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BACKGROUND: Youth violence, victimization, and bullying are pervasive in schools across the United States and are detrimental for learning and healthy development. K-12 school safety is an increasingly urgent issue to research and understand from multiple perspectives. Physical and psychological safety in school is linked to better student and school outcomes and is fundamental to fostering well-being and prosocial behavior. METHODS: Despite research demonstrating positive outcomes associated with school safety, there is no comprehensive conceptual model in the literature that considers precursors, strategies, mechanisms, and outcomes of school safety together. The current paper presents an equity-centered comprehensive model of school safety, which is intended as a holistic representation of the multiple factors and pathways that contribute to school safety and positive youth development. RESULTS: This model can guide research and practice through an equity-centered and comprehensive approach. This model can enable practitioners, researchers, and policymakers to make informed decisions and reach consensus regarding planning and decisions related to reducing violence and establishing supportive school environments. CONCLUSION: Our model suggests that a comprehensive approach can ensure the safety and well-being of students and staff. By thinking ecologically, schools, communities, and stakeholders can ensure that all aspects of the school context are included in school safety.
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Bullying , Safety , Schools , Violence , Humans , Adolescent , Bullying/prevention & control , Bullying/psychology , United States , Violence/prevention & control , Child , Students/psychology , Crime Victims/psychology , Adolescent DevelopmentABSTRACT
New Jersey (NJ) Safe Schools Program (NJSS) provides code-required trainings for NJ teachers supervising students in work-based learning (WBL) experiences. During the COVID-19 pandemic, increased use of chemical cleaning, sanitization, and disinfectant products (CSDPs) led to ventilation and other health concerns. NJSS conducted two surveys of newer NJ WBL teachers between October 2021 and June 2023, with a follow-up in fall 2022 for those who completed initial surveys before summer 2022. This study focused on questions regarding workspace ventilation; respirator and CSDPs trainings; awareness of government resources for safety and health (S&H); and demographics. Over 65% of participant classrooms have operable windows or ventilation systems, while 13% of school salons have ceiling fans. Half of participants didn't receive training on handling CSDPs, although 90% were aware of government S&H resources. Data suggested teachers have well-ventilated workspaces and are aware of different resources available, which is important to continue post COVID-19.
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OBJECTIVE: This systematic review used established rating criteria to describe the level of evidence for interventions aimed at preventing or reducing bullying perpetration and victimization in schools, synthesized the evidence for students from racially and ethnically diverse backgrounds, and reviewed the literature for available information to conduct an economic analysis of the interventions. METHODS: Major databases, gray literature, and evidence-base registries were searched to identify studies published from 2008 through 2022. The authors rated antibullying intervention models as having high, moderate, or low evidence depending on the number and rigor of studies with positive findings. RESULTS: Overall, 80 articles reporting on 71 original research studies describing a total of 48 antibullying interventions met the inclusion criteria for this review. Two schoolwide interventions received a high-evidence rating: the KiVa (Kiusaamista Vastaan) Antibullying Program and the Friendly Schools program. Multilevel interventions with components at the levels of school, classroom, and individual student most consistently showed strong evidence for reducing bullying behavior in elementary and middle school grades. Four interventions yielded positive effects in reducing bullying and victimization among diverse samples of students. CONCLUSIONS: Antibullying interventions can reduce bullying in schools. Some interventions show effectiveness with students from racially and ethnically diverse backgrounds. The gains relative to per-student costs were in the range that is considered cost-effective. Most implementation costs are spent on staff training and support. Research on successful implementation of whole-school interventions and additional synthesis of evidence pertaining to program structures would further advance the antibullying evidence base.
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PURPOSE OF REVIEW: There is widespread use of emergency preparedness drills in public K-12 schools across the US, but considerable variability exists in the types of protocols used and how these practices are conducted. This review examines research into both "lockdown drills" and "active shooter drills" as it relates to their impact on participants across different outcomes and evaluations of their procedural integrity. RECENT FINDINGS: A number of studies on lockdown drills yielded largely consistent findings about their impacts, whereas findings related to the effects of active shooter drills are less uniform. The research also demonstrated that lockdown drills, though not active shooter drills, can help participants build skill mastery to be able to successfully deploy the procedure. Differences in how drills impact participants and whether they cultivate skill mastery are largely attributable to the type of drill being conducted. This review suggests that employing clearly defined drill procedures incorporating best practices, coupled with instructional training, can help schools prepare for emergencies without creating trauma for participants.
Subject(s)
Civil Defense , Mass Casualty Incidents , Schools , Humans , Civil Defense/methods , Disaster Planning/methods , Disaster Planning/organization & administration , Wounds, Gunshot/prevention & control , Gun Violence/prevention & control , Mass Shooting EventsABSTRACT
BACKGROUND: Though separate bodies of research have shown sexual and gender minority (SGM) youth, and youth with disabilities, separately, face distinct social and health disparities, little is known about youth who both identify as SGM and have disabilities. OBJECTIVE: The current study examined differences in wellbeing among SGM youth by disability category (i.e., physical, developmental, psychiatric) across victimization, bullying, dating violence, school safety, and experienced stress. METHODS: Using self-reported data from 9418 SGM youth aged 13-17 in the United States, multivariate linear regressions were conducted to examine how stress and social safety experiences varied across disability status. RESULTS: Compared to SGM youth without a disability, SGM youth across all disability categories (physical, developmental, psychiatric) had greater odds of LGBT- and disability-based victimization, greater average stress, as well as lower levels of school safety. SGM youth with any disability, physical disability, or psychiatric disability also had greater odds of dating violence compared to SGM youth without a disability. CONCLUSION: SGM youth with disabilities may be in particular need of targeted programs that address both disability and sexual/gender identities, and may benefit from increased supports across developmental contexts (e.g., against bullying in school). Stakeholders should consider how such support can be improved, tailored, and implemented, for SGM youth and the diversity of disabilities they have.
Subject(s)
Bullying , Crime Victims , Disabled Persons , Intimate Partner Violence , Sexual and Gender Minorities , Stress, Psychological , Humans , Male , Adolescent , Sexual and Gender Minorities/statistics & numerical data , Sexual and Gender Minorities/psychology , Female , Disabled Persons/statistics & numerical data , Disabled Persons/psychology , Crime Victims/statistics & numerical data , Crime Victims/psychology , Bullying/statistics & numerical data , Stress, Psychological/psychology , United States , Intimate Partner Violence/statistics & numerical data , Intimate Partner Violence/psychology , Schools , Safety , Self ReportABSTRACT
INTRODUCTION: Using the 2017 National Crime Victimization Survey dataset, this study examined the association between the types of school security measures and students' bullying victimization and perceived school safety. METHOD: Using logistic regression and ordinary least square regression analyses, the study addressed whether these associations vary by sex and race/ethnicity, as most research has treated sex and race/ethnicity as covariates. RESULTS: The study found that none of the security measures were associated with bullying victimization among the total sample. However, there were sex and racial differences in the association between security measures and bullying victimization. There were also sex and racial/ethnic variations in the association between security measures and perceived school safety. DISCUSSION: Scholars, health care practitioners, and policymakers must reflect and reconsider whether increasing school security and control would contribute to the safety and well-being of racial/ethnic minority students in school.
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Bullying , Crime Victims , Child , Humans , Ethnicity , Minority Groups , Bullying/prevention & control , Schools , Security MeasuresABSTRACT
BACKGROUND: US schools increasingly implement commercially available technology for social media monitoring (SMM) of students, purportedly to address youth mental health and school safety. However, little is known about how SMM is perceived by stakeholders, including the students who are the focus of these efforts. OBJECTIVE: We aimed to assess attitudes toward SMM in schools among 4 stakeholder groups and examine reasons for holding supportive, neutral, or unsupportive views toward the technology. We also sought to explore whether any differences in attitudes were associated with binary sex, race, ethnicity, sexual orientation, or gender identity. METHODS: In October 2019, we conducted a convergent parallel mixed methods web-based survey of young adults (aged 18-22 y; n=206), parents (n=205), teachers (n=77), and school administrators (n=41) via Qualtrics web-based panels. We included Likert-type survey items to assess perceived benefits, risks, and overall support of SMM in schools and test for differences based on stakeholder group or demographic characteristics. We also included open-ended questions, and the responses to these items were analyzed using thematic content analysis of reasons given for holding supportive, neutral, or unsupportive views. RESULTS: The tests of group differences showed that young adults perceived lower benefit (P<.001) as well as higher risk (P<.001) and expressed lower overall support (P<.001) of the use of SMM in schools than all other stakeholder groups. Individuals identifying as nonheterosexual also perceived lower benefit (P=.002) and higher risk (P=.02) and expressed lower overall support (P=.02) than their heterosexual counterparts; respondents who identified as people of racial and ethnic minorities also perceived higher risk (P=.04) than their White counterparts. Qualitative thematic content analysis revealed greater nuance in concerns about SMM. Specifically, the primary reasons given for not supporting SMM across all stakeholder groups were (1) skepticism about its utility, (2) perceived privacy violations, and (3) fears of inappropriate or discriminatory use of the data. Within the young adult group in particular, concerns were also raised about (4) unintended and adverse consequences, including the erosion of trust between students and school institutions and administrators, and the chronic adverse effects of constant or prolonged surveillance. Thematic analysis also showed that individuals in every stakeholder group who indicated overall support of SMM were likely to cite the potential for enhanced school safety as the reason. Young adults' overall stances toward SMM were the most polarized, either strongly for or strongly against SMM, and responses from teachers indicated similar polarization but more often favored support of SMM in schools. CONCLUSIONS: This study found differing perspectives among stakeholder groups regarding SMM in schools. More work is needed to assess the ways in which this type of surveillance is being implemented and the range and complexity of possible effects, particularly on students.
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While Gender and Sexuality Alliances (GSAs) are associated with higher acceptance of sexual diversity and lower bullying-victimization, it is unclear which individual and school-level attributes strengthen these associations. Nationally representative data (N = 1,567 students; Mage = 15.4, SD = 0.16; 34% boys, 66% girls, 51% heterosexual, 49% sexually-diverse after propensity score matching) in 139 Dutch secondary schools were used. Multilevel regression analyses revealed that GSA presence was linked to more inclusive attitudes about sexual diversity and a safer disclosure climate among sexually-diverse students, and lower general bullying-victimization when the school had a GSA combined with school practices to tackle bullying. School professionals and researchers are recommended to recognize the significance of individual and school-level factors that affect GSA correlates.
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Bullying , Schools , Students , Humans , Female , Male , Adolescent , Bullying/statistics & numerical data , Bullying/prevention & control , Bullying/psychology , Netherlands , Students/psychology , Students/statistics & numerical data , Crime Victims/psychology , Adolescent Behavior/psychology , Sexual and Gender Minorities/psychology , Sexual and Gender Minorities/statistics & numerical data , SafetyABSTRACT
BACKGROUND: Mass school shootings have created fear in the American public. The results of this fear have been the hardening of schools, lockdowns, and active shooter drills, yet the mass shootings have not ended. The goal of this study was to analyze the mental health awareness of K-12 public schools teachers in Texas with a goal to identify the connections between mental health awareness and school safety. METHODS: Data were used from an archival database of K-12 teacher responses in the 2020 Texas Educators' Needs Assessment Regarding School Safety and Victims Services to assess the current state of student mental health concerns and the connection of these concerns to school safety. This needs assessment included one mixed methods survey that was collected from Texas K-12 educators and Texas educators working in higher education in 2020. The original study included 25,161 usable responses (6.1%). For the purpose of this study, only K-12 teacher responses were used in the analysis. The K-12 teacher participants (n = 19,888) included the following institutional levels: (a) special setting, 2,919 (14.7%); (b) elementary school, 6,813 (34.3%); (c) middle/intermediate school, 4,189 (21.1%); (d) high school, 5,864 (29.5%); and (e) district level, 103 (0.5%). A total of 8,053 participant's qualitative responses and 10 of the original quantitative survey questions from the archival data were used to identify all findings in the study. RESULTS: Collected qualitative and quantitative participant responses' outlined a need to improve student mental health by strengthening the focus on supporting all stakeholders (e.g., teachers, parents, counselors, and students) in mental health awareness and education. Participant comments focused on the lack of training, counselor support, and community support regarding the mental health needs of their students. CONCLUSION: Recommendations to improve student mental health that were developed from this study identified key goals in school counselor role and responsibility to student mental health, increased involvement of community agencies, and improvement to in-school mental health counseling. Final recommendations of this study were focused on the need to improve student mental health if stakeholders want to develop a positive school environment. The failure to build an environment that is focused on student mental health will continue to affect the goal to improve overall school safety.
Subject(s)
Mental Health , School Teachers , Humans , Texas , School Teachers/psychology , School Health Services , SchoolsABSTRACT
Organizational capacity building-the process of developing leadership, collecting and analyzing data, building buy-in, and implementing programming-is foundational to effectively changing schools, and frequently relies on technical assistance. This study employed a quasi-experimental, repeated measured design to evaluate the role of technical assistance provided through Safe School Certification model in improving school climate. Schools worked through an eight-element framework, using data from a sample of six middle and high schools in Washington, D.C. that completed data collection in all years of the evaluation. Students in schools receiving technical assistance for implementing the SSC Framework had more positive changes in perceptions of school climate than students in schools that did not receive support, but those differences were small. The results from this study offer limited evidence that providing schools with technical assistance to improve organizational capacity is associated with more positive student perceptions of school climate.
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Capacity Building , Schools , Students , Humans , Students/psychology , District of Columbia , Female , Adolescent , Male , Social Environment , Child , Organizational Culture , Models, OrganizationalABSTRACT
This study examined associations between self-reported mental health problems, body image, bullying victimisation and school safety in large adolescent samples in Japan and Russia, considering the effects of gender, culture and their interactions. In both Japan and Russia, girls reported a greater number of mental health problems, less bullying victimisation and much higher body dissatisfaction than boys did. Japanese adolescents rated themselves higher on total difficulties, reported less body dissatisfaction and bullying victimisation, and rated their school safety lower than that of Russian youths. Cross-cultural differences in total difficulties and body image were qualified by gender. Body dissatisfaction, bullying victimisation and school safety all independently contributed to adolescent mental health problems. The protective effect of school safety on total difficulties was larger for girls than for boys; the strength of the association between bullying victimisation and adolescent mental health problems differed across genders and cultures. The findings indicate a need for a cross-cultural approach and provide a strong basis for targeted interventions that seek to improve adolescent mental health.
Subject(s)
Bullying , Crime Victims , Humans , Adolescent , Male , Female , Mental Health , Japan , Body Image , Bullying/psychology , Schools , Crime Victims/psychologyABSTRACT
Youth are more likely to succeed when they feel safe at school and have access to caring relationships with adults. Systemic racism interrupts access to these assets. Within schools, racially/ethnically minoritized youth encounter policies rooted in racism, leading to decreased perceptions of school safety. Having a teacher mentor may mitigate some of the harmful effects of systemic racism and discriminatory practices. Yet, teacher mentors may not be accessible to all students. In this study, the authors tested a putative explanatory hypothesis for differences between Black and white children's access to teacher mentors. Data from the National Longitudinal Study of Adolescent Health were used. Linear regression models were used to predict access to teacher mentors, and a mediational analysis was conducted to determine the effect of school safety on the relationship between race and teacher mentor access. Results indicate that students from higher SES backgrounds and those with parents who have greater educational attainment are more likely to have a teacher mentor. Furthermore, Black students are less likely than white students to have a teacher mentor, and school safety mediates that relationship. The implications of this study suggest that challenging institutional racism and structures may improve perceptions of school safety and teacher mentor accessibility.
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Academic Success , Racism , Adolescent , Adult , Child , Humans , Mentors , Longitudinal Studies , SchoolsABSTRACT
OBJECTIVE: The current study examined whether bullying victimization was associated with bringing a weapon to school, fully or partly mediated by feeling unsafe in school, negative future education orientation, and skipping school. METHOD: Data from 6199 students (12-18 years old), who had filled out the 2017 School Crime Supplement to the National Crime Victimization Survey, were analyzed. RESULTS: The results showed a positive association between bullying victimization and bringing a weapon to school. The link was both direct and indirect through the mediating roles of feeling unsafe in school, having a negative future education orientation, and skipping school. CONCLUSION: Thus, victims of bullying tended to feel unsafe in school, have a negative future education orientation, and skip school-all of which were positively associated with bringing a weapon to school.
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Bullying , Crime Victims , Humans , Child , Adolescent , Schools , Emotions , StudentsABSTRACT
INTRODUCTION: The correlation between mass shootings, firearm injuries, and mental health is an ongoing polarized debate within the U.S., making it essential to develop public policy on mental illness and firearm injuries exacerbated by a significant increase in firearm sales in March 2020. Although many mass shooters are labeled "mentally ill," mental illness is only present in a small minority of cases. Most mentally ill people are never violent but are more likely to be the victims of violence. Easy access to firearms and a triggering event deriving from social and economic inequalities are primary causes of mass shootings and growing online radicalization. Radicalization can easily lead to fatal firearm injuries, particularly for individuals with diagnosed or undiagnosed mental illness. RECOMMENDATIONS: Proposed solutions include permits for firearms purchase, including a 25-year-old age limit, universal background checks, and banning large-capacity magazines. Additionally, a speedy and effective law enforcement response is the sole factor and the most reliable way to stop a mass shooting once it has started. The research identified several other recommendations, including expanding Medicare and mental health care access, expanding school safety and law enforcement training, and promoting public education about mental health and firearm safety.
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Firearms , Wounds, Gunshot , Aged , Humans , United States/epidemiology , Adult , Wounds, Gunshot/epidemiology , Mental Health , Medicare , HomicideABSTRACT
School-based law enforcement (SBLE) have become increasingly common in U.S. schools over recent decades despite the controversy surrounding their presence and lack of consensus around their associated benefits and harms. Drawing on the history and evidence base regarding SBLE, we advocate for an end to SBLE programs. Grounding our argument in principles of Community Psychology and positive youth development, we outline how the presence and actions of SBLE negatively affect individual students as well as school systems, with particularly harmful outcomes for students with minoritized and marginalized identities. Research on SBLE and school crime does not provide consistent evidence of positive impacts, and many studies find null effects for the relationship between SBLE and school crime or increases in crime and violence in schools. Though funding for SBLE is often prompted by high-profile acts of gun violence in schools, evidence suggests that SBLE neither prevents these incidents, nor lessens the severity when they do occur. Thus, we advocate for removing law enforcement from school settings and redirecting resources into inclusive, evidence-informed responses that are generally safer and more effective than SBLE. We close by outlining the policy landscape governing SBLE programs and ways communities can lobby for change.
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Purpose: This study examines adolescents' self-reported school-based developmental assets and four intersecting social positions as they relate to prevalence of bullying involvement. Methods: Participants were 80,456 ninth and 11th grade students who participated in the 2019 Minnesota Student Survey (30.2% youth of color; 11% lesbian/gay/bisexual/pansexual/queer/questioning; 2.9% transgender/gender diverse [TGD] or gender questioning). Exhaustive Chi-square Automatic Interaction Detection analysis was used to identify school-based developmental assets (i.e., school safety, school adult support) and intersecting social positions (i.e., sexual identity; gender identity/modality; racial/ethnic identity; physical disabilities/chronic illness; and/or mental health/behavioral/emotional problems) associated with the highest prevalence of involvement as physical and relational bullies, victims, and bully-victims. Results: Adolescents with 2+ marginalized social positions who often lacked school-based developmental assets were part of nearly all the highest prevalence bullying involvement groups. TGD and gender questioning adolescents, Native American youth, and youth living with both physical disabilities/chronic illness and mental health/emotional/behavioral problems-most of whom had additional marginalized social positions and lacked school-based assets-were particularly overrepresented in high prevalence groups. For example, 31.1% of TGD or gender questioning youth of color living with both types of disabilities/health problems who did not feel strongly that school was safe reported involvement as physical bully-victims-nearly six times the sample average rate. Conclusion: Adolescents with multiple marginalized social positions and those lacking certain school-based assets-often overlapping categories-were involved in bullying at higher-than-average rates. Findings underscore the need for schools to address intersecting experiences of stigma and structural oppression that may perpetuate bullying involvement disparities.
Subject(s)
Bullying , Transgender Persons , Adolescent , Adult , Female , Humans , Male , Gender Identity , Ethnicity , PrevalenceABSTRACT
The effects of school and classroom racial/ethnic diversity on peer victimization, self-blame, and perceived school safety were examined in a racially/ethnically diverse sample of students followed over the three years of middle school. Sixth grade students (N = 5,991, 52% female; M = 11.63 years) were recruited from 26 urban middle schools that systematically varied in racial/ethnic diversity. Based on student self-report, the sample was 31.6% Latino/Mexican, 19.6% White, 17.4%, Multiethnic/Biracial, 13% East/Southeast Asian, 10.9% Black, and 6.9% Other very small racial/ethnic groups. Each school had a structural diversity score based on the number and size of racial/ethnic groups enrolled. Using a novel method based on course schedules and class rosters, each student's individual exposure to diversity in their classes was assessed to capture dynamic diversity. Latent growth modeling showed that structural school diversity and dynamic classroom diversity were both related to less victimization at the start of middle school and a decrease over time. Dynamic classroom diversity buffered the associations between victimization and self-blame and between victimization and perceiving school as unsafe. Dynamic classroom diversity was more protective than structural school diversity. Implications for practice, intervention and policies to promote school racial/ethnic diversity were discussed.
Subject(s)
Bullying , Crime Victims , Peer Group , Safety , Female , Humans , Male , Ethnicity , Hispanic or Latino , Racial Groups , Schools , Child , Black or African American , White , Asian , Population Groups, USABSTRACT
The current study examined associations between Black adolescents' (Mage = 15.55, SD = 1.23) racial discrimination and suicide behaviors (i.e., suicide ideation, suicide plan, and suicide attempts), and whether perceived school safety was a protective moderator. Furthermore, we tested gender differences in relations, which were not significant. Racial discrimination predicted greater suicide behaviors, and school safety informed less suicide behaviors. School safety moderated the relation between discrimination and suicide plan, such that at low school safety, discrimination predicted having a suicide plan but was not significant at high school safety. Furthermore, school safety moderated the relation between discrimination and suicide attempts. At low school safety, discrimination predicted more suicide attempts, but was not significant at high school safety.
Subject(s)
Black or African American , Racism , Suicidal Ideation , Suicide, Attempted , Adolescent , Humans , Schools , SafetyABSTRACT
BACKGROUND: Lockdown drills are mandated within many educational settings in the US; they may contribute to adverse mental health and there is little to suggest their effectiveness. We describe factors associated with post-drill anxiety and perceived effectiveness of drills. METHODS: We surveyed youth-caregiver dyads presenting to the pediatric emergency department. Nonparametric tests compared factors across groups of child anxiety and caregiver perceived effectiveness of drills. Kappa statistics (κ) measured child-caregiver agreement on post-drill anxiety and depression symptoms. RESULTS: 108 child-caregiver dyads were included. Post-lockdown drill anxiety was reported by 27% of children; those reporting anxiety were more likely to have histories of bullying or skipping school for safety (p = 0.0004). Of caregivers, 47% believed drills effectively prevent firearm injury. There was a significant disparity between child and caregiver report of post-drill mental health symptomatology (κ anxiety = 0.19; κ depression = 0.30). Implications for School Health, Policy, Practice, and Equity: Understanding factors contributing to anxiety surrounding lockdown drills and perception of drill effectiveness may aid policy decisions and resource allocation. CONCLUSIONS: Lockdown drills may increase mental health symptoms in children, while caregivers may not recognize this occurrence. Studies to identify risk factors of acute and chronic post-lockdown drill anxiety will help determine how to better serve youth.
Subject(s)
Firearms , Wounds, Gunshot , Humans , Adolescent , Self Report , Anxiety/epidemiology , Perception , Caregivers/psychology , Depression/epidemiologyABSTRACT
INTRODUCTION: Adolescent mental health problems are widespread; however, there are still very few data on risk and protective factors for general and specific psychopathology. This study examined the structure of common mental health problems in Russian adolescents and the associations of temperamental effortful control and perceived school safety to the latent factors of adolescent mental health, taking age and gender into account. METHODS: Data were collected on 1850 adolescents (53% female) aged 12-18 using the self-report Eurasian Child Mental Health Study questionnaire, the Strengths and Difficulties Questionnaire, and the abbreviated Effortful Control scale of the Early Adolescent Temperament Questionnaire-Revised. Structural equation modeling was used to evaluate the structure of common mental health problems and to examine the associations with age, effortful control, and school safety. RESULTS: The five-correlated-factors model comprising internalizing, body dissatisfaction, psychosomatics, externalizing, and substance use, and the bifactor-(S-1) models with internalizing and externalizing as reference domains and four specific factors showed an adequate fit to the data and sufficient reliability and validity. Analyses established full metric invariance of these models across gender. Effortful control showed a general association with adolescent mental health problems and a specific association with externalizing problems. School safety showed specific negative associations with externalizing and substance use and with girls' internalizing problems. CONCLUSIONS: These findings provide a strong basis for further cross-cultural research into the structure and determinants of adolescent mental health and highlight the need for effective interventions.