International approaches to school-based mental health: Intent of the Special Issue

McLaughlin, Courtney L.

doi:10.1177/0143034317714839

Cited by 5 publications

(3 citation statements)

References 5 publications

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“…The number of institutions within 3 km from the school was obtained by Baidu map (a widely used guide application in China). These variables were included based on previous related studies …”

Section: Methodsmentioning

confidence: 99%

“…16 School, considered as a second home of youths, may be associated with improved mental wellbeing via a sense of integration. 17 Mental health programs in school settings play a crucial role in prevention efforts, 18 and many studies have shown that school-based interventions were associated with improved mental well-being among youths. 19,20 However, the association between schoolprovided psychological resources and student mental health has been less studied and remains a topic of debate.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of Factors Associated With Mental Well-Being Among Chinese Youths at Individual, School, and Province Levels

et al. 2023

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ImportanceAlthough rapid urbanization in China provided improved economic prosperity and educational opportunities, it was associated with increased internalizing and externalizing problems among youths, with negative outcomes for mental well-being. Previous studies suggested that factors in individual, school, and regional levels were associated with mental well-being, and comprehensively examining these factors may provide evidence for policies for improving youth mental health.ObjectiveTo investigate factors associated with mental well-being at individual, school, and province levels among Chinese youths.Design, Setting, and ParticipantsThis cross-sectional study analyzed nationally representative data collected December 1, 2021, to January 1, 2022, from schools in China. Among 435 schools, 144 institutions had primary school students, 107 institutions had middle school students, 95 institutions had primary and middle school students, and 89 institutions had high school students. A total of 398 520 students were included.ExposuresCharacteristics at individual, school, and province levels.Main outcomes and measuresThe main outcome was mental well-being, assessed by the Short Warwick-Edinburgh Mental Well-being Scale. Linear mixed-effects models were used to investigate individual, school, and regional disparities in mental well-being among youths.ResultsThere were 398 520 participants (194 460 females [48.80%]; mean [SD; range] age, 13.78 [2.40; 9-20] years). At the school level, 352 443 students (88.44%) were in public school and 291 354 students (73.11%) were in urban schools. Drinking (coefficient = −1.08; 95% CI, −1.12 to −1.05; P &lt; .001), smoking (coefficient = −0.89; 95% CI, −0.96 to −0.83; P &lt; .001), and increased age (coefficient per 1-year increase in age = −0.02; 95% CI, −0.03 to −0.01; P &lt; .001) were associated with worse mental well-being. Male sex (coefficient = 1.01; 95% CI, 0.98 to 1.04; P &lt; .001), being in a 1-child family (coefficient = 0.17; 95% CI, 0.13 to 0.20; P &lt; .001), being in the Han group (coefficient vs other ethnic groups = 0.20; 95% CI, 0.14 to 0.26; P &lt; .001), a higher frequency and coverage of psychological courses (eg, ≥2/wk for all students vs none: coefficient = 1.02; 95% CI, 0.36 to 1.69; P = .003), and a higher level of self-rated popularity in school (coefficient per 1-unit increase in score = 0.89; 95% CI, 0.88 to 0.89; P &lt; .001) were associated with improved mental well-being. However, age (eg, age and 1 courses/2 wk for all students: coefficient per 1-year increase in age = −0.047; 95% CI, −0.089 to −0.005; P = .03) and sex (eg, female sex and ≥2 courses/wk for some students: coefficient = −0.184; 95% CI, −0.323 to −0.046; P = .009) had interactions with the association between psychological courses and mental well-being.Conclusions and relevanceThis study found that social disparities in mental well-being existed and that various factors at different levels were associated with mental well-being among Chinese youths. These findings suggest that public mental health programs may be recommended for associated improvements in regional disparities in mental health resources.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessment of Factors Associated With Mental Well-Being Among Chinese Youths at Individual, School, and Province Levels

et al. 2023

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“…Besides families, schools represent the second social environment where children and adolescents spend a lot of their time, and on which a large part of their learning and development depends. Given the above, schools become the venue where early signs of mental health problems can be detected and where access to intervention can be provided promptly (9). This recognition has led to the rise of school-based mental health services, with the aims of promoting mental health awareness, as well as prevention and amelioration of students' mental health problems (10).…”

Section: Introductionmentioning

confidence: 99%

School-Based Mental Health Initiative: Potentials and Challenges for Child and Adolescent Mental Health

et al. 2022

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School-based mental health support services allow children and adolescents easy access to services without requirement of traveling to clinics and hospitals. We describe a School Mental Health Support Scheme (SMHSS) piloted in Hong Kong and discuss the challenges and learnings from the experience. This conceptual paper argues that accessibility is not the only advantage of such services. Teachers are significant others in child development, alongside with families. They play a central role in impacting the children's/adolescents' needs for competence and adult attachment, while schools provide an expanded social network of peers for one's social relationship. The fulfillment of these needs has powerful implications in the mental health of the children/adolescents. Teachers can help students to develop a sense of competence with self-worth and self-identity via providing guidance and feedback, whether they be on one's strengths or weaknesses, with acceptance, tolerance and unconditional positive regard. Particularly, the latter define a form of teacher-student relationship or adult attachment that offers the children/adolescents emotional security and nourishment, protecting them from failings and adversities. Teachers can also supervise and guide their students' social development with peers at schools. A recent meta-analysis has found preliminary evidence that those school-based mental health services integrated into the teachers' routine teaching activities are more effective. Teachers, who are overworked and stressed by the schools' overemphasis on academics and grades, have yet to fully grasp their unique roles in supporting students with mental health needs. This paper ends by advocating a paradigm shift in which both the healthcare professionals and educators should forge a mutually beneficial collaboration in jointly enhancing the mental health of children/adolescents at schools.

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School-based interventions to prevent anxiety and depression in children and young people: a systematic review and network meta-analysis

Caldwell

Davies

Hetrick

et al. 2019

The Lancet Psychiatry

200

179

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Background Rates of anxiety and depression are increasing among children and young people. Recent policies have focused on primary prevention of mental disorders in children and young people, with schools at the forefront of implementation. There is limited information for the comparative effectiveness of the multiple interventions available. MethodsWe did a systematic review and network meta-analysis, searching MEDLINE, Embase, PsycINFO, and Cochrane Central Register of Controlled trials for published and unpublished, passive and active-controlled randomised and quasi-randomised trials. We included educational setting-based, universal, or targeted interventions in which the primary aim was the prevention of anxiety and depression in children and young people aged 4-18 years. Primary outcomes were post-intervention self-report anxiety and depression, wellbeing, suicidal ideation, or selfharm. We assessed risk of bias following the Cochrane Handbook for Systematic Reviews of Interventions. We estimated standardised mean differences (SMD) using random effects network meta-analysis in a Bayesian framework. The study is registered with PROPSERO, number CRD42016048184.Findings 1512 full-text articles were independently screened for inclusion by two reviewers, from which 137 studies of 56 620 participants were included. 20 studies were assessed as being at low risk of bias for both random sequence generation and allocation concealment. There was weak evidence to suggest that cognitive behavioural interventions might reduce anxiety in primary and secondary settings. In universal secondary settings, mindfulness and relaxation-based interventions showed a reduction in anxiety symptoms relative to usual curriculum (SMD -0•65, 95% credible interval -1•14 to -0•19). There was a lack of evidence to support any one type of intervention being effective to prevent depression in universal or targeted primary or secondary settings. Comparison-adjusted funnel plots suggest the presence of small-study effects for the universal secondary anxiety analysis. Network meta-analysis was not feasible for wellbeing or suicidal ideation or self-harm outcomes, and results are reported narratively.Interpretation Considering unclear risk of bias and probable small study effects for anxiety, we conclude there is little evidence that educational setting-based interventions focused solely on the prevention of depression or anxiety are effective. Future research could consider multilevel, systems-based interventions as an alternative to the downstream interventions considered here.

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International approaches to school-based mental health: Intent of the Special Issue

Cited by 5 publications

References 5 publications

Assessment of Factors Associated With Mental Well-Being Among Chinese Youths at Individual, School, and Province Levels

Assessment of Factors Associated With Mental Well-Being Among Chinese Youths at Individual, School, and Province Levels

School-Based Mental Health Initiative: Potentials and Challenges for Child and Adolescent Mental Health

School-based interventions to prevent anxiety and depression in children and young people: a systematic review and network meta-analysis

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