Cyberbullying and Bullying Reports Among Youth in a Behavioral Health Inpatient Unit: Insights From Youth and Parent Intake Surveys.

BACKGROUND: Limited studies have examined the extent to which cyberbullying and offline bullying are factors related to youth admissions to behavioral health inpatient units. However, considering the rising use of technology and prevalence of youth bullying, intake procedures require adaptation to account for modern-day psychological pressures facing youth. AIMS: Our aims were to pilot and analyze results from a novel intake form, assessing offline bullying and cyberbullying, in a youth inpatient behavioral health facility. METHODS: Upon admission at an inpatient behavioral health facility in the Midwestern United States, 622 youth (ages 10 and older) and their parent/guardian completed intake forms including questions about their experience of bullying, cyberbullying, and feelings of safety in different environments, and feelings about whether bullying contributed to their inpatient admission. RESULTS: Overall, 21.50% (134/622) of youth self-reported being a cybervictim, 6.10% (38/622) reported being an offline bully victim, and 8.04% (50/622) reported mixed bullying. Bullied youth felt significantly less safe in all environments than non-bullied youth, and bullied youth who felt unsafe were more likely to attribute their hospitalization to bullying. Troublingly, only about one-third of parents were aware of cyberbullying. CONCLUSION: Using traditional standards of care that do not address offline bullying/cyberbullying, mental health care workers may be missing critical factors that contribute to youth inpatient hospitalization for mental health issues. Behavioral health units should consider adapting intake forms to include offline bullying/cyberbullying questions and developing programming for parents and adults to address issues of online and offline safety.

College Students' Experiences with, and Willingness to Use, Different Types of Telemental Health Resources: Do Gender, Depression/Anxiety, or Stress Levels Matter?

Objective:Telemental health (TMH) resources are plentiful; however, we know little about college students' opinions about such resources. We aimed to examine students' previous use of and willingness to use several types of TMH resources.Participants:Students (N = 662) from two U.S. Midwestern colleges participated.Methods:Using an online survey in spring 2017, we measured students' depression, anxiety, stress, and suicidal thoughts, preferences for care options during distress, and use and interest in anonymous chats with trained nonprofessionals, online therapy, and self-help resources.Results:Overall, 10.1-13.8% had experience with these TMH resources; however, 24.6-40.1% expressed willingness to try them. At-risk students, especially those higher in depression/anxiety scores, showed greater use of and willingness to use some applications.Conclusions:Counseling centers might consider endorsing TMH resources as potential pathways to care. TMH resources might help broaden reach with minimal cost, reduce mental health help-seeking barriers, and provide support to at-risk populations.

Piloting a Peer Support Program for Patients Who Screen Positive for Intimate Partner Violence, Suicidal Ideation, and Depression.

Peer support programs have been utilized for a variety of mental-health-related needs, including suicidality and depression. In this pilot program, we developed a peer support network to address multimorbidity involving intimate partner violence (IPV), suicidal ideation, and depression. Over one year, our Suicide Obviation Support (SOS) navigators enrolled and provided at-elbow support to 108 patients (67.6% women) who screened positive for IPV, many of whom also screened at moderate or high risk for suicidality (64.8%) and/or exhibited depression symptoms. At a 6-month follow-up, 63 participants (58.3%) were retained. Those who stayed enrolled in the program for six months were less likely to report IPV and depression symptoms and were at a lower risk for suicide than the original sample, and analyses showed that IPV, depression, and suicide risk scores declined significantly in this group. The SOS navigators provided direct support and continuity of care for these high-risk patients, which included referrals to mental health treatment and other types of support services, such as transportation and emergency housing. This program provides a model for healthcare systems that desire to implement peer support programs servicing individuals who face multiple, acute mental health care needs.

Audience Response Systems and Missingness Trends: Using Interactive Polling Systems to Gather Sensitive Health Information From Youth.

BACKGROUND: The widespread availability and cost-effectiveness of new-wave software-based audience response systems (ARSs) have expanded the possibilities of collecting health data from hard-to-reach populations, including youth. However, with all survey methods, biases in the data may exist because of participant nonresponse. OBJECTIVE: The aims of this study were to (1) examine the extent to which an ARS could be used to gather health information from youths within a large-group school setting and (2) examine individual- and survey-level response biases stemming from this Web-based data collection method. METHODS: We used an ARS to deliver a mental health survey to 3418 youths in 4 high schools in the Midwestern United States. The survey contained demographic questions, depression, anxiety, and suicidality screeners, and questions about their use of offline resources (eg, parents, peers, and counselors) and Web-based resources (ie, telemental health technologies) when they faced stressful life situations. We then examined the response rates for each survey item, focusing on the individual- and survey-level characteristics that related to nonresponse. RESULTS: Overall, 25.39% (868/3418) of youths answered all 38 survey questions; however, missingness analyses showed that there were some survey structure factors that led to higher rates of nonresponse (eg, questions at the end of survey, sensitive questions, and questions for which precise answers were difficult to provide). There were also some personal characteristics that were associated with nonresponse (eg, not identifying as either male or female, nonwhite ethnicity, and higher levels of depression). Specifically, a multivariate model showed that male students and students who reported their gender as other had significantly higher numbers of missed items compared with female students (B=.30 and B=.47, respectively, P<.001). Similarly, nonwhite race (B=.39, P<.001) and higher depression scores (B=.39, P<.001) were positively related to the number of missing survey responses. CONCLUSIONS: Although our methodology-focused study showed that it is possible to gather sensitive mental health data from youths in large groups using ARSs, we also suggest that these nonresponse patterns need to be considered and controlled for when using ARSs for gathering population health data.

Using Immediate Response Technology to Gather Electronic Health Data and Promote Telemental Health Among Youth.

INTRODUCTION: A sizeable number of youth are currently struggling with anxiety, depression, and suicidal thoughts, yet many will not receive treatment. We sought to better understand if immediate response technology (IRT) could be used to gather mental health care data and educate youth on telemental health (TMH) resources. METHODS: Using an IRT imbedded within an interactive, media-rich school-based presentation, we gathered mental health history and preferences for TMH resources from 2,789 adolescents with a wide range of demographic and psychological characteristics. RESULTS: More than 80 percent of adolescents satisfied inclusion criteria for survey completion, and responses were statistically comparable across four diverse high school settings. Using Chi-squared analyses, we found that less than 10 percent of adolescents, especially girls and those with high depression/anxiety scores, had previously used TMH resources. After interacting with the IRT, many more (29 percent to 43 percent) expressed willingness to use these resources. DISCUSSION: The IRT system was effective in gathering mental electronic health data, delivering targeted mental health education, and promoting positive attitudes towards TMH among adolescents. CONCLUSIONS: IRTs and other non-formalized technologies should be explored as cost-effective, easy-to-implement resources for electronic health data gathering and health care education.