementing facilitative leadership to develop a school nurse research agenda in western North Carolina

Implementing facilitative leadership to develop a school nurse research agenda in western North Carolina

Association Between Concussions and Suicidality in High School Students in the United States

Feeling Unsafe at School Among Adolescents in 13 Asian and European Countries: Occurrence and Associated Factors

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