Validation of a Measurement Model to Identify Socio-emotional Difficulties in Preschool Children: The Preschool Pediatric Symptom Checklist-Chilean Version.

Identifying issues in early childhood enables timely interventions, potentially mitigating future mental health risks. In this context, this study seeks to validate the model of Preschool Pediatric Symptom Checklist for detecting social and emotional challenges among Chilean preschoolers, as reported by their caregivers. In the first stage, 36 cognitive interviews using the published Spanish version of the PPSC were conducted with caregivers, parents and/or teachers of preschool aged children, so that they could review the questions and be sure that they understood them. In stage 2, 12 experts checked the questions for coherence and consistency. As a result, only one item was slightly modified. Then, 1009 preschool caregivers answered the preliminary version of the Chilean-adapted scale (PPSC-CL). Taking into account the minor changes incorporated in the scale, and using latent variable analysis techniques, it was possible to obtain evidence of validity for the four-factor structure of the PPSC-CL. Additionally, by using the questions about children's difficulties, a robust bifactor model was established, highlighting the presence of a general factor whose items have a specific component that sustain the existence of latent dimensions for internalizing, externalizing, and attentional problems. Thanks to this advancement, it will now be possible to identify and report the occurrence of global mental health challenges in preschool-aged children.

Earthquake exposure, adverse childhood experiences, and psychosocial functioning in Chilean children: A longitudinal study.

The impact of an 8.8 magnitude Chilean earthquake on elementary school students' psychosocial functioning was assessed along with exposure to adverse childhood experiences (ACEs). Skills for Life, a national school-based mental health program in Chile, routinely assesses first- and third-grade students' psychosocial functioning and classroom adaptation. Students (N = 19,627) were screened before (2009) and after (2011) the 2010 earthquake with parent- and teacher-report measures and with a parent-report of four ACEs (family psychopathology, child chronic illness, family social isolation, father absence). Earthquake exposure was categorized as mild, moderate, or severe for Chile's 15 regions. Multilevel models analyzed the unadjusted and adjusted impacts of earthquake exposure and ACEs on functioning while clustering for school- and district-level effects. In covariate-adjusted models, earthquake exposure and three ACEs were significantly associated with worsened psychosocial functioning; earthquake exposure and all four ACEs were significantly associated with worsened classroom adaptation. New family psychopathology, B = 1.90, p < .001; chronic illness, B = 2.25, p < .001; and severe earthquake impact, B = 1.29, p < .001, held the strongest negative effects on psychosocial well-being. Moderate, B = 3.04, p = .011, and severe earthquake exposure, B = 2.53, p = .047, and new family psychopathology, B = 1.99, p < .001, were associated with the worst classroom functioning 1-year postdisaster. Findings suggest that both exogenous and home-based stressors can have significant consequences for children's psychosocial functioning and classroom adaptation, and routine screening helps quantify how individual students are affected by chronic versus acute stressors.

Mental health predicts better academic outcomes: a longitudinal study of elementary school students in Chile.

The world's largest school-based mental health program, Habilidades para la Vida [Skills for Life (SFL)], has been operating on a national scale in Chile for 15 years. SFL's activities include using standardized measures to screen elementary school students and providing preventive workshops to students at risk for mental health problems. This paper used SFL's data on 37,397 students who were in first grade in 2009 and third grade in 2011 to ascertain whether first grade mental health predicted subsequent academic achievement and whether remission of mental health problems predicted improved academic outcomes. Results showed that mental health was a significant predictor of future academic performance and that, overall, students whose mental health improved between first and third grade made better academic progress than students whose mental health did not improve or worsened. Our findings suggest that school-based mental health programs like SFL may help improve students' academic outcomes.

Implementation and Outcomes of a National School-Based Mental Health Program for Middle School Students in Chile.

Background: Chile's national school-based mental health program, Skills for Life (SFL), has demonstrated effectiveness in improving behavioral and academic outcomes in first- through third-grade students. The current study assessed the feasibility and outcomes of SFL's program for sixth- through eighth-grade students. Methods: We assessed the percentage of students who participated in the program and longitudinal changes on teacher-reported Teacher Observation of Classroom Adaptation Re-Revised (TOCA-RR) scores, youth-reported Pediatric Symptom Checklist-Chile (PSC-Y-CL) scores, grade-point average, and school attendance from sixth to eighth grade (2016-2018) for SFL's workshop intervention. Linear mixed effects models analyzed the association between outcome variables and workshop attendance. Results: Of the 30,649 sixth graders who attended the 754 participating schools in 2016, 28,204 (92.0%) were screened with the TOCA-RR. Of the 1829 students who screened at risk, 1344 had available workshop data for seventh grade, with 86.9% of them participating in most (≥ 7) workshop sessions. Workshop attendance was significantly associated with improvements in school attendance and peer relationships (a TOCA-RR subscale) in eighth grade. Conclusions: With high rates of behavioral health screening and workshop attendance, this study demonstrated the feasibility of implementing SFL's middle school program on a national scale. Higher workshop attendance by at-risk students was associated with better school attendance and peer relationships in eighth grade, as well as better but not significantly different outcomes on other measures (e.g., teacher-rated school performance and aggressive behavior in the classroom). Overall, these findings provide preliminary evidence of the feasibility and benefits of SFL's middle school program.

Wellbeing of School Communities in the Context of COVID-19 Pandemic: A Qualitative Study in Chilean Low-SES Schools.

The COVID-19 pandemic continues to impact schools and how education is conveyed to students. One of the aspects that has gained strength is supporting the wellbeing of educational communities. The purpose of this study was to describe and understand the construction of school wellbeing during the pandemic, based on the notion of collective and sustainable wellbeing. Through a qualitative design, we conducted a study in four Chilean low-SES schools in which a national school mental health program is implemented. A total of 41 in-depth interviews and one group interview were conducted with students, parents, teacher, teacher assistants, school principals, psychosocial professionals, and the school mental health officers during the second half of the 2020 school year. Thematic content analyses showed that, while facing the school closure challenges, schools strived to protect students' and teachers' wellbeing. However, participants highlighted necessary conditions for sustaining the school community's wellbeing and mental health in the context of the COVID-19 pandemic: assuring digital connectivity for all students; coordinated work with families and within the school; strengthening networks; curriculum adaptation and diversified pedagogical strategies; and emotional support toward teachers, families, and students. We discuss these findings and their implications for a sustainable and collective perspective of the wellbeing of school communities in low-SES schools, as well as for policy, practice, and research from the perspective of schools for social justice and health promotion.

Intervención preventiva de salud mental escolar en adolescentes: desafíos para un programa público en comunidades educativas / Preventive Intervention School Mental Health in Adolescents: Challenges for a Public Program in the Educational Communities

Se presenta la contribución del "Programa Habilidades para la Vida" a las prácticas de prevención de salud mental adolescente en escuelas de Chile. Se evalúa la intervención preventiva del programa, en particular observando si adolescentes que asistieron al taller preventivo (N = 212) muestran cambio en las variables desadaptación escolar (DE) y disfunción psicosocial (DP), según su asistencia y la de sus padres. El diseño fue expost facto, longitudinal prospectivo, con mediciones pre y post. El análisis consideró ANOVA de medidas repetidas y pruebas t para muestras relacionadas. Los resultados indican disminución en algunos factores de riesgo asociados a DE y la estabilidad de la DP de los adolescentes. Se discuten las implicancias de este estudio para la ciencia preventiva y las políticas públicas.

This paper shows the contribution of "Skills for Life Program" to prevention practices adolescent mental health in schools in Chile. Study included a sample of adolescents (N = 212) who participated in the preventive intervention of the program. The goal was to examine changes in variables of school maladjustment (SM) and psychosocial dysfunction (PD) based on their attendance and their parents to the preventive intervention. Design was ex-post-facto, longitudinal prospective, pre and post measurements. Analysis considered repeated measures ANOVA and t tests for related samples. Results indicate a decrease in risk factors associated with SM and PD stability of adolescents. Study implications will be discussed for preventive science and public policy.