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Feeling Unsafe at School and Associated Mental Health Difficulties among Children and Adolescents: A Systematic Review.

ABSTRACT: This study systematically reviewed the literature on perceived school safety. We investigated the prevalence, factors and associated mental health difficulties, as well as cross-cultural findings. Five databases were searched up to 9 February 2021 for peer-reviewed papers published in English. We included quantitative studies that explored the perception of school safety among children and adolescents. The reference lists of the selected papers were also searched. We conducted a narrative synthesis of the included studies. The review included 43 papers. The mean prevalence of the students who felt unsafe at school was 19.4% and ranged from 6.1% to 69.1%. Their perceived safety was associated with a wide range of personal, school, and social factors. Not feeling safe at school was related to being victimized and mental health difficulties, including depressive symptoms and suicidal behavior. Higher perceived school safety was associated with measures such as the presence of a security officer and fair school rule enforcement. The results showed the lack of cross-cultural studies on perceived school safety. Empirical studies are needed that examine the mechanisms of school safety, using valid measures. A clear definition of school safety should be considered a key aspect of future studies.

SUBMITTER: Mori Y

PROVIDER: S-EPMC8002666 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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Feeling Unsafe at School and Associated Mental Health Difficulties among Children and Adolescents: A Systematic Review.

Mori Yuko Y Tiiri Elina E Khanal Prakash P Khakurel Jayden J Mishina Kaisa K Sourander Andre A

Children (Basel, Switzerland) 20210317 3

This study systematically reviewed the literature on perceived school safety. We investigated the prevalence, factors and associated mental health difficulties, as well as cross-cultural findings. Five databases were searched up to 9 February 2021 for peer-reviewed papers published in English. We included quantitative studies that explored the perception of school safety among children and adolescents. The reference lists of the selected papers were also searched. We conducted a narrative synthe ...[more]

PMID: 33802967

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Project description:UnlabelledBackgroundDepression is an important cause of disability among children and adolescents. Depression screening is one possible method for managing depression, and screening programs have been initiated in some school and medical settings. However, in 2005, the Canadian Task Force on Preventive Health Care and the United Kingdom National Institute of Clinical Excellence did not recommend depression screening among children and adolescents. By contrast, in 2009, the United States Preventive Services Task Force recommended that all adolescents, but not younger children, be screened for depression in medical settings with integrated depression management services, although no trials of screening were identified. The objectives of this systematic review are to evaluate in children and adolescents the accuracy of depression screening tools; depression treatment efficacy; whether depression screening improves depression outcomes; and potential harms related to depression interventions and screening.Methods/designData sources will include the bibliographic databases MEDLINE, Cochrane CENTRAL, PsycINFO, EMBASE, LILACS and Web of Science, supplemented by reference harvesting of eligible articles, relevant systematic reviews, relevant guidelines and recommendations, and selected journals, and by searches for unpublished studies. Eligible studies will report data for children and adolescents aged 6 to 18 years. Eligible diagnostic accuracy studies must compare a depression screening tool to a validated diagnostic interview for major depressive disorder and report diagnostic accuracy data. Eligible treatment studies must be randomized controlled trials of pharmacological, psychotherapeutic, or other depression treatments commonly available for children and adolescents in pediatric, primary-care, and family medicine settings. Eligible screening studies must be randomized controlled trials that compare depression outcomes between children or adolescents who underwent depression screening versus those who did not. Studies of harms will include randomized controlled trials and observational studies that evaluate harms from depression screening or treatment. Two investigators will independently review titles and abstracts, followed by full article review. Disagreements will be resolved by consensus. Two investigators will independently extract the data, with discrepancies resolved via consensus.DiscussionThe proposed systematic review will determine whether there is sufficient evidence of benefits in excess of harms and costs to support screening for depression in childhood and adolescence.

Project description:BackgroundAlthough adolescents are highly vulnerable to mental health challenges, they receive little attention, especially in developing countries. We investigated the mental health difficulties (MHDs) faced by adolescent students in four senior high schools in Ghana, their coping strategies and support systems.MethodsIn this convergent mixed-methods study, quantitative data was obtained using validated strengths and difficulties questionnaire to assess the mental health of 405 adolescents. Qualitative data was collected through in-depth interview with 18 teachers and seven focused group discussions with 35 students. Adjusted odds ratios (OR) for MHDs were estimated through ordinal logistic regression in Stata 14.2. Qualitative data was analyzed inductively and deductively using ATLAS.ti 7.1.ResultsOver half (58.5%) experienced peer (20.5%), emotional (16.3%), conduct (13.3%) and hyperactivity (3.0%) problems, whereas 5.4% exhibited prosocial behaviours. MHDs were associated with females (OR = 2.27, 95% CI: 1.47-3.50), bullying (OR = 1.72, CI: 1.07-2.75), domestic violence (OR = 1.87, CI: 1.10-3.17), substance abuse (OR = 8.14, CI: 1.41-46.8), academic pressure (OR = 2.40, CI: 1.30-4.42) and self-perceived poor school performance (OR = 7.36 CI: 2.83-19.16). Qualitatively, we identified financial challenges, spiritual influences, intimate relationships, bullying, and domestic violence as the main themes attributed to MHDs. Coping strategies included isolation, substance use and spiritual help. The main school-based support system was the guidance and counselling unit, but there were complaints of it been ineffective due to trust and confidentially issues, and non-engagement of qualified counsellors.ConclusionsAs many triggers of MHDs emanate in schools, we need mental health-friendly school environments where trained psychotherapists head counselling centres. We propose incorporating mental health education into school curricula and generating surveillance data on adolescent's mental health.

Project description:BackgroundYoung people frequently make use of the internet as part of their day-to-day activities, and this has extended to their help-seeking behavior. Offline help-seeking is known to be impeded by a number of barriers including stigma and a preference for self-reliance. Online help-seeking may offer an additional domain where young people can seek help for mental health difficulties without being encumbered by these same barriers.ObjectiveThe objective of this systematic literature review was to examine young peoples' online help-seeking behaviors for mental health concerns. It aimed to summarize young peoples' experiences and identify benefits and limitations of online help-seeking for this age group. It also examined the theoretical perspectives that have been applied to understand online help-seeking.MethodsA systematic review of peer-reviewed research papers from the following major electronic databases was conducted: PsycINFO, Cumulative Index of Nursing and Allied Health Literature, PubMed, Cochrane Library, Association for Computing Machinery Digital Library, and Institute of Electrical and Electronics Engineers Xplore. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. The search was conducted in August 2017. The narrative synthesis approach to reviews was used to analyze the existing evidence to answer the review questions.ResultsOverall, 28 studies were included. The most common method of data collection was through the use of surveys. Study quality was moderate to strong. Text-based query via an internet search engine was the most commonly identified help-seeking approach. Social media, government or charity websites, live chat, instant messaging, and online communities were also used. Key benefits included anonymity and privacy, immediacy, ease of access, inclusivity, the ability to connect with others and share experiences, and a greater sense of control over the help-seeking journey. Online help-seeking has the potential to meet the needs of those with a preference for self-reliance or act as a gateway to further help-seeking. Barriers to help-seeking included a lack of mental health literacy, concerns about privacy and confidentiality, and uncertainty about the trustworthiness of online resources. Until now, there has been limited development and use of theoretical models to guide research on online help-seeking.ConclusionsApproaches to improving help-seeking by young people should consider the role of the internet and online resources as an adjunct to offline help-seeking. This review identifies opportunities and challenges in this space. It highlights the limited use of theoretical frameworks to help conceptualize online help-seeking. Self-determination theory and the help-seeking model provide promising starting points for the development of online help-seeking theories. This review discusses the use of these theories to conceptualize online help-seeking and identify key motivations and tensions that may arise when young people seek help online.

Dataset Information

Feeling Unsafe at School and Associated Mental Health Difficulties among Children and Adolescents: A Systematic Review.

Publications

Feeling Unsafe at School and Associated Mental Health Difficulties among Children and Adolescents: A Systematic Review.

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