Rates of Mental Health Service Utilization by Children and Adolescents in Schools and Other Common Service Settings: A Systematic Review and Meta-Analysis

Duong, Mylien T.; Bruns, Eric J.; Lee, Kristine; Cox, Shanon; Coifman, Jessica; Mayworm, Ashley M.; Lyon, Aaron R.

doi:10.1007/s10488-020-01080-9

Cited by 235 publications

(164 citation statements)

References 47 publications

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“…For example, absenteeism and poor mental health have a bidirectional relationship, with poorer reported mental health in adolescents leading to increased absenteeism ( Lawrence et al, 2019 ), and chronic absenteeism resulting in decreased physical and mental health outcomes for children and adolescents ( Wood et al, 2012 ). The importance of attending school in person is also highlighted by the fact that many children and youth also receive mental health services while they are physically present at school ( Duong et al, 2021 ).…”

Section: School Attendance and Student Mental Healthmentioning

confidence: 99%

COVID-19 and Student Well-Being: Stress and Mental Health during Return-to-School

Schwartz

Exner‐Cortens

McMorris

et al. 2021

Canadian Journal of School Psychology

161

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Students have been multiply impacted by the COVID-19 pandemic: threats to their own and their family’s health, the closure of schools, and pivoting to online learning in March 2020, a long summer of physical distancing, and then the challenge of returning to school in fall 2020. As damaging as the physical health effects of a global pandemic are, much has been speculated about the “second wave” of mental health crises, particularly for school-aged children and adolescents. Yet, few studies have asked students about their experiences during the pandemic. The present study engaged with over two thousand ( N = 2,310; 1,288 female; Mage = 14.5) 12- to 18-year-old Alberta students during their first few weeks of return-to-school in fall 2020. Students completed an online survey that asked about their perceptions of COVID-19, their fall return-to-school experiences (84.9% returned in-person), their self-reported pandemic-related stress, and their behavior, affect, and cognitive functioning in the first few weeks of September. The majority of students (84.9%) returned to school in person. Students reported moderate and equal concern for their health, family confinement, and maintaining social contact. Student stress levels were also above critical thresholds for 25% of the sample, and females and older adolescents (age 15–18 years) generally reported higher stress indicators as compared to males and younger (age 12–14 years) adolescents. Multivariate analysis showed that stress indicators were positively and significantly correlated with self-reported behavioral concerns (i.e., conduct problems, negative affect, and cognitive/inattention), and that stress arousal (e.g., sleep problems, hypervigilance) accounted for significant variance in behavioral concerns. Results are discussed in the context of how schools can provide both universal responses to students during COVID-19 knowing that most students are coping well, while some may require more targeted strategies to address stress arousal and heightened negative affect.

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Section: School Attendance and Student Mental Healthmentioning

confidence: 99%

COVID-19 and Student Well-Being: Stress and Mental Health during Return-to-School

Schwartz

Exner‐Cortens

McMorris

et al. 2021

Canadian Journal of School Psychology

161

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“…Additionally, an increase in average waiting times for access to CAMHS [13], along with a substantial likelihood of referral rejection [14], means that many CYP cannot benefit from specialist support, particularly when the cross-sector communication needed to signpost to alternative sources of support is notoriously poor [15]. Indeed, a recent systematic review found that over 25% of CYP with diagnoses or elevated symptoms were not utilising any form of mental health support, specialist or otherwise [16], suggesting that even alternative support is inaccessible to many.…”

Section: Rationalementioning

confidence: 99%

Delivering and implementing child and adolescent mental health training for mental health and allied professionals: a systematic review and qualitative meta-aggregation

2021

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Background The increasing prevalence of mental health difficulties among children and young people (CYP) suggests that early intervention is vital. A comprehensive system of care and support requires the involvement of mental health professionals, including psychologists and psychiatrists, and allied professionals, including teachers, police, and youth workers. A critical starting point is the provision of effective training, in order that these professionals can better support the mental health needs of the CYP that they encounter. Objectives Given the primacy of training in the CYP mental health support system, understanding the factors that maximise potential gains and facilitate uptake is pertinent. The current review therefore located and explored qualitative research evidence, to identify the barriers and facilitators underpinning successful delivery and implementation of training focussed on the mental health of CYP, for both mental health and allied professionals. Methods A systematic review and qualitative meta-aggregation were conducted. Systematic searches were carried out using ASSIA, EMBASE, MEDLINE, NICE Evidence, PsycINFO, and Scopus databases, for papers published between 2000 and 2020. Twelve thousand four hundred forty-eight records were identified, of which 39 were eligible for review. The records were appraised for quality using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research, and synthesised using the qualitative meta-aggregation method. Results One hundred eighty-two raw findings were extracted from the 39 papers, which were condensed into 47 sub-categories, 19 categories, and finally 5 synthesis statements. These synthesis statements reflected the barriers and facilitators influencing the training delivery process (“support”; “content, design, and planning”), and the implementation of training into the workplace (“context”; “perceived value”; “organisational factors”). Conclusions The synthesis statements and underlying categories provide practical recommendations for those designing, delivering, or implementing CYP mental health training. Recommendations ranged from facilitating peer support during training, to the idea that training will be better implemented when perceived need is high. The review provides a robust evidence-based foundation to “common-sense” principles, drawing them into a coherent and organised framework using a synthesis method grounded in pragmatism. Protocol registration number PROSPERO reference ID: CRD42020162876.

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“…Efficacious mental health services such as TF-CBT are unlikely to yield public health impact unless they are consistently implemented in accessible settings. Schoolbased mental health (SMH) services account for 50-80% of all youth mental health services in the USA [9][10][11]. Despite this, treatments found to be efficacious in other settings (e.g., community mental health) have not been "scaled-out" to the educational sector [12].…”

Section: School Mental Health and The Implementation Gapmentioning

confidence: 99%

Protocol for a hybrid type 2 cluster randomized trial of trauma-focused cognitive behavioral therapy and a pragmatic individual-level implementation strategy

et al. 2021

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Background More than two-thirds of youth experience trauma during childhood, and up to 1 in 5 of these youth develops posttraumatic stress symptoms that significantly impair their functioning. Although trauma-focused cognitive behavior therapy (TF-CBT) has a strong evidence base, it is rarely adopted, delivered with adequate fidelity, or evaluated in the most common setting where youth access mental health services—schools. Given that individual behavior change is ultimately required for successful implementation, even when organizational factors are firmly in place, focusing on individual-level processes represents a potentially parsimonious approach. Beliefs and Attitudes for Successful Implementation in Schools (BASIS) is a pragmatic, motivationally focused multifaceted strategy that augments training and consultation and is designed to target precise mechanisms of behavior change to produce enhanced implementation and youth clinical outcomes. This study protocol describes a hybrid type 2 effectiveness-implementation trial designed to concurrently evaluate the main effects, mediators, and moderators of both the BASIS implementation strategy on implementation outcomes and TF-CBT on youth mental health outcomes. Methods Using a cluster randomized controlled design, this trial will assign school-based mental health (SMH) clinicians and schools to one of three study arms: (a) enhanced treatment-as-usual (TAU), (b) attention control plus TF-CBT, or (c) BASIS+TF-CBT. With a proposed sample of 120 SMH clinicians who will each recruit 4–6 youth with a history of trauma (480 children), this project will gather data across 12 different time points to address two project aims. Aim 1 will evaluate, relative to an enhanced TAU condition, the effects of TF-CBT on identified mechanisms of change, youth mental health outcomes, and intervention costs and cost-effectiveness. Aim 2 will compare the effects of BASIS against an attention control plus TF-CBT condition on theoretical mechanisms of clinician behavior change and implementation outcomes, as well as examine costs and cost-effectiveness. Discussion This study will generate critical knowledge about the effectiveness and cost-effectiveness of BASIS—a pragmatic, theory-driven, and generalizable implementation strategy designed to enhance motivation—to increase the yield of evidence-based practice training and consultation, as well as the effectiveness of TF-CBT in a novel service setting. Trial registration ClinicalTrials.gov registration number NCT04451161. Registered on June 30, 2020.

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Rates of Mental Health Service Utilization by Children and Adolescents in Schools and Other Common Service Settings: A Systematic Review and Meta-Analysis

Cited by 235 publications

References 47 publications

COVID-19 and Student Well-Being: Stress and Mental Health during Return-to-School

COVID-19 and Student Well-Being: Stress and Mental Health during Return-to-School

Delivering and implementing child and adolescent mental health training for mental health and allied professionals: a systematic review and qualitative meta-aggregation

Protocol for a hybrid type 2 cluster randomized trial of trauma-focused cognitive behavioral therapy and a pragmatic individual-level implementation strategy

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