Associations Between Depression Literacy and Help-Seeking Behavior for Mental Health Services Among High School Students Abstract Despite the growth in school-based mental health services (SBMHS), rates of mental health help-seeking among adolescents remain low, especially for ethnic minority youth. This study examined factors associated with adolescents’ help-seeking of mental health services among a sample of 369 racially diverse high school students (age M = 15.5 years, SD = 0.72, 81.3% were ethnic minorities). We examined the relationships among mental health literacy for depression, knowledge barriers related to services and providers, perceived stigmatization by others, emotional/behavioral difficulties, and actual help-seeking behavior. Logistic regression results showed that adolescents with higher mental health literacy for depression and more emotional/behavioral difficulties are more likely to report seeking help in general and from providers outside of school specifically, but not for services inside of school alone. Asian-American students were less likely to seek help than Caucasian peers. It is important to promote mental health literacy to encourage help-seeking among high school students.

Leveraging Technology to Facilitate Teachers’ Use of a Targeted Classroom Intervention: Evaluation of the Daily Report Card.Online (DRC.O) System Abstract Historically, teachers’ uptake and implementation of empirically supported classroom interventions have involved substantial face-to-face consultation. However, most schools do not have the resources to provide this intensive level of support and many teachers may not need it. Thus, evaluation of alternative supports is warranted. In this pilot study, we evaluated the feasibility and effectiveness of an interactive web-based technology [i.e., the Daily Report Card.Online (DRC.O)] designed to facilitate teachers’ use of the DRC with minimal external support and examined individual teacher characteristics associated with DRC use. Elementary school teachers (N = 54) were given access to the DRC.O Web site and asked to use it to implement a DRC with one child. With regard to implementation, 16% were short-term adopters (less than 1 month) and 39% were long-term adopters (1–7 months of use). On average, short-term adopters adhered to 37% of data entry procedures, whereas long-term adopters adhered to 74% of data entry procedures. Higher teacher stress was associated with shorter use and lower adherence. Web site analytics revealed that, on average, long-term adopters completed all steps of DRC development in less than 1 h and spent only 3 min per day engaged in data entry for progress monitoring. The magnitude of change in student target behaviors and Strengths and Difficulties Questionnaire scores was moderate to large. These results reveal the feasibility and promise of the DRC.O and generate hypotheses for future research. Implications for additional evaluation of technology-driven implementation supports for teachers are discussed.

Effectiveness Trial of Brief Indicated Cognitive-Behavioral Group Depression Prevention in French-Canadian Secondary Schools Abstract Most adolescent depression prevention programs have been tested in the USA and other Anglo-Saxon countries. Their effects in other contexts are less clear. We conducted a pilot trial aimed at testing the effectiveness of the Blues program, a brief indicated cognitive-behavioral (CB) group program to prevent depression originally developed in the USA, in French-Canadian secondary schools. CB group facilitators were endogenous school clinicians. A total of 74 students (mean age= 15.50; 66% female) with elevated depressive symptoms were randomized to CB group (n = 37) or educational brochure control (n = 37). Participants completed diagnostic interviews and surveys at pretest, posttest, and 6-month follow-up. Results showed that CB group had a large, statistically significant effect on MDD onset at 6-month follow-up. CB group also had a positive effect on depressive symptoms, intermediate outcomes (pleasant activities, negative thoughts), and one secondary outcome (improved interaction with parents) at posttest. These effects were not maintained at follow-up. This trial replicates results from a previous US effectiveness trial. The clinically meaningful effects of brief indicated CB group prevention, at least with regard to the prevention of MDD onset, hold in French-Canadian students when the intervention is implemented by school clinicians. Work is still needed to augment and maintain CB effects in real-world practice.

“Lost in Transition”: A Systematic Mixed Studies Review of Problems and Needs Associated with School Reintegration After Psychiatric Hospitalization Abstract The purpose of this review was to identify the problems and needs associated with school reintegration after psychiatric hospitalization. Principles outlined by the Evidence for Policy and Practice Information and Coordinating Centre (EPPI-Centre) for systematic mixed studies reviews were used to search 14 electronic databases with all possible literature from inception to September 2017. Quality was appraised by two sets of two independent reviewers using an adapted version of the Mixed Methods Appraisal Tool. Fourteen studies met the inclusion criteria. The key themes revolve around the different systems of the bioecological model: the youth ontosystem, microsystems (family, school) and mesosystems (family–hospital, family–school, school–hospital). Predominant emergent themes of each system converged toward a better communication, collaboration and coordination among all concerned actors. Many problems seem to alter school reintegration after psychiatric hospitalization and different needs are still required to be met. Future research directions and implications for intervention are discussed.

Loneliness and Personality Profiles Involved in Bullying Victimization and Aggressive Behavior Abstract Bullying is a worrisome reality due to its harmful consequences. Although many constructs have been associated with bullying victimization and aggressive behavior, its relationship both with loneliness and personality has received little attention. The main objective of this study is to identify differences in bullying victimization and aggressive behavior scores based on a typology of personality and loneliness profiles. Six hundred and four middle school students (54% female) from the province of León (Spain), aged between 12 and 15 (Mage = 13.3 ± 1.12), completed the Eysenck Junior Personality Inventory, the Loneliness Scales, the Bullying Victimization Scale, and the Short Aggression Questionnaire. Correlations, linear regressions, and latent profile analysis (LPA) were performed. Age (β = − 0.90, p < 0.001), peer loneliness (β = 0.70, p < 0.001), isolation (β = 0.18, p < 0.001), neuroticism (β = 0.06, p = 0.048), and psychoticism (β = 0.06, p = 0.026) predicted bullying victimization. Moreover, the LPA distinguished five distinct profiles based on the loneliness and personality subscales. The disruptive and peer-alienated profiles obtained the highest scores in bullying victimization, and the former also had the highest aggression scores. Loneliness and personality are closely linked to victimization and aggressive behavior. It is crucial for health and school communities to identify and address these vulnerabilities for the prevention of bullying victimization and aggression.

Multi-tiered Approaches to Trauma-Informed Care in Schools: A Systematic Review Abstract Childhood trauma can adversely impact academic performance, classroom behaviour, and student relationships. Research has gradually explored integrated approaches to care for traumatised students in schools. Increasingly, research has pointed to implementation of multi-tiered programs to trauma-informed care for traumatised students in schools. However, evaluations of these programs are limited and no systematic review of the existing evidence has been conducted. The aim of this research was to be the first systematic review to explore evidence on multi-tiered, trauma-informed approaches to address trauma in schools. Results of this systematic review yielded 13 published and unpublished studies. Findings indicated that further research, guided by empirical evidence of the effectiveness of multi-tiered and trauma-sensitive approaches in schools, is required. Recommendations for research in the area of trauma-sensitive, multi-tiered care in schools are provided.

Benefits of a Highly Entitative Class for Adolescents’ Psychological Well-Being in School Abstract Previous studies of the protective factors for adolescents’ psychological well-being in school have focused on the emotional relationships under the classroom climate. In contrast, the present study focused on the structural relationships among students. To investigate this issue, we examined the effects of class entitativity, that is, the extent that a class is a coherent group rather than a number of students, on students’ attitudes about themselves, their peers, and the whole class. A total of 408 adolescents completed measures of perceived class entitativity (i.e., homogeneity and interaction among students), self-efficacy, peer trust, and identification with the class. The results of a structural equation model analysis indicated that class entitativity was positively correlated with students’ self-efficacy and their identification with the class, which were in turn correlated with students’ trust of their peers. Further analysis revealed that homogeneity was positively associated with students’ self-efficacy, while higher level of interaction was associated with stronger identification with the class. These findings highlight the essential role of structural relationships between students in their psychological well-being and have implications for student-oriented practices in schools.

Efficacy of a Combined Approach to Tier 2 Social-Emotional and Behavioral Intervention and the Moderating Effects of Function Abstract Systematic literature reviews have supported the effectiveness of behavioral Tier 2 interventions, with research being particularly plentiful in relation to Check-In/Check-Out (CICO) and social skills training (SST). Though findings indicate either approach is effective in isolation, a recent study suggested these approaches might be particularly effective when integrated. The purpose of the current study was to build upon this initial single-case design study with a larger sample within a randomized controlled trial. Participants included 91 elementary students who had been identified as being at risk of social-emotional and behavioral difficulties. Students were randomized into three intervention conditions: CICO only, SST only, and CICO + SST. Prior to intervention, information was collected regarding the function of student problem behavior and the extent of social skill deficits. Systematic direct observation data were then completed at pre- and post-test regarding student positive and negative social engagement. Multivariate general linear models were then conducted, with pre-test scores serving as covariates and intervention group and behavioral function serving as fixed factors. Results indicated that implementation of CICO, SST, and a combined CICO + SST was functionally related to a reduction in negative social engagement. Follow-up post hoc tests indicated that after adjusting for pre-test responding, the difference between conditions in effectiveness was moderated by behavioral function. Specifically, SST was less effective for students whose behavior functioned to escape social and academic situations. No such differences were noted between students whose behavior functioned to attain adult or peer attention. Implications for practice, methodological limitations, and directions for future research are reviewed.

Child Maltreatment Knowledge and Responses Among Teachers: A Training Needs Assessment Abstract Knowledge gaps, false beliefs, and limited skills with regard to child maltreatment are commonly found among teachers, despite their vital role in the lives of maltreated children. In Canada, little has been done to develop training or other supports for teachers around detecting and responding to child maltreatment. This study conducted a multi-informant assessment of teachers’ child maltreatment training needs, as well as identified factors that may influence teachers’ training participation and use of maltreatment-related knowledge and skills. We gathered qualitative information from three informant groups in one Canadian city, namely 19 school social workers, 9 child welfare practitioners, and 21 foster caregivers. Participants shared their experiences when working with teachers to support maltreated children, as well as their beliefs about gaps in teachers’ maltreatment-related knowledge and skills. Participants were also asked about factors that might influence the delivery of child maltreatment training to teachers and teachers’ responses to maltreatment-related behaviour at school. Findings showed consensus across all three participant groups that child maltreatment training for teachers is currently inadequate. Participants identified gaps in knowledge and skills among teachers in the detection and reporting of suspected maltreatment, as well as in their use of trauma-sensitive classroom strategies. Findings also highlighted multi-level factors that may affect teachers’ decision-making and actions in response to child maltreatment, especially school- (e.g. inadequate educational resources) and teacher-level influences (e.g. teacher overburden). Recommendations for teacher training, implications for school staff and other professionals, and future directions for research are discussed.

How Do Parent Psychopathology and Family Income Impact Treatment Gains in a School-Based Intervention for Trauma? Abstract The current study examined the impacts of parent psychopathology and family socioeconomic status on symptom reduction for children participating in Bounce Back, a school-based intervention for elementary students exposed to trauma. Participants in this study were 52 first through fourth graders (Mage= 7.76; 65% male) who were predominately Latinx (82%). Schools were randomly assigned to immediate treatment or waitlist control. Children whose parents reported higher socioeconomic status showed steeper declines in symptoms compared to lower socioeconomic status. Further, children of parents who endorsed high PTSD symptoms reported attenuated treatment effects, whereas children of parents who endorsed high hostility reported enhanced treatment effects. Although Bounce Back is an effective intervention for reducing PTSD symptoms and improving coping skills among children exposed to trauma and other ongoing stressors, treatment gains are attenuated for children from families with low socioeconomic status, and parent psychopathology also impacts treatment effects. The effectiveness of Bounce Back may vary based on socioeconomic status and parent psychopathology. Future research should examine methods of tailoring Bounce Back for children coping with economic stress and parent psychopathology.