A roadmap to equitable school mental health screening.

Youth in the United States are experiencing mental health concerns at alarming rates. Considering the nation's legacy of racism and growing recognition of the impact of social determinants of health on educational and mental health inequities, it is imperative to re-envision how we approach mental health screening in schools to center equity. A focus on mental health screening for the sole purpose of identifying individual at-risk students ignores key contextual considerations, is ineffective in addressing health and educational inequities, and has the potential to perpetuate oppressive practices in schools. Equity-focused mental health screening requires a shift from individual- and deficit-focused approaches to systems- and holistic-focused approaches that (a) identify strengths and stressors among individuals, groups, and communities; (b) dismantle structural forms of oppression; and (c) promote positive mental health outcomes for minoritized youth. Integrating recommendations from the educational equity literature and critical school mental health frameworks, this paper identifies core considerations for equitable school mental health screening and provides guiding principles for each phase of the screening process, from screening readiness to execution to follow up. To implement these recommendations and transform school-based mental health care, schools should (a) incorporate multiple perspectives; (b) prioritize student, family, and community voices; and (c) build collaborative partnerships to co-construct a vision for equitable school mental health.

Extending Validation of a Social Emotional Health Measure For Middle School Students.

The Social Emotional Health Survey-Secondary-2020 (SEHS-S-2020) is a well-studied option for assessing social emotional health to support students within a multitiered system of school support. While a growing body of literature supports the SEHS-S-2020 measure for assessing student covitality, there is less validation evidence specifically for middle-school-aged students. The present study aimed to fill this gap in the literature by examining its use for younger adolescents. Study participants were from two samples, including a cross-sectional sample with 9,426 students in Grades 7-8 from 32 counties in California and a longitudinal sample with 414 students in Grades 6-8 from two middle schools. Data analyses examined structural validity, internal consistency, measurement invariance, criterion validity, predictive validity, and response stability. Results indicate excellent fit indices for a four-level higher-order measurement model, with adequate concurrent and one-year predictive validity coefficients, supporting the use of the SEHS-S-2020 measure with young adolescents in middle school settings. The discussion focuses on implications for assessing students' psychosocial assets, universal school-based screening, and cultural and intersectionality considerations when interpreting SEHS-S-2020 responses. Supplementary Information: The online version contains supplementary material available at 10.1007/s40688-022-00411-x.

Associations of School Diversity with Students' Race-based Victimization and School Connectedness: A Combined Influence of Student and Teacher Racial/Ethnic Diversity and Socioeconomic Diversity.

School diversity has been shown to be associated with students' school experiences. However, most studies have focused solely on student racial/ethnic diversity, in spite of the multifaceted nature of diversity. This study assessed how the combined influence of student and teacher racial/ethnic diversity and socioeconomic diversity were related to race-based victimization, school connectedness, and racial/ethnic disparities of these outcomes. The participants were Asian, Black, Latinx, and White students (n = 100,408; 46.2-53.5% female) in Grade 7 to Grade 12 attending 278 public schools in California. The participating schools' diversity contexts were categorized into four latent profiles differentiated by varying levels of student and teacher racial/ethnic diversity and socioeconomic diversity. Race-based victimization was the least prevalent in schools with low student racial/ethnic diversity, low socioeconomic diversity, and moderate teacher racial/ethnic diversity. The magnitude of racial/ethnic disparities in race-based victimization differed across the four latent profiles; racial/ethnic disparities were minimal when there were similar numbers of students in each racial/ethnic group. School diversity's relation with school connectedness was minimal. White students perceived higher school connectedness than other racial/ethnic groups across profiles, but the White-Latinx gap was smaller in profiles with schools having a homogeneous Latinx student population. The findings underline the importance of understanding school diversity's interaction with students' characteristics, particularly racial/ethnic identity, on students' school experiences.

Comparing Informants for Mental Health Screening at the Preschool Level.

Universal screening for mental health in preschools provides the opportunity for early identification and early intervention, but guidance regarding which informants to use is needed. Preschoolers' (N = 535) parent and teacher reports across two screening forms were analyzed to determine similarities and discrepancies for classification results and screener scores. The analyses also examined if an additional rater provided incrementally valid information to the prediction of longitudinal kindergarten outcomes. Parents' and teachers' screening scores were significantly correlated across forms by rater and across raters. However, categorical classification results indicated that teachers were more likely than parents to rate preschoolers in at-risk ranges across forms. Finally, hierarchical regression analyses revealed teacher ratings were predictive of kindergarten social-emotional, cognitive, and academic outcomes, and that the addition of parent ratings did not significantly improve prediction of outcomes. Implications are discussed in the context of multiple raters within multiple-gating screening procedures.

Moving towards Implementation of Universal Mental Health Screening by Examining Attitudes toward School-based Practices.

Universal mental health screening is a proactive approach to identify students who may benefit from prevention or early intervention services. Despite known benefits, few schools are engaging in screening efforts and it is critical to examine factors that may impede or enhance implementation. Following implementation of a universal screening program across five preschools and elementary schools, this study investigated the attitudes of teachers (N = 40) and parents (N = 330) and found strong agreement among stakeholders about the acceptability and appropriateness of universal mental health screening. Teachers and parents expressed less willingness to regularly complete screening forms, yet teachers reported that the Behavior Assessment System for Children - Third Edition: Behavioral Emotional Screening System was a usable screening tool. Implications and future directions to enhance implementation efforts are discussed.

Social support profiles associations with adolescents' psychological and academic functioning.

Social support is empirically linked to improved adolescent psychological and academic functioning. This study explored typologies characterized by family, peer, and school support among students in early (Grade 7; n = 27,399) and late (Grade 11; n = 27,984) adolescence. We assessed how each latent profile related to key aspects of psychological and academic functioning and the moderation of gender in these associations. Three convergent profiles (i.e., High, Moderate, and Low Support) and two divergent profiles (i.e., Minimum Peer Support and Minimum Family Support) were found in both grade levels, with psychological and academic functioning differentiated by the profiles. The Minimum Peer Support and Minimum Family Support profiles showed the lowest functioning in all domains across grade levels. The High Support profile showed the highest psychological health and academic performance. Gender moderation was observed in the associations between social support profiles and psychological functioning and was more prominent among 7th graders than 11th graders. Findings suggest that social support's impact is determined by combinations of various support sources, age, and gender. The social support profiles and their associations with students' characteristics and outcomes may inform practitioners in supporting vulnerable groups and planning interventions.

Heterogeneity Among Moderate Mental Health Students on the Mental Health Continuum-Short Form (MHC-SF).

Measures of positive well-being are needed to support the shift away from a deficit-based approach to mental health. This study examined one measure, the Mental Health Continuum-Short Form (MHC-SF), as a measure of positive well-being used in school-based mental health monitoring efforts. This study used latent profile analysis (LPA) to explore the mental health classifications of 10,880 California high school students' responses to MHC-SF emotional, psychological, and social well-being items. Five latent mental wellness profiles emerged, including two ordered profiles (i.e., High Well-Being and Low Well-Being) and three profiles spanning the two ordered profiles. The High Well-Being profile had the most favorable psychological adjustment, and the three moderate well-being range profiles had differentiated functioning. Informing the utility of the MHC-SF, this study also compared the MHC-SF categorical diagnostic criteria with the LPA's empirical classification approach and found the two classification approaches to be congruent. The findings provide an impetus for educators to attend to students in moderate well-being ranges and emphasize promoting positive mental well-being as an essential component of school-based mental health services.

Cyberbullying victimization and student engagement among adolescents: Does school climate matter?

Although the psychological impacts of cyberbullying victimization (CBV) have been documented, research is inconclusive about the role of contextual factors in the association between CBV and student engagement. Sampling 16,237 adolescents from 43 schools in Delaware, we used multilevel modeling to test how CBV was associated with emotional and cognitive-behavioral engagement at both the student and school levels, with the control for demographic factors and traditional bullying victimization (TBV). We also examined the moderating effects of school climate and grade level on the association between CBV and student engagement. CBV had a small but significant positive association with emotional engagement and a small but significant negative association with cognitive-behavioral engagement. School-level climate intensified the negative association between student-level CBV and cognitive-behavioral engagement and mitigated the positive association between student-level school climate and emotional engagement. The positive association between CBV and emotional engagement was stronger for high school than middle school students, whereas the negative association between CBV and cognitive-behavioral engagement was stronger for middle than high school students. The findings support the promotive role of positive school climate in student engagement promotion. The findings also support the healthy context paradox, which suggests that bullying victims' engagement in schools may be exacerbated in a social context with positive school climate perceived by the group members. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

An Empirical Approach to Complete Mental Health Classification in Adolescents.

Using latent profile analysis (LPA), this study empirically identified dual-factor mental health subtypes, with a goal of examining structural stability of emerging latent classes over three high school years. Profiles' relations with distal indicators of well-being, psychosocial distress, and self-reported grades were examined to explore the validity of emerging classes. A sample of 332 high school students reported on their social-emotional strengths and psychological distress during the fall term of their ninth-, tenth-, and eleventh-grade years. In Grade 12, students reported on measures assessing their grades and social-emotional experiences. Independent LPAs for each grade year yielded four mental health subtypes - complete mental health, moderately mentally healthy, symptomatic but content, and troubled - and provided evidence for the structural stability of the dual-factor mental health construct. Across high school years, most students were in the complete or moderately mentally healthy classes, with the troubled class consistently representing the smallest proportion of the sample. Students in classes with higher levels of strengths and lower levels of distress reported higher grades, prosocial contribution to community, and higher life satisfaction, and fewer symptoms of anxiety and depression. Implications and future directions for research and school-based practice are discussed.

Languishing Students: Linking Complete Mental Health Screening in Schools to Tier II Intervention.

Despite innovations in the screening and early identification of students who may benefit from school mental health services, many schools struggle to link screening to intervention decisions, particularly at the Tier II level. Universal complete mental health screening, which measures strengths along with risk factors, is a strength-based approach that enables identification of students who do not report active mental health risk yet have limited psychosocial strengths. These languishing students are ideal candidates for Tier II interventions. Using a case study to link screening to intervention, this paper describes a contemporary approach to complete mental health screening, identify candidates for Tier II intervention, select appropriate interventions, and monitor student outcomes. Implications and challenges for school psychologists are discussed.

A latent transition analysis of the longitudinal stability of dual-factor mental health in adolescence.

Dual-factor models of mental health are increasingly supported but little is known about longitudinal trends in dual-factor mental health. The current study used latent profile analysis (LPA) to empirically identify dual-factor mental health classes at each of Grades 9 through 12 and latent transition analysis (LTA) to examine stability of classes over four academic years. A sample of 875 adolescents from two cohorts reported on their social-emotional strengths and psychological distress. Cross-sectional LPAs for each grade year resulted in four mental health classes: complete mental health, moderately mentally healthy, symptomatic but content, and troubled. An LTA model indicated that the complete mental health class exhibited the most stability, followed by moderately mentally healthy and symptomatic but content classes. The troubled class exhibited the least stability. Less than 24% of participants remained in the same mental health class across all years. Findings support regular monitoring of students' dual-factor mental health to accurately inform mental health promotion, prevention, and intervention efforts.

Examining the BASC-3 BESS Parent Form-Preschool Using Rasch Methodology.

This study examined the Behavior Assessment System for Children-Third Edition Behavioral and Emotional Screening System, Parent Form-Preschool, which is used to identify children at risk for emotional/behavioral problems. Rasch rating scale methods were used to provide information about psychometric properties of items, parent raters, and the response scale. Using the norming sample of 459 children, we investigated the structure of the screener, performance of the scale, and coverage of the maladaptive behavior construct to identify children with emerging behavioral difficulties. Most items showed good fit to the rating scale methods model with broad coverage of the latent domain. Items measuring internalizing and externalizing problems indicated a greater tendency for at-risk behavior, and items measuring adaptive skills offered a minimal contribution to measuring risk status. No differential item functioning was observed due to child gender; however, differential item functioning was observed between ratings for Caucasian and Hispanic or African American students for select items.

Bullying victimization and student engagement in elementary, middle, and high schools: Moderating role of school climate.

Bullying is the most common form of school violence and is associated with a range of negative outcomes, including traumatic responses. This study used hierarchical linear modeling to examine the multilevel moderating effects of school climate and school level (i.e., elementary, middle, and high schools) on the association between bullying victimization and student engagement. Participants included 25,896 students in 4th to 12th grades from 114 schools. Results indicated that, after controlling for student and school demographic factors, positive school climate was associated with higher behavioral/cognitive and emotional engagement of students across all grades. This highlights the critical and fundamental role of positive school climate in bullying prevention and intervention, among students across all grade levels, including those with frequent bullying victimization experience. Results also showed that negative associations between student-level bullying victimization and engagement were intensified in more positive school climates. This finding suggests that, in comparison with students in schools with less positive school climates, the engagement of bullying victims in schools with a more positive school climate might be more negatively influenced by their victimization experience. Additionally, the relation between student-level bullying victimization and emotional engagement was significantly different across middle and high schools. (PsycINFO Database Record

University student voices on healing and recovery following tragedy.

OBJECTIVE: Guided by conservation of resources theory, this study provides empirical data on students' psychosocial adjustment following a mass murder tragedy, what changed or did not change from their pretragedy adjustment levels, and their view on what helped most in the immediate aftermath. METHOD: Students (n = 593) who participated in a study of college adjustment the year prior to a mass murder that affected the university community were recontacted following the tragedy, providing prospective, longitudinal data (n = 141 pretragedy Time 1 and posttragedy; n = 73 pretragedy Times 1 and 2 and posttragedy). RESULTS: For both anxiety and depression, repeated-measures analysis of variance showed a significant Time × Resource Loss interaction. Students with any resource loss had a steeper incline in symptoms than did students reporting no resource loss. From pre- to posttragedy, there was an increase in psychological sense of school membership but no change in general self-efficacy and social support. Students with clinical levels of posttragedy distress reported more childhood trauma and depression symptoms at college entry. Student-initiated and -led memorial activities were rated as most helpful. IMPLICATIONS: Perceived resource loss is important in understanding the impact of the trauma on mental health and could be a part of intake for supportive services. Given that it was the students with greater prior trauma exposure and depression symptoms who were more likely to have clinical distress posttragedy, targeted outreach to current and former university counseling center clients to "check in" may be helpful to reach those who may be in most need. (PsycINFO Database Record

Effects of mischievous responding on universal mental health screening: I love rum raisin ice cream, really I do!

Student surveys are often used for school-based mental health screening; hence, it is critical to evaluate the authenticity of information obtained via the self-report format. The objective of this study was to examine the possible effects of mischievous response patterns on school-based screening results. The present study included 1,857 high school students who completed a schoolwide screening for complete mental health. Student responses were reviewed to detect possible mischievous responses and to examine their association with other survey results. Consistent with previous research, mischievous responding was evaluated by items that are legitimate to ask of all students (e.g., How much do you weigh? and How many siblings do you have?). Responses were considered "mischievous" when a student selected multiple extreme, unusual (less than 5% incidence) response options, such as weighing more than 225 pounds and having 10 or more siblings. Only 1.8% of the students responded in extreme ways to 2 or more of 7 mischievous response items. When compared with other students, the mischievous responders were less likely to declare that they answered items honestly, were more likely to finish the survey in less than 10 min, reported lower levels of life satisfaction and school connectedness, and reported higher levels of emotional and behavioral distress. When applying a dual-factor mental health screening framework to the responses, mischievous responders were less likely to be categorized as having complete mental health. Implications for school-based mental health screening are discussed. (PsycINFO Database Record

Factor structure and differential item functioning of the BASC-2 BESS Spanish Language Parent Form.

Given the steady increase of students from diverse backgrounds in the U.S. educational system, in particular immigrant and Latino students, it is important to consider how to best support all students within our schools. The present study focuses on the Behavior Assessment System for Children-Second Edition (BASC-2) Behavioral and Emotional Screening System (BESS) Parent Spanish form, which is a promising assessment tool for those who are interested in screening for behavioral and emotional risk among Spanish-speaking populations. The present study included 725 students of Latino descent in Grades K-6 in an urban school district and their parents or legal guardians, who served as the informants. All parents completed the BESS language form (English or Spanish) of their choice. A confirmatory factor analysis (CFA) supported a 4-factor structure (Externalizing, Internalizing, Inattention, and Adaptive Skills) similar to that of the BESS Parent English form: χ2(77) = 248.06, p < .001; CFI = 0.903; TLI = 0.940. However, differential item functioning (DIF) analyses revealed 5 items (16.7%) demonstrated significant levels of DIF, with 4 of the 5 being easier to endorse in English. This study provides preliminary evidence of partial invariance of the BESS Parent across language forms. Although some evidence of invariance across language forms at the structural and item levels exists, more research is necessary to determine whether the DIF found in the present study results in any perceptible test bias. (PsycINFO Database Record

Surveillance of middle and high school mental health risk by student self-report screener.

INTRODUCTION: A 2009 National Academies of Sciences report on child mental health prevention and treatment concluded that screening for mental health risk is an essential component of service delivery. To date, however, there are few practical assessments available or practices in place that measure individual child risk, or risk aggregated at the school or community level. This study examined the utility of a 30-item paper and pencil student self-report screener of behavioral and emotional risk (BER) for surveying community risk among 7 schools. METHODS: In 2010, 2,222 students in 3 middle and 4 high schools in a medium-sized school district in Georgia were administered the Behavioral and Emotional Screening System Self-Report Child/Adolescent form (BESS Student). The BESS is designed to measure 4 sub-syndromal BER factors for developing mental health disorders: inattention/hyperactivity, internalizing, school problems, and personal adjustment. Analysis of Variance and Chi Square analyses were used to assess the association between adolescent self-reported BER as an indicator of school BER, grade level, child ethnic identification and gender, socioeconomic status, and special education placement status. RESULTS: BESS scores differentiated well between schools for overall BER and special education status, as well as between grade levels, ethnicity, and gender groups. One high school, known by the school administration to have numerous incidents of student behavior problems, had the most deviant 4 BER domain scores of all 7 schools. Girls rated themselves as having a higher prevalence of BER (14%) than boys (12%); middle school students reported fewer difficulties than high school students. CONCLUSION: Middle and high school students were capable of identifying significant differences in their own BER across schools, suggesting that universal mental health risk screening via student self-report is potentially useful for identifying aggregated community risk in a given school that may warrant differential deployment of mental health prevention and intervention strategies. BESS results reliably identified individual mental health risk associated with special education placement, which is documented to lead to poor school outcomes such as school dropout and lack of enrollment in post-secondary education.

A factor analytic investigation of the BASC-2 Behavioral and Emotional Screening System Parent Form: psychometric properties, practical implications, and future directions.

The Behavior Assessment System for Children, Second Edition (BASC-2) Behavioral and Emotional Screening System Parent Form (BESS Parent; Kamphaus & Reynolds, 2007) is a recently developed instrument designed to identify behavioral and emotional risk in students. To describe the underlying factor structure for this instrument, exploratory (EFA) and confirmatory factor analyses (CFA) were conducted utilizing two subsets of a large, nationally-representative sample. The results of the EFA suggested that the BESS Parent contained a four-factor latent structure (i.e., Externalizing, Internalizing, Adaptive Skills, and Inattention), which was supported by CFA. Results support further investigation into utilizing four subscales in addition to an overall risk score; distributional and reliability information for the BESS Parent subscales is provided. Practical implications for school psychologists interested in early identification and directions for future research are discussed.

Factor structure of the BASC-2 Behavioral and Emotional Screening System Student Form.

The BASC-2 Behavioral and Emotional Screening System (BESS) Student Form (Kamphaus & Reynolds, 2007) is a recently developed youth self-report rating scale designed to identify students at risk for behavioral and emotional problems. The BESS Student Form was derived from the Behavior Assessment System for Children-Second Edition Self-Report of Personality (BASC-2 SRP; Reynolds & Kamphaus, 2004) using principal component analytic procedures and theoretical considerations. Using 3 samples, the authors conducted exploratory factor analyses (EFA) and confirmatory factor analyses (CFA) to understand the underlying factor structure of the BESS Student Form. The results of the EFA suggested that the SRP contained a 4-factor (i.e., Personal Adjustment, Inattention/Hyperactivity, Internalizing, School Problems) emergent structure, which was supported by CFA in 2 additional samples. Practical and research implications are discussed.

Protecting and promoting: an integrative conceptual model for healthy development of adolescents.

Resilience and positive youth development have substantial overlap and offer complementary perspectives on fostering healthy youth development. However, these two areas have not yet been fully integrated into a unified approach, one that has the potential to build on the interconnectedness of risk, protection, and assets within the ecological systems affecting adolescent development. This article draws on extant research to delineate linkages between the risk and resilience and positive youth development literatures. School-related outcomes are examined within an integrative conceptual model delineating eight developmental domains useful for future research on underlying mechanisms associated with healthy outcomes, as well as prevention and intervention efforts.