Promoting Mental Health Help-Seeking Behaviors by Mental Health Literacy Interventions in Secondary Education? Needs and Perspectives of Adolescents and Educational Professionals.

Mental health literacy (MHL) interventions in secondary schools may help to improve competencies that adolescents require to stay mentally healthy and seek help if mental health problems arise. These MHL interventions should be tailored to the needs of adolescents and educational professionals (EPs) to reach sustainable implementation and long-term effectiveness. However, evidence is lacking on these needs. Thus, our aim was to explore their experiences with, and perspectives on, mental health help seeking and needs regarding MHL interventions. We performed online focus group discussions and interviews with adolescents (n = 21; 13-19 years) and EPs (n = 12) and analyzed the data using directed content analysis. We identified three themes related to mental health help seeking: (1) Limited MHL competencies of adolescents, (2) Limited competencies of EP to provide mental health support, and (3) Limited mental health promotion in the school environment. We further identified three themes regarding MHL interventions: (1) Addressing basic mental health knowledge and skills, (2) Interactive and easily accessible, and (3) Sustainable implementation. Improving the MHL competencies of adolescents and EPs, and creating a mental health-literate school environment can promote adolescents' mental health help seeking. Our findings highlight the importance of developing MHL interventions that are tailored to both adolescents' and EPs needs.

Supporting Adolescents with Mental Health Problems in Secondary Education: Feasibility of a Supported Education Intervention.

Mental health problems in adolescence can have a profound influence on school functioning, educational attainment and thus future societal participation. Supported education (SEd) is a potentially useful method for educational professionals to help adolescents with mental health problems in secondary school improve their functioning by stimulating collaboration, ownership, and participation. In this study, we examined the feasibility of SEd in secondary education by examining its acceptability, implementation, and preliminary effectiveness. We performed a mixed-methods study using quantitative data (questionnaires) and qualitative data (interviews) from educational professionals (EP) and adolescents, aged 13-17, about their experiences with a SEd intervention. Regarding the acceptability of the intervention, three main themes emerged: (a) structure, (b) autonomy, and (c) applicability of the intervention. Themes regarding the implementation were: (a) lack of time, (b) personal attitude, (c) mastery, and (d) complexity of the school environment. The findings show that, for those that followed the intervention, SEd is a promising approach to support adolescents with mental health problems to improve their functioning and participation in school. Further research is needed on the effectiveness of the intervention.

Gray matter volume and white matter lesions in chronic kidney disease: exploring the association with depressive symptoms.

OBJECTIVE: Chronic kidney disease (CKD) is associated with structural brain damage and with a high prevalence of depression. We therefore investigated structural brain alterations in both gray and white matter in CKD patients, focusing on depression-related (frontal-subcortical) regions. METHOD: This cross-sectional MRI study in 24 CKD patients and 24 age- and sex-matched controls first tested whether CKD was associated with regionally lower gray matter (GM) volumes and more severe white matter lesions (WMLs). In exploratory subanalyses, we examined whether differences were more pronounced in CKD patients with depressive symptoms. RESULTS: CKD patients showed lower global GM volume (P=.04) and more severe WMLs (P=.04) compared to controls. In addition, we found substantial clusters of lower GM in the bilateral orbitofrontal-cortex for CKD patients, which were however nonsignificant after proper multiple-comparison correction. In exploratory analyses for depressed CKD patients, reduced GM clusters were mainly detected within the frontal lobe. WML severity was unrelated to depression. CONCLUSION: CKD was characterized by differences in brain structure. Although subthreshold, lower GM volumes were observed in depression-related brain areas and were more pronounced for depressed patients. There is a need for replication in larger and longitudinal studies to investigate whether WMLs and regional GM reductions may render CKD patients more susceptible for depression.