Adolescent, parent, and provider perspectives on school-related influences of mental health in adolescents with suicide-related thoughts and behaviors

Potential Harms of Responding to Youth Suicide Risk in Schools

The potential harms related to interventions for adults with suicide-related risk, particularly hospitalization, have been well documented. Much less work has focused on the potential harms related to interventions with youth struggling with suicidal thoughts and behaviors. Young people are most likely to receive mental health services in schools, which are recognized as meaningful sites for effective suicide prevention work. However, no overviews have conceptualized the potential harms to youth when schools engage in ineffective suicide prevention efforts. In this article, we discuss three prominent overlapping areas of potential harms: (1) privacy-related, (2) relationship-related, and (3) mental health-related. We then discuss key factors thought to influence the development and maintenance of these potential harms. We conclude by noting ways in which school-based mental health providers may attempt to reduce unintentional harms in this area, with an overarching goal of helping support school mental health providers and the youth they serve.

Collaborating to support school reintegration following suicide-related crises: Voices from the field

Adolescent psychiatric hospitalization for suicide-related crises continues to rise. Although previous reviews have identified frameworks for supporting youth as they return to school settings, there is a need to identify and address barriers to collaboration across hospitals and schools. This qualitative study explored school and hospital professional perspectives to inform a pathway toward partnership for improving practices for school reintegration. As part of a larger project that has been developing guidelines for adolescent school reintegration following psychiatric hospitalization for suicide-related crises, the present study explored professional perceptions of (a) school interactions during hospital stays and (b) recommendations for adolescents, families, school professionals, and hospital professionals. We conducted in-depth interviews with 19 school professionals and seven hospital professionals and analyzed transcribed interviews using Applied Thematic Analysis. Communication and collaboration emerged as cross-cutting themes across research questions, with additional themes considered across a continuum of care. Findings inform the ways in which professionals can collaborate to support adolescent recovery, spanning universal approaches implemented in advance of a crisis to approaches enacted during and following psychiatric care. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Mental Health and Suicide Attempts in Adolescents: A Systematic Review

Suicide has become one of the leading causes of mortality among the adolescent population. This worrisome fact demands an exhaustive analysis of this social phenomenon's reality.

OBJECTIVE

This paper aims to carry out a systematic review of the existing scientific literature in recent years on suicide among minors and adolescents.

METHOD

To achieve this purpose, central databases, WoS, Scopus, and Dialnet, were analyzed, obtaining 34 articles.

RESULTS

The results are structured into three main categories. (1) Risk factors: psychological and mental health factors, family and context factors, and, finally, school factors. (2) Prevention: School as prevention, emotional education programs, and tools to deal with this situation. And, finally, the third block, (3) family experiences in the face of suicidal behavior.

CONCLUSIONS

The studies reviewed highlight the enormous complexity of this problem and show a worrying situation regarding suicide, considering multifactorial aspects such as depression, psychosocial issues, and mood disorders, as well as causes related to the school environment, such as bullying and lack of connection with school. In addition, they denote the importance of family factors in this aspect. Finally, the results highlight the importance of prevention and early detection, underlining the need to develop concrete actions to alleviate this growing situation among adolescents.

Training School Staff to Support Students Returning to School After A Psychiatric Hospitalization

Supporting students returning to school after a mental health crisis often involves more training than many school staff members receive. With the increase in youth mental health diagnoses, there has also been an increase in the number of youth requiring psychiatric emergency department visits and hospitalizations. As such, this study employed a basic qualitative design to gather the perspectives of school staff who support students' mental health about their experiences and training needs related to supporting youth returning to school after psychiatric hospitalization. Semi-structured interviews were conducted with 10 school mental health professionals or administrators. Thematic analysis was used to analyze the data. Three themes were identified: 1) most participants received minimal formal training in graduate school on hospital to school transition, 2) most participants learned about hospital to school transition on the job, and 3) participants made recommendations and identified specific training needs. Implications for training are discussed including a need for variety (e.g., some practitioners need basic training while others need more advanced training) and different format preferences (in-person may be preferred but online asynchronous is more convenient).

Practice experiences for school reintegration: Endorsement for virtual reality with adolescents hospitalized for suicide-related crises

This study applied qualitative methods and a user design approach to develop and iteratively refine a model for a virtual reality intervention designed to supplement standard inpatient treatment for adolescents hospitalized for suicide-related crises: the practice experiences for school reintegration (PrESR). The PrESR model allows patients to practice therapeutic skills within an immersive school environment to increase skill knowledge and skill use and to improve school reintegration. Adolescents previously hospitalized for suicide-related thoughts and behaviors (n = 13), hospital professionals with experience providing supports to hospitalized adolescents (n = 7), and school professionals with experience supporting adolescents with suicide-related risks (n = 12) completed focus group and/or one-on-one interviews to inform the development of the PrESR model. Transcribed interviews were analyzed using content analysis, and structured feedback was analyzed by calculating frequencies. Participating adolescents were between the ages of 13 and 18, identifying their race as White (61%), Asian (7.7%), American Indian and Black (7.7%), or Black (7.7%; note that 15.4% preferred not to answer) and their ethnicity as Hispanic (23%) or non-Hispanic (77%). Adolescents identified their gender as girl or woman (46%), boy or man (38%), or "some other way" (15%). A majority of adolescent and professional participants endorsed the PrESR as holding the potential to promote skill learning. Feedback addressed improvements to scenarios and skills; safety concerns, constraints to consider, and barriers to implementation; and information to include in the treatment manual. Findings also informed the types of difficulties adolescents face in schools and the potential feasibility of a virtual reality intervention to enhance standard inpatient care of adolescents hospitalized for suicide-related crises. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Information sharing between psychiatric hospitals and schools to better support adolescents returning to school following a suicide-related crisis

As rates of adolescent hospitalization for suicide-related crises increase, so does the urgency for improving adolescent school reintegration. Communication and collaboration are considered key mechanisms for continuity of care during times of transition; however, to date, few studies have identified critical information to share or have explored strategies for navigating challenges to information sharing during and following school reintegration. The present study explored previously hospitalized adolescent (n = 19), parent (n = 19), school professional (n = 19), and hospital professional (n = 19) views of information sharing and their perceptions of facilitators and barriers to this communication. Applied thematic analysis revealed three key themes related to the best information to share across entities, including the (a) need to consider environmental relevance to information (i.e., informing school supports and hospital treatment), (b) importance of considering information unique to each patient's circumstance (i.e., sharing information on a "case-by-case basis"), and (c) duality between families preferring to share minimal information but school professionals desiring the maximum (i.e., less is more vs. more is better). Regarding facilitators and barriers to information sharing, six key themes emerged, including (a) understanding risks and benefits of information sharing; (b) trust in hospitals and schools; (c) mental health stigma; (d) communication processes; (e) navigating individual, family, school, and community contexts; and (f) "push and pull" between privacy and need. Findings inform key considerations for collaborating with families in determining if and what information to share during school reintegration.

Cultural threads in writing mastery: a structural analysis of perfectionism, learning self-efficacy, and motivation as mediated by self-reflection in Chinese EFL learners

BACKGROUND

The study explores language acquisition in Chinese English as a Foreign Language (EFL) education, where English proficiency is crucial for global opportunities. As China gains prominence, the demand for English skills rises beyond communication to include academic and business success. The Chinese education system emphasizes proficient English writing for further education and professional achievement. This research investigates the complex linguistic context for EFL learners in China, analyzing the intersection of psychological factors, cultural nuances, varied pedagogy, and individual experiences.

METHODS

Structural Equation Modeling (SEM) is utilized for analysis, enabling the creation of a metric set to explore intangibles such as perfectionism, learning self-efficacy, motivation, study habits, cultural influences, and introspection. The research utilizes a diverse sample from multiple universities across different regions of China, incorporating demographic factors to encompass the varied characteristics within the EFL learner community.

RESULTS

Results reveal that perfectionism (β = 0.30, p < 0.001), learning self-efficacy (β = 0.25, p = 0.005), motivation (β = 0.35, p < 0.001), study habits (β = 0.20, p = 0.01), and self-reflection (β = 0.28, p < 0.001) significantly predict writing proficiency. Cultural effects (Beta = 0.15, p = 0.05) show a statistically significant, albeit minimal, impact. Mediation-moderation analysis underscores perfectionism as a mediator (Beta = 0.25, p = 0.005), emphasizing its influence on other predictors. Cultural factors act as moderators (Beta = 0.15, p = 0.01), shaping the link between predictors and writing skills. The combined mediation and moderation effects on writing proficiency are positively significant (Beta = 0.20, p = 0.02).

CONCLUSIONS

This study makes a significant theoretical contribution, enhancing existing models and providing practical insights for EFL educators and policymakers. Emphasizing the intricate relationship between psychological factors and cultural dynamics underscores the necessity for a sophisticated, culturally sensitive approach to language acquisition in Chinese EFL instruction. Beyond language skills, the research recognizes the importance of fostering a conducive environment that encourages personal development, socio-cultural awareness, and a holistic learning approach.

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.