Mental Health Services in North Carolina's Public Schools.

Most school-age children who receive mental health services do so in their public schools, but the scope and quality of those services can vary. This article describes current school mental health efforts in North Carolina, as well as policy initiatives that could shape those practices in the coming years.

Parent- and Teacher-Rated Effectiveness of Cognitive-Behavioral Therapy for Children and Adolescents Under Usual Care Conditions in a University Outpatient Clinic.

Compared to randomized controlled trials, studies examining the effectiveness of cognitive behavioral therapy (CBT) in children and adolescents with mental disorders are rare, and a teacher perspective is scarce. The present study investigated the effectiveness of routine CBT in 519 patients aged 6-18 years with mental disorders. Changes in mental health problems were assessed in teacher (Teacher Report Form, TRF) and parent rating (Child Behavior Checklist, CBCL) and were analyzed within the total sample, yielding statistically significant, small to medium effect sizes (teacher rating: d = .74-2.39; parent rating: d = .65-1.18). Changes in a subgroup of patients with elevated symptom scores at treatment start were compared to a historical control group receiving weekly academic tutoring. Net total score effect sizes lay between d = 0.98 and d = 1.29 for teacher rating (parent rating: d = 0.84 to d = 1.01). Nevertheless, a substantial number of patients remained in the clinical range. Symptom changes during family- and patient-based CBT interventions did not differ from treatments including additional school-based interventions, as was also the case for the comparison of treatments with and without additional pharmacotherapy.

The Association Between Resiliency Factors and Suicide Indicators Among American Indian/Alaska Native Middle School Students in New Mexico: A Strength-Based Analysis.

OBJECTIVE: Suicide is a leading cause of death among American Indian/Alaska Native (AI/AN) young people aged 10-19 years in the United States, but data collection and reporting in this population are lacking. We examined results of an oversample project in New Mexico to determine the association between resiliency factors and suicide-related behaviors among AI/AN middle school students. METHODS: We conducted analyses using data from the 2019 New Mexico Youth Risk and Resiliency Survey for students in grades 6 through 8. An oversampling method was used to increase the sample size of AI/AN students. We used logistic regression to determine the association between resiliency factors and suicide indicators among AI/AN students, stratified by sex. RESULTS: Among female AI/AN students, community support had the strongest protective effect against having seriously thought about suicide (adjusted odds ratio [aOR] = 0.23; 95% CI, 0.14-0.38), while family support was significantly associated with the lowest odds of having made a suicide plan (aOR = 0.15; 95% CI, 0.08-0.28) and having attempted suicide (aOR = 0.21; 95% CI, 0.13-0.34) (P < .001 for all). Among male AI/AN students, school support had the strongest protective effect against all 3 outcomes: seriously thought about suicide (aOR = 0.34; 95% CI, 0.19-0.62; P < .001), having made a suicide plan (aOR = 0.19; 95% CI, 0.09-0.39; P < .001), and having attempted suicide (aOR = 0.27; 95% CI, 0.12-0.65; P = .003). CONCLUSIONS: Oversampling AI/AN young people can help accurately quantify and understand health risk behaviors and strengths of this population, leading to improved health and wellness. Family, community, and school-based support should be considered in interventions geared toward suicide prevention among AI/AN young people.

One-Year follow-up effects of a cognitive behavior therapy-based transdiagnostic program for emotional problems in young children: A school-based cluster-randomized controlled trial.

BACKGROUND: The present study examined the long-term efficacy of a transdiagnostic prevention program, Super Skills for Life (SSL), among young children with emotional problems. SSL is based on the principles of cognitive behavioral therapy, behavioral activation, and social skills training. METHODS: One-hundred and twenty-three Spanish-speaking children, aged 6 to 8 years, and their parents participated in the study. They were recruited from ten schools. Schools were randomly allocated to either the intervention (IG) or waiting-list control (WLC) groups. The children's parent completed a set of questionnaires to measure their child's anxiety and depressive symptoms, general difficulties and positive attributes, and psychosocial impairment. Parent's assessment at baseline and at a 12-month follow-up was assessed using an intent-to-treat approach. RESULTS: The IG, compared to WLC group, showed significant baseline-to-follow-up reductions in anxiety and depressive symptoms, as well as in behavioral difficulties and psychosocial impairment in various life domains. LIMITATIONS: The small sample size and the reliance on parental reports were the major limitations of this study. CONCLUSIONS: This study provides initial evidence of the long-term effects of SSL, suggesting that it is a promising indicated preventive intervention for young children with emotional problems.

Adoption of PBIS within school districts.

Recent research in implementation science has focused on identifying factors that predict adoption of evidence-based practices in schools. Less attention has focused on examining the adoption of practices within districts. This study included a sequential cohort of 552 districts in 25 U.S. states adopting an evidence-based framework, school-wide positive behavioral interventions and supports (PBIS). We examined schools within districts reporting on PBIS fidelity during their first five years of PBIS initiatives. Latent change score and multi-level growth modeling were used to examine and predict the percent of district adoption of PBIS over time. Results showed a significant increase in the rate of district adoption over the first 4 years of the initiative, with a decrease in growth between years 4 and 5. District size, proportion of students receiving free or reduced lunch, and districts located in cities and towns were found to be significant predictors of the percent of schools adopting PBIS. Implications for future implementation research and strategies for increasing the adoption of PBIS are discussed.