School-based autism evaluations in the COVID-19 era.

School psychologists play a critical role in school-based Autism (AU) evaluations. Evidence-based AU evaluations should be multimodal, include multiple informants, and assess functioning across several domains. In the current era of COVID-19, school-based AU evaluations have become increasingly complex with school psychologists having to significantly adapt face-to-face evaluation procedures and/or conduct evaluations via teleassessment approaches. This poses profound challenges for some families, many of whom are from vulnerable groups. In the current article, we outline school psychologists' traditional role in school-based AU evaluations and review best practice guidelines. We then discuss the impact of COVID-19 on these processes and provide a framework for school psychologists to use when conducting school-based AU evaluations during this unprecedented time. We also provide resources school psychologists may find useful as they conduct school-based AU evaluations during the COVID-19 pandemic. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Schools on the front lines: School based health centers amidst COVID-19.

School based health centers (SBHCs) are often at the front line of medical and mental health services for students in the schools they serve. Citywide school closures in New York City in March 2020 and ongoing social distancing procedures resulted in significant changes in SBHC services as well as access to these services. Furthermore, the combination of COVID-19 related stressors and the increased likelihood of adverse childhood events experienced by urban youth creates conditions for the exacerbation of mental health concerns among youth in metropolitan areas. The following article will explore the role of SBHCs as community agents focused on prevention and reduction of mental health concerns prior and during the current pandemic, as well as existing health disparities experienced by urban youth populations. The authors will also discuss research examining mental health concerns already present in global populations affected by COVID-19 as it may foreshadow the challenges to be faced by U.S. urban youth. Lastly, the authors describe recommendations, practice implications, and opportunities for preventative strategies and therapeutic interventions in school based health settings. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Identifying Essential Components of School-Linked Mental Health Services for Refugee and Immigrant Children: A Comparative Case Study.

BACKGROUND: Foreign-born children rarely use traditional school mental health services. Comprehensive programs that combine mental health services with academic, economic, and socioemotional supports reach more foreign-born children and improve wellbeing. However, little practical guidance exists regarding how to best combine these diverse services. METHODS: To identify essential service components and their organization, we interviewed 92 parents, school staff, mental health providers, and community agency staff from 5 school-linked mental health programs designed specifically to serve immigrant and refugee youth. RESULTS: Foreign-born parents did not distinguish between academic, behavioral, and emotional help for their children; these western categorizations of functioning were not meaningful to them. Consequently, programs needed to combine 4 components, organized in a pyramid: family engagement, assistance with basic needs, assistance with adaptation to a new culture, and emotional and behavioral supports. Family engagement was the foundation upon which all other services depended. Assistance with economic and cultural stressors directly promoted emotional wellbeing and helped parents trust clinical mental health interventions. CONCLUSIONS: Specific strategies to implement the 4 essential components include home visits by program staff, a one-stop parent center located in the school to help with basic needs, working with cultural brokers, and informed consent procedures that clearly explain recommended care without requiring immigrant and refugee parents to internalize western conceptualizations of psychopathology. Future evaluations should assess the cost and effectiveness of these strategies. These data are essential to advocate payment for these nonclinical services by traditional funding mechanisms.

Suicide prevention: Using the number of health complaints as an indirect alternative for screening suicidal adolescents.

BACKGROUND: Suicide is the second leading cause of death in adolescents. Screening for persons at risk usually includes asking about suicidal ideation, which is considered inappropriate in some societies and situations. To avoid directly addressing suicide, this paper investigates whether the Health Behaviour in School-aged Children Symptom Checklist (HBSC-SCL), a validated non-clinical measure of eight subjective health complaints (e.g. headache, feeling low), could be used as a tool for screening suicidal ideation and behavior in adolescents. METHODS: 5262 secondary school students aged 12-18 answered the Luxembourgish HBSC 2014 survey, including the HBSC-SCL items and suicidal ideation and behavior questions. RESULTS: Each HBSC-SCL item correlates with suicidal ideation and behavior. A sum score was calculated ranging from zero to eight health complaints to predict respondents who considered suicide (area under the ROC curve = 0.770). The ideal cut-off for screening students who consider suicide is three or more health complaints: sensitivity is 66.3%, specificity is 75.9% and positive predictive value is 32.9%. LIMITATIONS: One limitation is HBSC-SCL's low positive predictive value. This is a general problem of screening rare events: the lower the prevalence, the lower the positive predictive value. Sensitivity and specificity could be improved by taking age-, gender- and country-specific cut-off values, but such refinements would make the score calculation more complicated. CONCLUSIONS: The HBSC-SCL is short, easy to use, with satisfactory screening properties. The checklist can be used when suicide cannot be addressed directly, and also in a more general context, e.g. by school nurses when screening adolescents.

Establishment and validation of a mental health literacy measurement in Canadian educators.

We aim to create the first mental health literacy measure addressing mental health knowledge of educators and assess its psychometric properties. We developed a 30-item multiple choice measure, Mental Health Literacy Tool for Educators (MHL-ED), with experts in both mental health and education. We administered it to educators (n = 909) from 6 Canadian provinces. We analysed the factor structure, internal consistency reliability, construct validity and responsiveness to change of MHL-ED. Factor analysis resulted in 4 factors of MHL-ED addressing: general mental illness and related treatment; assessment and diagnostic tools and treatments; causes and risk factors of mental illness; and epidemiology of mental health and mental illness. MHL-ED demonstrated strong internal consistency reliability. The construct validity was established because the hypothesis was supported that school based mental health professionals scored significantly higher than classroom teachers and school administrators/school support staff; and further MHL-ED scores were positively related with stigma measures. We did not identify floor or ceiling effects of MHL-ED. MHL-ED is reliable and valid to evaluate mental health literacy levels among educators working in junior high and secondary school settings, and may be considered for use in future research in this field.