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Background: The COVID-19 pandemic negatively impacted global mental health, with adolescents experiencing disproportionate effects. Limited research has explored the impact of different pandemic restrictions on adolescent mental health, and only a few studies have examined the longer-term impacts of the pandemic on adolescent mental health. These investigations are crucial for informing public health policies, particularly the integration of mental health care in future public health emergencies. Methods: This study aimed to investigate the impact of lockdown duration and the impact of adolescents' subjective experiences of the pandemic on their wellbeing, internalising symptoms, and externalising symptoms. Australian adolescents (N = 1,001, mean age = 14.2 years) completed a baseline survey in 2021, shortly after pandemic lockdowns were lifted (Time 1), and a follow-up survey approximately 12 months later (Time 2). Predictors of interest were the total duration of COVID-19 lockdowns across 2020–2021, and adolescents' subjective experiences of the pandemic on their social connections, learning, technology use and family relationships. A range of covariates were included in analyses to examine subgroup differences. Results: Linear mixed-effects models indicated that total duration of the lockdown was not associated with any of the outcomes at Time 1 or Time 2 (all ps > 0.017). Negative subjective experience of the pandemic on learning was associated with greater externalising symptoms at both Time 1 (t = 5.17, df = 980, p <.001) and Time 2 (t = 2.72, df = 708, p =.007). Negative subjective experience of the pandemic on social connection was associated with greater internalising symptoms at Time 2 only (t = 3.20, df = 709, p =.001). Negative subjective experience of the pandemic on family relationships or technology use was not associated with any of the outcomes at Time 1 or Time 2 (all ps > 0.017). Conclusions: Adolescents' negative subjective experience of the pandemic on learning and social connections was associated with greater internalising and externalising symptoms after the lockdown had been lifted. Duration of lockdowns was not associated with any of the primary outcomes. During future public health emergencies, mental health interventions should be tailored to assist adolescents to adapt to new learning environments, and to build and maintain social connections. [ABSTRACT FROM AUTHOR]

Objectives: The Future Proofing Study (FPS) was established to examine factors associated with the onset and course of mental health conditions during adolescence. This paper describes the design, methods, and baseline characteristics of the FPS cohort. Methods: The FPS is an Australian school‐based prospective cohort study with an embedded cluster‐randomized controlled trial examining the effects of digital prevention programs on mental health. Data sources include self‐report questionnaires, cognitive functioning, linkage to health and education records, and smartphone sensor data. Participants are assessed annually for 5 years. Results: The baseline cohort (N = 6388, M = 13.9 years) is broadly representative of the Australian adolescent population. The clinical profile of participants is comparable to other population estimates. Overall, 15.1% of the cohort met the clinical threshold for depression, 18.6% for anxiety, 31.6% for psychological distress, and 4.9% for suicidal ideation. These rates were significantly higher in adolescents who identified as female, gender diverse, sexuality diverse, or Aboriginal and/or Torres Strait Islander (all ps < 0.05). Conclusions: This paper provides current and comprehensive data about the status of adolescent mental health in Australia. The FPS cohort is expected to provide significant insights into the risk, protective, and mediating factors associated with development of mental health conditions during adolescence. [ABSTRACT FROM AUTHOR]

Background: Depression is common during adolescence and is associated with adverse educational, employment, and health outcomes in later life. Digital programs are increasingly being implemented in schools to improve and protect adolescent mental health. Although digital depression prevention programs can be effective, there is limited knowledge about how contextual factors influence real-world delivery at scale in schools. Objective: The purpose of this study was to examine the contextual factors that influence the implementation of the Future Proofing Program (FPP) from the perspectives of school staff. The FPP is a 2-arm hybrid type 1 effectiveness-implementation trial evaluating whether depression can be prevented at scale in schools, using an evidence-based smartphone app delivered universally to year 8 students (13-14 years of age). Methods: Qualitative interviews were conducted with 23 staff from 20 schools in New South Wales, Australia, who assisted with the implementation of the FPP. The interviews were guided by our theory-driven logic model. Reflexive thematic analysis, using both deductive and inductive coding, was used to analyze responses. Results: Staff perceived the FPP as a novel ("innovative approach") and appropriate way to address an unmet need within schools ("right place at the right time"). Active leadership and counselor involvement were critical for planning and engaging; teamwork, communication, and staff capacity were critical for execution ("ways of working within schools"). Low student engagement and staffing availability were identified as barriers for future adoption and implementation by schools ("reflecting on past experiences"). Conclusions: Four superordinate themes pertaining to the program, implementation processes, and implementation barriers were identified from qualitative responses by school staff. On the basis of our findings, we proposed a select set of recommendations for future implementation of digital prevention programs delivered at scale in schools. These recommendations were designed to facilitate an organizational change and help staff to implement digital mental health programs within their schools. [ABSTRACT FROM AUTHOR]