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The growing number of autistic adults challenges the limited adult service system. While data on service use and barriers are available, there is limited information from the individual's perspective on which services are most helpful in adulthood and how service use is connected to community participation outcomes. Forty autistic adults participated in a study combining global positioning system community participation measures with survey and interview data on service use, including which services are most helpful in adulthood, barriers to services, and service needs. Participation outcomes were analyzed relative to demographics, number and types of services received in the past 2 years, and current mental health service use. Participants received an average of two services in the past 2 years, most frequently mental health and employment services. Individuals currently seeing a mental health counselor were more likely to be working full-time and visit more community locations compared to those who were not seeing a counselor. Participants reported mental health services as the most helpful service received in adulthood followed by employment services. While an emphasis is often placed on employment services in the transition to adulthood, findings suggest a need for integrated mental health and employment services for autistic adults. [This paper was presented at the Conference on Rehabilitation Education (NCRE/CSAV/RSA) Annual Meeting, 16 September 2022.]

The U.S. healthcare system struggles to provide adequate language assistance to medical practitioners and patients. As a result, health providers and patients rely on ad hoc interpreters, including children, to communicate. Bilingual children who regularly interpret for others, whom we refer to as child language brokers, are important linguistic and cultural conduits for their communities and bridge language differences in vital contexts, such as health and medical settings. In this paper, we explore the experiences of 17 adolescent language brokers and consider the settings, tasks, and people they engage with when language brokering for health. Findings illustrate that child language brokering is a real and important component for immigrant family health, that child language brokering for health is not a uniform experience, and that language brokering for health can sometimes have severe ramifications.

Purpose: This paper aims to focus on the involvement of mental healthcare professionals in a co-design process of a digital healthcare platform. Many people with severe mental disorders need constant support and monitoring, and with long waiting lists and scarce resources in mental healthcare, there is a dire need for innovative digital solutions to counteract those issues. This paper elaborates on a co-design process of a digital platform and mobile app designed for people with mental disorders. The platform primarily considers two perspectives: (i) the patients and (ii) the healthcare professionals. Design/methodology/approach: This paper is based on canonical action research, where the co-design involvement with 13 healthcare professionals is analyzed and their interactions with three primary scenarios are focused. Findings: The main contribution of this paper is three co-design principles: (i) clarity and information accessibility regarding the patient's side, (ii) efficiency and flexibility when it comes to the healthcare professional's side and (iii) a notification function in the mobile application. Originality/value: The theoretical contribution is the conceptualization of the three co-design principles that others can use when designing digital platforms in healthcare in general and psychiatric care in particular. The practical contributions are firstly outlined through the co-design process itself, where scenarios to guide the work are used, and secondly, the improvements made in the digital platform derived from the results of the co-design process.

This paper draws upon evidence captured from a parent consultation exercise conducted by Helen Dunn (author) and Paula Keenan on behalf of Children in Northern Ireland (CiNI) for the Department of Health as part of the Review of Children's Social Care led by Professor Ray Jones during 2022-23. CiNI is the regional umbrella organisation for the children's sector in Northern Ireland. This paper will be of interest to those who are keen to hear parents and carers views and their experiences of Social Work and Social Care in Northern Ireland. The Review also engaged Voice of Young People in Care (VOYPIC) a charity for children and young people with a lived experience of care in Northern Ireland. They formed an Experts by Experience Reference Group of young people who were currently in or had experience of the care system.

Extractive knowledge is prevalent in higher education community engagement. It is a type of epistemic injustice that is harmful to the historically and systemically minoritized communities and community nonprofits that many universities, particularly predominately white institutions, seek to engage. Extractive knowledge results from what we can think of as transactional relationships with community members or community nonprofits. These are largely superficial but impactful relationships perpetuating injustice in higher education spaces that imagine themselves working to create greater justice. In this article, we make two primary arguments: a.) Extractive knowledge is an epistemic injustice prevalent in community-engaged higher education, and b.) The Robert Wood Johnson Foundation's model for transformative community engagement and the Fitz Center for Leadership in Community's Practice Principles provide strategies and models for more epistemically just approaches to community engagement that shape knowledge in epistemically responsible ways, in partnership with communities and alignment with communities' goals and outcomes, this paper finishes with the Fitz Center's Health Equity Program and a community-led partnership as examples of these Practice Principles that lead toward reciprocal, responsible, community-driven, and transformational community engagement.

Systemic racism is pervasive in US society and disproportionately limits opportunities for education, work, and health for historically marginalized and minoritized racial and ethnic groups, making it an urgent issue of social justice. Because systemic racism is a social determinant of health prevalent across multiple social and institutional structures, it requires multilevel intervention approaches using effective designs and analytic methods to measure and evaluate outcomes. Racism is a fundamental cause of poor health outcomes, including mental health outcomes; thus, mental health services and programs that address racism and discrimination are key to promoting positive mental health of racial and ethnic minority youth. While multilevel interventions are well-suited for improving outcomes like youth mental health disparities, their evaluation poses unique methodological challenges, requiring specialized design and analytic approaches. There has been limited methodological guidance provided to researchers on how to test multilevel interventions using approaches that balance methodological rigor, practicality, and acceptability across stakeholder groups, especially within communities most affected by systemic racism. This paper addresses this gap by providing an example of how to rigorously evaluate a hypothetical, theoretically based, multilevel intervention promoting mental health equity in three US school systems using an anti-racist approach intervening at the macro- (i.e., school system), meso- (i.e., school), and micro- (i.e., family and student) levels to improve mental health in adolescents. We describe the design, sample size considerations, and analytic methods to comprehensively evaluate its effectiveness while exploring the extent to which the components interact synergistically to improve outcomes. The methodological approach proposed can be adapted to other multilevel interventions that include strategies addressing macro-, meso-, and micro-levels of influence.

Multilevel interventions (MLIs) are appropriate to reduce health disparities among Indigenous peoples because of their ability to address these communities' diverse histories, dynamics, cultures, politics, and environments. Intervention science has highlighted the importance of context-sensitive MLIs in Indigenous communities that can prioritize Indigenous and local knowledge systems and emphasize the collective versus the individual. This paradigm shift away from individual-level focus interventions to community-level focus interventions underscores the need for community engagement and diverse partnerships in MLI design, implementation, and evaluation. In this paper, we discuss three case studies addressing how Indigenous partners collaborated with researchers in each stage of the design, implementation, and evaluation of MLIs to reduce health disparities impacting their communities. We highlight the following: (1) collaborations with multiple, diverse tribal partners to carry out MLIs which require iterative, consistent conversations over time; (2) inclusion of qualitative and Indigenous research methods in MLIs as a way to honor Indigenous and local knowledge systems as well as a way to understand a health disparity phenomenon in a community; and (3) relationship building, maintenance, and mutual respect among MLI partners to reconcile past research abuses, prevent extractive research practices, decolonize research processes, and generate co-created knowledge between Indigenous and academic communities.

Background: More than 20 million children in the United States lack access to primary health care. Practice Learning: Research shows that students with regular access to physical and mental health services have fewer absences, are more social, less likely to participate in risky behaviors, have improved focus and higher test scores. Implication For School Health Policy, Practice, And Equity: School-based health centers (SBHCs) can be an important, valuable and viable health care delivery option to meet the full-range of primary health care needs of students where they spend the majority of their wake hours, ie, in school. Children in rural and other underserved communities, as well as those underinsured, non-insured, economically challenged, underserved, and the most vulnerable among us are especially at risk. Conclusions: This paper discusses the history, value, and importance of SBHCs from myriad perspectives, including physical and emotional wellbeing, academic and social success, and the promotion of a positive transition to adulthood. In addition, the authors' experiences that resulted in building the first SBHC in the Mid-Hudson Valley Region of New York State are shared. These experiences form the foundation for creating an important roadmap for individuals and school leaders that are interested in bringing a SBHC to their school and district.

Background: We now have sufficient evidence demonstrating inequalities in specific avoidable causes of death for adults with intellectual disability compared to their peers without intellectual disability. Apart from COVID-19, the largest differentials that disadvantage people with intellectual disability are in relation to pneumonia, aspiration pneumonia, epilepsy, cerebrovascular disease, ischaemic heart disease, deep vein thrombosis, diabetes and sepsis. The aim of this systematic review is to report on strategies at the individual, population or policy levels aimed at preventing these conditions that are applicable to adults with intellectual disability and that have been based on or recommended by research. Methods: Systematic review of PUBMED, EMBASE, CINAHL, PsychInfo, Social Care Online, International Bibliography of the Social Sciences (IBSS), Web of Science, Scopus, Overton, the Cochrane Library and Google Scholar databases was carried out. Searches were completed on 30 June 2023. Quantitative, qualitative and mixed-methods research; systematic, scoping or evidence-based reviews; and audit and reports of mortality reviews were included. Publications included in the review were about preventing the eight potentially avoidable causes of death. Findings: Ninety-four papers were included in the review (9 in relation to pneumonia; 11 for aspiration pneumonia; 18 for sudden unexpected death in epilepsy; 7 for cerebrovascular disease; 8 for ischaemic heart disease; 4 for deep vein thrombosis; 31 for diabetes; 6 for sepsis). The eight most frequently occurring potentially avoidable causes of death in people with intellectual disability are very different medical conditions, but they shared striking similarities in how they could be prevented. The literature overwhelmingly implicated the need to make lifestyle changes to address obesity, lack of exercise and poor nutrition, and to have regular medical reviews. In addition, 'whole-population' approaches are required that look beyond the individual to the social determinants of health. Conclusions: We found little peer-reviewed evidence specifically about preventing these conditions in people with intellectual disability. However, most of the literature about preventative strategies pertaining to the general population was applicable to people with intellectual disability, albeit that some 'reasonable adjustments' would be required.

Current childhood obesity treatment programs do not address medically underserved populations or settings where all members of an interdisciplinary team may not exist - either within one organization or within the community. In this paper, we describe the use of a community-academic partnership to iteratively adapt Epstein's Traffic Light Diet (TLD), into Building Healthy Families (BHF), a community-placed evidence-based pediatric weight management intervention (PWMI) and evaluate its effectiveness in reducing BMI z scores. Nine cohorts of families completed BHF. Participants included children aged 6-12 years with obesity (M = 9.46, SD = 1.74). The Framework for Reporting Adaptations and Modifications-Expanded guided our classification of modifications across BHF cohorts. Using the FRAME reporting structure, the changes that were documented were (1) planned and occurred pre-implementation, (2) based on decisions from local stakeholders (e.g., school administrator, members of the implementation team), and (3) specific to changes in content and context - with a focus on implementation and potential for local scale-up. The nature of the adaptations included adding elements (whole of family approach), removing elements (calorie counting), and substituting elements (steps for minutes of physical activity). Across 9 cohorts, 84 families initiated the BHF program, 69 families successfully completed the 12-week program, and 45 families returned for 6-month follow-up assessments. Results indicated that the BMI z score in children was reduced by 0.31 ± 0.17 at 6 months across all cohorts. Reduction in BMI z score ranged from 0.41 in cohort 4 to 0.13 in cohort 5. Iterative adaptations to BHF were completed to improve the fit of BHF to the setting and participants and have contributed to a sustained community PWMI that adheres to the underlying principles and core elements of other evidence-based PWMIs. Monitoring adaptations and related changes to outcomes can play a role in long-term sustainability and effectiveness.

This paper offers an overview of the current status of individuals with autism spectrum disorders (ASD) and developmental disorders (DD) in Oman. A review of demographic and background information about Oman is first presented, followed by an overview of the current status of individuals with autism and developmental disorders, in terms of disability-related legislation, prevalence and diagnosis, as well as treatment and education. In the last section of the paper, major challenges faced in the field are addressed, including lack of autism awareness, lack of healthcare and educational programs or related services, lack of highly qualified professionals to implement evidence-based practices, issues regarding early identification and early intervention, as well as issues pertaining secondary transition, independent living and employment. Corresponding recommendation is proposed at the end of each challenge.

Purpose: The paper offers commissioners and practitioners insights into how a gender and culturally sensitive COVID-19 vaccination clinic was set up in a local area that was experiencing lower uptake rates. Design/methodology/approach: This paper seeks to examine and share a city-wide approach to improve vaccine uptake in a large metropolitan city in the UK. Findings: In mitigating inequalities and ensuring underserved populations have access to the COVID-19 vaccine, there is a need to work with communities to develop vaccine clinics that provide a local, convenient and trusted offer that meets the needs of residents. Originality/value: Developing a local COVID vaccine offer that meets cultural needs focusing on an area of low uptake in a large metropolitan city.

Background: Australian research indicates that post-parental care transitions are rarely planned and primarily occur following a crisis for a primary carer. This paper examines disability staff perceptions of transitions for people with intellectual disability and their ageing carers in rural South Australia. Method: A focus group interview model was used, with a semi-structured interview guide initiating group discussions. A thematic analysis methodological approach was selected to analyse the data. Results: This paper reports on the theme of Service Delivery, which has three sub-themes of Availability; Distance; and Individual Access. The key findings are presented and supported by the use of exemplar quotes. Conclusions: This research indicates a poor intersection of general and specialist services is inhibiting post-parental transitional care for rural people. Simply allocating money to the individual does not resolve the issues, and the interface between different services needs to be better considered at government level.

To address the urgent need of mental health services on college campuses, particularly for historically marginalized students in HWIs (Historically White Institutions), the current paper presents a model of embedded counseling within campus cultural centers. Embedded counseling refers to having a mental health provider co-located and delivering services in a department or center on campus instead of within the traditional college counseling offices. Despite potential benefits, little research exists on embedded counseling and even less on embedded counseling within cultural centers. Embedded counseling is an important service delivery approach to understand given the high need for mental health treatment experienced by historically marginalized communities and the barriers to service they face. The authors propose a model that describes characteristics of culturally matched embedded counseling and the systemic support needed to have a successful program for underserved communities. This paper offers recommendations for structuring and implementing the culturally responsive framework for services.

Purpose: This paper aims to generate a better understanding of how challenges and opportunities for sustainable change during digitalization relate to the organizing work of change agents mandated to facilitate technology adoption from within local work organizations. Design/methodology/approach: This study examines the work of welfare technology coordinators, health-care professionals who are mandated to facilitate the use of technologies in home-based services in a Norwegian city. Data comprise ethnographic observations of meetings and work practices, interviews and documents collected over one year. A practice-based approach was applied to analyze how the welfare technology coordinators go about integrating technologies with the work practices, and the forms of negotiations this work implies in their work community. Findings: The analysis identified four sets of practices in the coordinators' work: exploring and integrating new technologies into work practices, legitimizing aims and values, formalizing routines and responsibilities and critically considering existing and envisioned service practices. Through these practices, emerging problems and disconnections in the service organization were attended to in a continuous manner. Originality/value: The study contributes to the literature by examining the work of internal change agents mandated to facilitate multiple and simultaneous technology adoption and demonstrates the importance of recognizing the continuous efforts and negotiations of these agents as significant to sustainable organizing.

In this paper, we discuss challenges associated with implementing a policy for Ancillary Care (AC) for related and unrelated (serious) adverse events during an Ebola vaccine trial conducted in a remote area of the Democratic Republic of the Congo. Conducting clinical trials in resource-constrained settings can raise context-related challenges that have implications for study participants' health and wellbeing. During the Ebola vaccine study, three participants were injured in road traffic accidents, but there were unexpected difficulties when trying to apply the AC policy. First, because of the nature of the adverse events, the insurer refused to cover the costs. Second, the AC policy did not address treatments by traditional medicine, even though traditional medicines are frequently used and highly trusted in the study community. This highlighted a contrast between the researchers' well-intentioned AC approach and the participants' legitimate preferences. The way in which researchers should address their responsibility to provide AC is not straightforward; it requires contextualization. Our experience highlights the importance of involving community representatives and the local ethics committee to ensure development of an AC policy that is culturally and ethically appropriate. Additionally, the insurance contract should clearly stipulate which adverse events are linked to the trial participation, and thus eligible for coverage, to avoid controversies when claims are made.

Autism evaluation processes are often fragmented and lead to delays in accurate identification and services. These inefficient processes also lead to substantial burden on families when navigating the autism diagnostic odyssey that often requires information-sharing across providers and settings. Collaboration across schools, clinical settings, and communities can facilitate equitable and efficient access to autism evaluation services. Children and families from minoritized and marginalized backgrounds are particularly positioned to benefit from school-clinic collaboration. This paper: (1) highlights the current state of autism identification and systems inefficiencies and inequities along racial/ethnic/socioeconomic lines; (2) compares the processes, benefits, and challenges between educational identification and clinical diagnosis of autism; (3) describes how school-clinic collaboration processes can address these systems inefficiencies and inequities; (4) presents examples of models that use school-clinic collaboration; and (5) offers specific recommendations for providers.

This article is a call for collective action across health equity researchers and advocates to build a more just world. We attempt to make sense of senseless structural and interpersonal brutality in the context of the current political climate across the United States, whereby the spectrum of gender nonconformity has been and continues to be stigmatized. From drag performance to transgender identities to gender-affirming health care, extremists have instrumentalized primary levers of democracy--the courts, legislatures, and social media--to attempt to outlaw and eradicate gender expansiveness and those who provide forms of support and care, including gender-affirming medical care, to transgender, nonbinary, and gender-expansive (TNBGE) individuals.

Background: School-based dental sealant programs are noted to increase sealant uptake among children, especially those from low-income families and those living in rural and underserved areas. However, nationally school-based dental sealant programs are substantially underutilized. This paper describes a partnership approach to a school-based dental sealant program for Title 1 public schools in Hawaii. Methods: The Hawaii Keiki--Healthy and Ready to Learn program partnered with the Hawaii Dental Service to develop and implement an interprofessional, school-based sealant program (SBSP). This article describes the development of key factors, such as partnerships, an interprofessional team, team roles, policies, and marketing tools to optimize program success. Results: The SBSP has completed over 3 academic years of implementation in Hawaii public schools. In its initial year (school year [SY] 2019-2020), which presented challenges due to the COVID-19 pandemic, it served 6 schools (106 students screened) on 1 island. It expanded to 14 schools on 1 island (193 students screened) in its second year (SY 2020-2021), 28 schools on 3 islands (653 students screened) in its third year (SY 2021-2022), and during the Fall of the fourth year, the program reached 50 schools on 3 islands (1821 students screened) and is projected to reach over 70 schools by the end of SY 2022-2023. Conclusion: Taking advantage of strategic partnerships and key interprofessional team members, a school-based dental sealant program can help to improve the oral health of children in public schools by helping to decrease barriers to care.

Objective: This review summarizes evidence pertaining to the impact of the COVID-19 pandemic on the psychological health of children and adolescents with autism spectrum disorder (ASD). Materials and Methods: An electronic search was conducted using four major databases--PubMed, ScienceDirect, Web of Science, and Google Scholar. Using an umbrella methodology, the reference lists of relevant papers were reviewed, and citation searches were conducted. The study included articles written in English between January 2020 and March 2021 that focused on the psychological health of autistic children and adolescents. Results: All eight studies included in the final review were cross-sectional. Three of the eight studies were conducted in Italy, two in Turkey, and one study each in Portugal, Spain, and the United Kingdom, with a total of 1,407 participants. All studies used a mixture of standardized and non-standardized questionnaires to collect data. The total number of patients were 1407 at a mean age of 9.53 (SD = 2.96) years. Seven studies report gender; male 74.7% (657/880) and female 25.3% (223/880). The finding showed that behavioral issues in children and adolescents with ASD have significantly increased; 521 (51.9 percent) of the 1004 individuals with ASD presented with behavioral changes, including conduct problems, emotional problems, aggression, and hyperactivity. Some studies also found increased anxiety and difficulties managing emotions. Only one study reported clinical stabilization in children with ASD during COVID-19. Finally, 82.7% of families and caregivers of children with ASD (544 out of 658) faced challenges during COVID-19. Conclusion: Although the studies in this review suggest a general worsening of ASD children's clinical status, it remains difficult to draw definitive conclusions at this moment, with newer COVID-19 variants on the rise worldwide. During this difficult pandemic period, caregivers, families, and healthcare professionals are recommended to pay more attention to the ASD patients' health and care needs.

Background: COVID-19 necessitated emergency telepractice for student-led speech-language therapy clinical practicals in training institutions, with limited preparation and evidence-based guidelines. Beyond the pandemic, practitioners and university training sites are likely to continue to offer telepractice necessitating thorough preparation for telepractice services underpinned by a comprehensive understanding of the complexities involved in online therapy. Aims: Adopting realist evaluation principles, our aim in this paper was to explore broadly what works and does not work in a set of student-led telepractice sessions in a diverse, resource-limited context. The broader goal of this project was to provide evidence-based support to enhance the efficiency and success of telepractice sessions in student clinical training contexts. Methods & Procedures: We used qualitative observational methods with reflexive thematic analysis to analyse 28 video recordings and 61 observation notes of student-led paediatric telepractice sessions from a South African university clinic as part of a pilot study. Outcomes & Results: We identified four overarching considerations for student-led telepractice: (1) additional, specific preparation is required, (2) with greater management of technology and adaptation of tasks, especially during times of poor connectivity; (3) telepractice relies heavily on caregiver input and collaboration; and (4) promoting engagement online, holding a client's attention, building rapport and offering reinforcement are critical skills that are complicated by the lack of face-to-face contact. Conclusions & Implications: Our findings indicate that telepractice pedagogy needs to be explicitly taught and students require practical assistance as they learn how to use this service delivery approach effectively. There are some aspects peculiar to telepractice that require unique consideration and planning, especially in contexts where service providers and users may be unfamiliar with this form of service provision. The findings of this pilot study can be used by clinical educators and student clinicians to enhance clinical training opportunities involving telepractice.

This paper examines embedded counseling programs across ten Post-Secondary Canadian counseling centers. We highlight common drivers for developing embedded counseling programs, commonalities and differences across programs, successes and challenges in implementation, and recommend a common set of metrics. Our overview demonstrates variability in program structure that reflects the host faculty or department and the culture, expectations, and realities they each face. Based on lessons learned, we highlight emerging and promising practices for university counseling centers.

In Aotearoa New Zealand, significant health inequities persist between Maori (the Indigenous people) and non-Maori. These ethnic-based inequities are intrinsically linked to Aotearoa New Zealand's colonial and colonising racist history. Decolonising health systems imbued with racist ideology, and mitigating inequities, is foundational to improving the health outcomes of Maori and Indigenous peoples worldwide. Social justice and equity are internationally recognised core values and functions of the discipline of hauora a iwi/public health and, more recently, recognised as acting against racism. Tertiary institutions in Aotearoa New Zealand that offer hauora a iwi/public health as a programme of study have an obligation to improve Maori health and reduce inequities through their teaching. This project aimed to provide a set of core Maori hauora a iwi/public health competencies, which can be used to support Indigenous equity-focused, anti-racist hauora a iwi/public health curricula for tertiary institutions, locally and internationally. This paper reports the process of developing a novel set of core Maori hauora a iwi/public health competencies (as a framework that can be delivered by both Maori and non-Maori/non-Indigenous health academics), designed and set within their international context of educating for Indigenous health equity as well as the Aotearoa New Zealand hauora a iwi/public health context.

The purpose of this paper is to explore 10-year trends in the use of Assistive Technology (AT). Using 2006 and 2015 Behavioral Risk Factor Surveillance System (BRFSS) data, univariate analysis were performed, and the rate of change was calculated. In both 2006 and 2015 data, a higher per cent of Blacks were using AT compared to Whites and Hispanics (p < 0.001); however, the rate of increase indicate that Blacks had the lowest per cent change (23.9%) compared to Whites (26.8%) and Hispanics (27.3%). Results indicated that AT use is statistically more prevalent in women, individuals who are not married (e.g. divorce, widowed, separated), the veteran population, lower educational attainment levels (e.g. some high school or less), lower income levels, the ageing population, unemployed (e.g. out of work, retired, unable to work) and individuals with limited functioning because of a disability. Similarly, individuals who have healthcare coverage, and individuals with concerns with medical costs used AT more. Even though most factors yielded higher utilisation rates when comparing 2006 to 2015 data, the rate of change had varying 'speeds' of improvement.

This paper examines ideas about mental health, wellbeing and school education to illustrate important issues in the relationship between mental health and education. The COVID crisis has amplified the pre-existing mental health problems of children and young people in England and recognition of the opportunities in schools to address these. The paper gives an overview of child and adolescent mental health services and how they position the role of schools. It examines prominent concepts of mental health and their relationship to wellbeing, setting this in a discussion of 'mentally healthy' schools, mental health in special educational needs and whole-school approaches. This analysis shows how the relationship between mental health and wellbeing has not been adequately worked out, using this as the basis for arguing for the dual-factor mental health model which separates mental illness/disorder from wellbeing as two related dimensions. The paper then translates the dual-factor model into a two-dimensional framework that represents the distinctive but related aims of school education (wellbeing promotion) and mental health services (preventing, coping, helping mental health difficulties). This framework involves a complex conception of wellbeing, with schools playing an important role in promoting wellbeing (beyond emotional wellbeing), tiered models and establishing school-wide social emotional learning. It is about a whole-school curriculum approach that involves considering what is to be learned and how it is taught. It contributes to a more nuanced concept of wellbeing that has a place for meaningful learning and challenge.

Autism spectrum disorder (ASD) is a neurodevelopmental disability affecting 1 in 44 children nationally. Timely referral to intervention and support services for ASD has consistently demonstrated significant long-term positive effects on symptoms and subsequent skills and family outcomes. This paper highlights a novel and innovative approach of short-term consultations for best practices to ultimately increase access to timely ASD evaluations and support through a state-wide school telehealth initiative. The goal of the initiative was to facilitate rapid access to ASD evaluation and support (within 2 weeks of referral in school-age youth) among under-resourced school systems in Central Texas. First, this paper provides background relative to current disparities that many children face when attempting to obtain ASD evaluations and support. Second, a statewide legislative response is described that created a mental health consortium targeting increased access to broad-based mental health services and supports, particularly in underserved areas. Next, the Texas Child Health Access Through Telemedicine (TCHATT) program is outlined with a particular focus on day-to-day operationality and concentrated efforts to increase mental health literacy among school teams relative to ASD symptoms and co-occurring behavioral health concerns. Year 1 utilization data metrics (September 2020-May 2021) and representative case examples are presented. Finally, early "lessons learned" and future directions are discussed.

In light of the ongoing COVID-19 pandemic, the health disparities plaguing our communities are highlighted more than ever. Community-based learning (CBL) and community-based participatory research (CBPR) provide a highly relevant framework in addressing health problems, especially those related to the Social Determinants of Health (AHRQ, 2020). Throughout the COVID-19 pandemic, the team at the Community Health Division (CHD) within the Family Medicine Department of Georgetown University School of Medicine (GUSOM) maintained and deepened relationships with community partners through engagement activities, which not only actively addressed community needs but also acted as an educational tool for a growing number of interdisciplinary students. This paper explores the effectiveness of CBL and CBPR as a framework, even when presented with challenges of the COVID-19 pandemic. It further underscores how students at Georgetown University have become more intimately involved in community health engagement during the pandemic. This serves as an encouraging model for establishing a student-based research learning community.

The supply of school mental health (SMH) providers and services cannot meet the demand of students in-need, and this gap is expected to widen in coming years. One way to increase the reach of helpful services for youth is to grow the SMH workforce through task-shifting to paraprofessionals. Task-shifting could be especially promising in expanding Motivational Interviewing (MI) interventions, as MI can be molded to target a number of academic and behavioral outcomes important to schools. However, no review of training exclusively paraprofessional samples in MI has yet been conducted. The current paper provides a scoping review of 19 studies of training paraprofessional providers to use MI to evaluate trainee characteristics, training content and format, and outcomes. Of these 19 studies, 15 reported that paraprofessionals improved in using MI following training. Nine studies reported that task-shifting MI was positively received by clients and/or providers. Six studies examined task-shifting MI in youth-serving contexts, and four examined the practice in traditional school contexts, suggesting its potential for use in SMH. Other findings and implications, such as client behavior change and provider fidelity, are shared, along with ideas for advancing research, practice, and policy in this subfield.

The unprecedented magnitude and effects of the COVID-19 pandemic have rendered it a highly disruptive and traumatic phenomenon. This paper considers the impact of COVID-19 on South African students and Student Counseling Services in Higher Education. The paper specifically reflects on shifts in student mental health and psycho-social vulnerability as a consequence of the pandemic, and the increased demand for the student counselor advocacy role. The inevitable need for technological shifts to traditional student counseling practice is considered, as well as the transformational dilemma or "double-edged sword" inherent in such change, given the historical, psycho-social, and economic complexities of South African society which impact on student access and participation in Higher Education. The paper lastly considers the adoption of a customized or "blended" student counseling approach that incorporates traditional and technological-based elements, and that can accommodate student personal and mental health needs, preferences as well as contextual peculiarities and challenges.

There has been an increase in school mental health research aimed at producing generalizable knowledge to address longstanding science-to-practice gaps to increase children's access to evidence-based mental health services. Successful dissemination and implementation are both important pieces to address science-to-practice gaps, but there is conceptual and semantic imprecision that creates confusion regarding where dissemination ends and implementation begins, as well as an imbalanced focus in research on implementation relative to dissemination. In this paper, we provide an enhanced operational definition of dissemination; offer a conceptual model that outlines elements of effective dissemination that can produce changes in awareness, knowledge, perceptions, and motivation across different stakeholder groups; and delineate guiding principles that can inform dissemination science and practice. The overarching goal of this paper is to stimulate future research that aims to advance dissemination science and practice in school mental health.

Limited research explores postsecondary disability resource professionals' (DRPs) perceptions and experiences supporting students during the COVID-19 pandemic. As part of a larger study utilizing national survey and interview data, this paper explores DRPs' experiences and observations related to student mental health during the pandemic-related lockdowns and subsequent transitions back to in-person campus settings. The findings of this study reveal DRPs are grappling with increasing student numbers, continuing need for expanded mental health accommodations and supports, and a persisting urgency to re-examine the role of the disability resource office (DRO) on campus related to student mental health. Implications and strategies for practice.

Family separation policies' impacts on children's education and well-being are critical issues of our time. This paper argues through ethnographic study that although im/migrant parents believed in the promise of a better life for their children as they migrated, COVID-19 and remote schooling contributed to a breakdown in structures of care once they were in the United States. Thus, the experience of remote schooling during 2020 was a difficult task for parents and children who were already dealing with the trauma of detention or separation at the border. Ultimately, we argue that to understand the educational experiences of im/migrant parents and children in the United States, we must consider a multiple disruptions framework. The findings in this article reveal the layered consequences that broader immigration policy has on the everyday educational lives of im/migrant children and their parents.

Background: Government restrictions enforced globally in response to COVID-19 necessitated changes to the delivery of mental health services, with many psychology professionals (PPs) forced to transfer their face-to-face practice to virtual means (telephone/video therapy) overnight. This review explores what is known about the experiences of PPs providing psychological support to people with intellectual disabilities (PWID) during the pandemic. Method: Literature was systematically searched and 11 papers were identified, critically appraised and thematically synthesised. Results: Four themes were synthesised from findings: (1) 'Impact at Service Level', (2) 'The Emotional Impact on PPs', (3) 'The Limitations of Virtual Support', (4) 'Unexpected Gains'. Conclusions: This review highlights the challenges and positives in experiences of PPs, whilst acknowledging the inequalities experienced by PWID. It is hoped that the findings can be used to aid education and training, and inform future practice and policy. Future research is recommended.

Objectives: Mental health problems such as anxiety and depression have been steadily rising among university students in the Philippines. While there exists literature determining students' quality of life and health access behaviour, there remains a substantial gap in having a local framework with which to understand their vulnerabilities. In this paper, we aim to identify the socio-cultural factors that exacerbate the challenges that Filipino university students navigate in their attainment of well-being. Design: The study used an exploratory qualitative design. Setting: Data were collected from university students attending a private higher education institution in Manila, the Philippines. Method: Using a cultural epidemiological approach and a qualitative design, semi-structured interviews were conducted online with 60 university-level students. Interviews were recorded, transcribed and translated into English. Data were open coded and thematically analysed. Results: The lived experience of 60 university students revealed that factors including volatile household dynamics, intergenerational [mis]understanding of mental illness, stressful academic engagement and religious associations contributed to the individual framing of their conditions, which ranged from self-stigma to self-prescribed isolation. Various experiences linked to the Filipino value of "pagdamay" (sharing the burden) significantly aided students' management of their conditions. Conclusion: Drawing on the narratives elicited, a community-based approach using the university as the core for intervention delivery is proposed that may positively impact on students' mental health seeking behaviour.

This paper explores the connections between parental nonsupport of a young person's trans or gender diverse identity and young trans people's experiences of justiciable legal problems1 as well as access to the legal system to address these issues. Qualitative youth data were drawn from the TRANSforming JUSTICE: Trans Legal Needs Assessment Ontario (TFJ) study. The narratives of 16 young trans people (16-29 years) were analyzed to identify parental factors in relation to encountering legal problems and accessing the legal system. Five themes emerged: parental nonsupport of gender identity, identity documentation issues, accessing medical care, employment legal problems, and housing legal problems. Results indicate that parental nonsupport of a young person's trans or gender diverse identity may render a young person more vulnerable to experiencing justiciable legal problems and may also create barriers to accessing the legal system to address these issues.