Assessing Adolescent Mental Health Service Use: Developing the Adolescent Mental Health Support Scale (AMHSS)

Psychometric properties of the Knowledge and Attitudes to Mental Health Scales in a Dutch sample (KAMHS-NL): A comprehensive mental health literacy measure in adolescents

BACKGROUND

Mental health literacy (MHL) is crucial for early recognition of and coping with mental health problems, and for the use and acceptance of mental health services, leading to better health outcomes, especially in adolescence. The prevalence of mental health problems among adolescents is seen as a major public health concern and MHL is an important factor in facilitating positive mental health outcomes. However, the availability of valid measurement instruments for assessing the multifaceted nature of MHL is limited, hindering the ability to make meaningful comparisons across studies. The Knowledge and Attitudes to Mental Health Scales (KAMHS) is a promising comprehensive instrument for measuring adolescents' mental health literacy but its psychometric properties have not been explored in any other contexts than the Welsh. The aim of this study was to translate the KAMHS into Dutch, adapt it in this context, and evaluate its psychometric properties.

METHODS

We performed a cross-sectional study with Dutch adolescents between the ages 11-16. We translated the KAHMS and assessed its content validity using cognitive interviewing with n = 16 adolescents. Next, n = 406 adolescents were asked to fill in the translated KAMHS-NL and reference scales, on mental health (SDQ and WHO-5), resilience (BRS), and mental health help-seeking behaviors. We assessed construct validity based on a priori hypotheses regarding convergent and divergent correlations between subscales of KAMHS-NL and the reference scales. Finally, we assessed structural validity via confirmatory factor analysis and exploratory structural equation modeling.

RESULTS

The KAMHS-NL showed good content validity and satisfactory construct validity. In total, 28 of the 48 hypotheses regarding convergent and divergent correlations between the KAMHS and reference scales were confirmed. Contrary to our expectations, weak, but significant associations were found between MHL and resilience. The KAMHS showed an acceptable to good internal consistency (McDonald's omega ranging from 0.62 to 0.84). Finally, we could generally confirm the postulated structure of the KAMHS-NL in the Dutch sample with a 5-factor solution (RMSEA = 0.033; CFI = 0.96).

CONCLUSIONS

The Dutch version of the KAMHS is a valid measure for detecting differences in MHL levels in adolescents. The KAMHS is a promising instrument for assessing MHL in adolescents in a multifaceted manner in other countries which may facilitate rigorous global MHL research. The instrument therefore deserves further validation research in other settings and comparisons across various cultural contexts.

Caregiver Experiences of Adolescent School Reentry After Adolescent Hospitalization Due to Suicidal Thoughts and Behaviors: Recommendations to Improve Reentry Practices

BACKGROUND

Suicide rates among adolescents increased over the past few decades. Following psychiatric hospitalization, many adolescents return to school, a context that can influence recovery. Families can play an integral role in supporting adolescents through the hospitalization and school reentry process; however, little research has focused on family experiences during adolescent school reentry. Grounded in ecological systems theory, the aim of the present study was to explore the experiences of caregivers whose children were hospitalized for suicidal thoughts and behaviors (STBs) and provide recommendations for the school reentry process.

METHODS

In-depth interviews were conducted with caregivers (n = 19) whose adolescents returned to school following hospitalization for suicide-related crises. Researchers analyzed the transcribed interviews using applied thematic analysis.

RESULTS

Themes emerged regarding academic difficulties during hospitalization; breakdowns in communication between schools, families, and hospitals; logistical challenges during the school reentry planning process; and challenges navigating peer relationships and academics following school reentry.

IMPLICATIONS AND CONCLUSIONS

Few reentry recommendations account for the specific challenges faced by families. Recommendations informed by caregiver experiences are needed to ensure that families can effectively support the recoveries of their children. This study presents caregiver-informed recommendations to facilitate an improved reentry process for caregivers and adolescents.

Analysis on the Key Influence of Adolescent Health Information Literacy Using Big Data Analysis Technology under Social Network Environment

Purpose/Significance. This paper aims to explore the influence mechanism of adolescent health information literacy on health behavior. Method/Process. 13–19 year olds are taken as the survey objects to investigate their health information literacy through a questionnaire. Health information literacy mainly includes health information needs, acquisition, evaluation, use, and behaviors. A total of 252 adolescents' data were collected in this study, and model testing was performed with the help of regression analysis and structural equation modeling. Conclusion/Results. The results of the study show that adolescents' health information needs, acquisition, evaluation, and application abilities have a positive impact on health behaviors in the social network environment. Emotional responses and individual cognition as intermediate variables play important roles between health information literacy and health behaviors. Health information needs and health information assessments have the highest impact on mental health and social health, respectively. The society should pay special attention to the influence of adolescents' health cognition and anxiety on health behavior in the context of social network.

Teacher and School Characteristics Associated with the Identification and Referral of Adolescent Depression and Oppositional Defiant Disorders by U.S. Teachers

Teachers contribute to the process of identifying and referring students for mental health services, however, relatively little is known about how they make those decisions and how decision-making differs across school contexts. This study used a vignette-based method to investigate individual and school contextual factors associated with the likelihood that teachers identify and refer students for mental health services. Teachers were recruited from public middle and high schools across the U.S. using a stratified random sampling strategy. Teachers (N = 462) responded to vignettes by indicating their concern for students, as well as their likelihood of providing mental health referrals. Vignettes varied by problem type (depression, oppositional defiant disorder), problem severity (moderate, severe), and student gender (male, female). Data on school characteristics were extracted from the U.S. Department of Education database. Regression models indicated several significant associations of teacher demographic characteristics and school characteristics with vignette ratings. For example, female teachers were more likely than males to rate vignettes as concerning, and middle school teachers were more likely than high school teachers to indicate they would refer students for mental health services. Teachers in schools with a higher proportion of Black students rated depression vignettes as less serious and indicated they were less likely to refer students for mental health services than teachers in majority white schools. Results suggest school characteristics may contribute to established disparities in mental health service access. Findings have implications for targeting mental health supports in schools.