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In counselor education programs, students acquire clinical experience through both practicum and internship; this time frequently marks students' first counseling experiences working with suicide in a clinical context. Often, students in practicum or internship working with clients who may be experiencing suicidal ideations do not feel properly equipped to deal with suicide. This study aimed to develop a practice model for online counselor education programs that increases counseling students' self-efficacy to work with clients who may present with suicidal ideations. Sixty online graduate-level clinical mental health counseling students completed a pre- and posttest self-efficacy assessment. Findings showed that students' self-efficacy increased due to taking the online basic counseling skills class that included teaching activities related to suicide screening, assessment, and intervention.

Black, school-aged youth may experience socioeconomic, psychological, and emotional difficulties that affect their mental health, leading to maladaptive ways of coping, such as cannabis use. Instead of getting treatment and support to help them manage their stressors in positive ways, Black youth often receive punitive school practices, including referrals to the juvenile justice system. Counselors who work with school-aged youth are likely to encounter many Black youth and can thus either be instrumental to their psychological development or inadvertently impede their well-being with over-pathologization and criminalization of their cannabis use. In this article, the author reflects on a particular experience he had working with a Black youth and how it influenced his cultural competency and development as a counselor. The author also discusses the socioeconomic landscape and psychological experience of Black youth and their rationale for cannabis use. The article concludes with implications for professional counselors.

Suicide, which is defined as an individual's intentionally attempting to end his or her life, is considered an important public health problem. In this study, it was aimed to examine the relationship between cognitive distortions and suicide probability in university students who are in age groups at risk for suicide, and to examine the mediating roles of the attachment dimensions of anxiety and avoidance, in this relationship. The study group consisted of 441 university students. In the study, Suicide Probability Scale, Experiences in Close Relationships Inventory, Cognitive Distortions in Relationships Scale and a personal information form were used as data collection tools. In accordance with the purpose of the study, a correlation analysis between variables and regression analyses were applied to examine the mediating roles of avoidance and anxiety in the relationship between cognitive distortions and suicide probability. The findings showed that there was a moderate positive correlational relationship between suicide probability scores and avoidance scores and there was a moderate positive correlational relationship between suicide probability scores and cognitive distortion scores. It was shown that there were low and moderate positive correlations between cognitive distortion scores, and avoidance and anxiety scores. The results of the mediation analyses showed that anxiety and avoidance had a partial mediating role in the relationship between cognitive distortion and suicide probability. The results were discussed in light of the literature.

We explored secondary school principals' knowledge of suicide prevention programs, their perceptions of the logistical and cultural barriers associated with suicide prevention program adoption, and their justification for adopting (or not adopting) suicide prevention programs in their schools. Principals, as positional leaders of schools, can lead the adoption and support of school-based suicide prevention programs for their students. Using a phenomenology framework, we conducted semi-structured interviews of eight secondary school principals working in public schools in the south-central United States. The principals readily identified the importance of supporting students' mental health to enhance their learning as a justification for implementing suicide prevention programs for their students. They shared how limited staffing, time, perception of school responsibility for student mental health, and lack of knowledge of available suicide prevention resources were logistical, cultural, and knowledge barriers to adopting suicide prevention programs for students. Our research has profound implications for practice.

The Perfectionism Social Disconnection Model (PSDM) and the Existential Model of Perfectionism and Depressive Symptoms (EMPDS) are promising models of perfectionism and psychopathology. However, research examining suicide ideation within the PSDM is scarce, and no research has examined suicide ideation as an outcome in the EMPDS. Moreover, tests of the PSDM and EMPDS have been conducted separately and most research has examined the PSDM and EMPDS using cross-sectional or two-wave longitudinal designs, which do not provide a satisfactory test of mediation. In the current study, we addressed these limitations by testing whether perfectionism confers vulnerability to suicide ideation via feelings of mattering and anti-mattering (from the PSDM) and via difficulty accepting the past (from the EMPDS) in a three-wave longitudinal design in two independent samples of undergraduate students and community adults. Participants completed measures on three occasions over 6 weeks. Findings revealed that socially prescribed perfectionism indirectly predicted suicide ideation via difficulty accepting the past in both samples. In addition, in the undergraduate sample only, socially prescribed perfectionism indirectly predicted higher suicide ideation via anti-mattering, and self-oriented perfectionism indirectly predicted higher suicide ideation via mattering. Based on our findings, we advocate for future research to include suicide ideation in the PSDM and EMPDS, to integrate explanatory models, and to examine a mattering-specific EMPDS.

Background: It is vital to improve the mental health (MH) of young people in Hong Kong, where the suicide rate has nearly doubled among those aged 15-29 years since 2014. This multi-method evaluation aimed to assess Coolminds, which promoted MH literacy by engaging students, parents, and educators in secondary schools in Hong Kong. Methods: Students, parents, and teachers completed self-report measures before and after attending workshops aimed at raising MH literacy. Pre- and post-survey data were collected between November 2021 and August 2022. Qualitative data from participant feedback and a focus group interview with Coolminds staff were analyzed using descriptive content analysis. Results: The final dataset included 2903 students, 395 parents, and 325 educators from 52 schools. Only 3 schools had engagement with all 3 key groups. Significant improvements in MH knowledge were observed after the Coolminds workshops for all 3 groups. Qualitative analysis identified a reactive approach to MH issues, and bureaucratic and logistical challenges as barriers to implementation. Conclusion: Findings support the effectiveness of the Coolminds curriculum in improving MH literacy for each group and the demand for MH promotions in school settings. The implementation challenges indicate the need for future initiatives to better align with local needs and practices.

Suicide rates among Black youth have risen faster than any other racial/ethnic group in the past two decades. Black youth residing in rural areas are subject to systemic challenges such as minimal access to mental healthcare providers, generational poverty and oppressive social structures that lead to racial discrimination. Racial discrimination places rural Black youth at increased risk for anxiety, depression, and suicide. Protective factors have been found to mitigate the negative impact of racial discrimination on mental health, but there is limited research covering suicidality and Black youth. This scoping review explores what is known about the role of protective factors in moderating the association between racism/discrimination and suicide risk among Black youth in the United States. Findings were mixed regarding the influence of protective factors in moderating the effects of racial discrimination on suicide risk and more exploration among Black youth in impoverished rural areas is warranted.

Background: Despite emerging evidence for the effectiveness of school-based suicide prevention programmes worldwide, there are few being implemented in the United Kingdom, and their social validity (i.e., the feasibility, acceptability, and utility) is not yet known. Aims: We aimed to conduct a scoping study to determine: (1) the social validity and potential benefits of school-based suicide prevention interventions, (2) the perceived need for such interventions, and (3) barriers and facilitators to implementation. Sample and Methods: A total of 46 participants took part. Semi-structured interviews were conducted with mental health professionals (N = 8), school staff (N = 8), and parents whose children had experienced suicidal ideation/behaviours (N = 3) in England. Focus groups were also completed with children and young people (N = 27) aged 15-18 across three state secondary schools. Data were analysed using thematic framework analysis. Results: Three themes were identified: (1) the need for and importance of suicide prevention in children and young people, (2) schools as a setting for delivery, and (3) key components of suicide prevention programmes. Conclusions: Participants overwhelmingly agreed that there is a need for a greater and more consistent emphasis on school-based suicide prevention. School appears to be an acceptable location for suicide prevention, and participants felt discussions about suicide should begin at the start of secondary school. However, there are potential barriers that need to be considered, including tailoring for neurodiversity, challenging cultural/family beliefs and stigma, managing personal experiences of suicidal thoughts or previous bereavement from suicide, and a lack of existing training for school staff.

Suicide is a serious public health problem and is the fourth leading cause of death among adolescents. Suicide ideation is the most significant predictor of suicide. However, few empirical studies have examined the relationship between stressful life events, insomnia, depression symptoms, self-esteem, and suicide ideation among college students. This study builds on O'Connor's The integrated motivational-volitional model of suicidal behavior theory will verify the relationship between these five factors through a large data study among college students, and further reveal the mechanisms and interventions of suicide ideation among college students. A total of 2717 (mean age = 19.81 years, 22.49% male) college students from South China participated in this behavioral and health survey. Using self-reported questionnaires which were Adolescent Self Rating Life Events Check-list, MINI-C, Insomnia Severity Index, PHQ-9, and Self-Esteem Scale to assess the subjects' demographic information, suicide ideation, stressful life events, insomnia, depressive symptoms, and self-esteem levels as comprehensively as possible. A moderated chain mediation model was used to validate their relationship. The results showed that stressful life events significant positively predicted insomnia symptoms, depressive symptoms, and suicide ideation. The mediating effect of depression between stressful life events and suicide ideation was significant. The chain mediating effect of insomnia and depression between stressful life events and suicide ideation was significant. However, the mediating effect of insomnia between stressful life events and suicide ideation was not significant. Also, the positive prediction of stressful life events and depression on suicide ideation was weaker when the individual's self-esteem level was higher, and the moderated chain mediating effect was significant. This study developed a moderated chain mediation model, and proposes a new integrated stress coping-self-perception model of suicide ideation to discover the important role of self-esteem levels in adolescent suicide prevention.

The current study examined verbal cues of veracity and deception in 911 calls reporting homicides or suicides of another person. Specifically, the current study compared differences in the presence/absence and number of potential verbal indicators between a sample of deceptive callers who concealed their role in causing the person's death and truthful callers who did not cause the person's death. Results demonstrate consistency with previously proposed indicators of veracity and deception in 911 calls. More precisely, a greater number of self-handicapping statements and descriptions of physical sensations were made by deceptive individuals, whereas truthtellers were more likely to spontaneously self-correct inaccurate statements. Practical implications and limitations are discussed.

At the 2020 American String Teachers Association (ASTA) Conference held in Orlando Florida, an attendee of the Wellness Committee Listening Session recommended that a study be conducted to determine the prevalence and awareness of mental health concerns among students and teachers within the organization. Members agreed that there is more needed to be understood so that ASTA could provide professional development webinars, resources, as well as local, state, and national conference sessions. In response to this request and the clear need for more information, a survey was developed and deployed to the ASTA membership in the fall of 2020. Follow-up interviews with members who volunteered in response to an invitation on the survey were conducted in the spring and early summer of 2021. Teachers reported a high prevalence of student mental health issues prior to and during the pandemic and reported concerning levels of work overload, compassion fatigue/burnout, and mental health issues. Generational differences in mental health perceptions were noted, as were opportunities to provide targeted professional development and community-level services.

College students' mental health concerns have dramatically increased in prevalence and severity over the past decade, overwhelming the capacity of counseling centers to meet demand for services. In response, institutions of higher education (IHEs) increasingly emphasize prevention, education, and outreach efforts aimed at improving well-being. Although this focus has prompted an increase in research on student well-being, few studies have investigated the unique contributions of malleable psychosocial factors on student outcomes. This study aims to address this gap in the literature by examining the relative impact of an array of psychosocial factors--adaptive and maladaptive perfectionism, coping self-efficacy, social connectedness, perceived burdensomeness, grit, resilience, and meaning in life--on academic performance and distress and suicidality in a sample of 7505 students from 15 U.S. IHEs. Controlling for institutional selectivity and non-malleable aspects of students' identities and pre-college experiences, facets of perfectionism, grit, and emotion-focused coping self-efficacy were the psychosocial factors most strongly associated with GPA, and perceived burdensomeness, social connectedness, emotion-focused coping self-efficacy, and resilience were most strongly associated with distress and suicidality. Among non-malleable factors, race/ethnicity explained the most variance in GPA and gender identity explained the most variance in distress and suicidality. Results are discussed in light of persistent, identity-based disparities in academic achievement and suicide risk and the potential of psychosocial factors as intervention targets to improve academic performance and reduce suicide risk.

This study builds on existing literature on autism spectrum disorder (autism) and sexual and gender minority (SGM) identities and is the first to examine self-declared frequency rates, associated functional impairments, and treatment engagement levels for sexual minority (SM) and non-SM populations with and without autism cross-sectionally via a large nationwide college-student sample across 3 years. Using data from the American College Health Association-National College Health Assessment (ACHA-NCHA) III, we analyzed data from 81,286 college students (ages 18-25 years old) randomly selected from 75 U.S. colleges and universities. Included ACHA-NCHA-III measures consisted of self-reported demographics, SM and gender minority (GM) identities, autism diagnosis, stress, academic impairment, mental health symptoms, and treatment engagement. We found a 2.8% self-declared frequency of autism in the SM group, compared with 0.9% self-declared frequency among the non-SM sample. Autistic college students with both SM and GM identities had the greatest levels of reported adverse stress and the most negative academic and mental health outcomes (i.e., suicidality), followed by college students with two minority identities (i.e., Autism and SM, SM and GM), across all groups. These findings emphasize the need for mental healthcare providers to consider SM and GM identities in non-autistic and, especially, in autistic college students to assess suicide risk and inform treatment.

Danish schools offering "preparatory basic education and training" (FGU schools) have students that are characterized by having different academic, social, or personal problems. In addition, many FGU students are at high risk of suicidal behavior. Many young people with suicide behavior do not seek help and early identification is important for suicide prevention. Teachers are in a position where it could be relevant to implement a gatekeeper intervention. To ensure successful implementation of an intervention, it is important to establish organizational readiness for change, including its innovation-specific capacity, which are the facilitating requirements in the organization specific to the intervention. We aimed to explore the innovation-specific capacity to implement a gatekeeper intervention at FGU schools in Denmark. This study is based on an online survey completed by teaching staff (n = 251) at FGU schools to explore their overall knowledge about and experience with students' suicidal behavior. Limited knowledge of suicide prevention was found among teaching staff. Most knowledge was from personal experience. There is a need for teaching staff to be educated about suicidal behavior. There is a lack of innovation-specific capacity to implement a gatekeeper intervention.

Suicidal behaviour is a major socio-health problem worldwide. However, there are few empirically validated programs for universal prevention of suicidal behaviour in school settings. The aim of the present study was to design and validate the "PositivaMente" program for the prevention of suicidal behaviour in school-age adolescents aged 14-15 from the North of Spain. A quasi-experimental design was used with pre- and post-treatment evaluation with experimental and control groups and a six-month follow-up. The final sample consisted of 264 participants (M = 14.30 years, SD = 0.56; 54.5% girls), with 161 participants in the experimental group and 103 in the control group. Measuring instruments were administered to assess suicidal behaviour, emotional and behavioural difficulties, depressive symptomatology, prosocial behaviour, subjective well-being, and self-esteem. The "PositivaMente" program was designed and implemented in educational settings. A statistically significant improvement in subjective well-being was found, as well as a statistically significant reduction in emotional problems and problems with peers among female participants in the experimental group versus those in the control group at the 6-month follow-up. However, male participants did not seem to benefit from the program. The overall evaluation from the sample and satisfaction with "PositivaMente" were positive. Empirically supported actions for the prevention of suicidal behaviour need to be designed in order to make informed decisions. Future studies should implement the "PositivaMente" program with other populations and contexts, develop a brief version, and collect information on cost-effectiveness.

The objectives of this article are to examine the epidemiology of suicide for Black college men; social determinants of mental health, mental health inequities, and suicide prevention for Black college men; role of mental health utilization for Black college men; role of culture in addressing mental health needs for Black college men; racial trauma and mental health for Black college men; role of socio-economic barriers for Black college men; mental health needs of Black college men amid the COVID-19 pandemic; mental health needs of African and Caribbean college men; mental health needs of Black gay, bisexual, queer, and trans+ college men; and implications for colleges and universities in addressing the mental health needs of Black college men.

Childhood adversity can have detrimental impacts on life course mental and physical health. Timing, nature, severity, and chronicity of adversity are thought to explain much of the variability in health and developmental outcomes among exposed individuals. The current study seeks to characterize heterogeneity in adverse experiences over time at the individual, family, and neighborhood domains in a cohort of predominantly Black children (85% Black and 15% White, 46.2% girls, 67.2% free/reduced lunch in first grade), and to examine associations with mental health from sixth grade to age 26. Participants were part of a randomized universal preventive interventions trial in first grade with prospective follow-up through early adulthood. Separate models characterized heterogeneity in adversity in elementary, middle, and high schools. Changes in adversity over time and relationships with mental health (anxiety, depression, suicidal behaviors) were investigated using a random-intercept latent transition analysis (RI-LTA). We identified three-class solutions in early childhood, middle school, and high school. Generally, both a higher and a lower poly-adversity class were observed at each time point, with varying nature of adversity characterized by the third class. RI-LTA indicated prevalent within-individual changes in adverse exposure over time and differential associations with mental health and suicidal behaviors. Results suggest that treating adverse exposures as a static construct may limit the ability to characterize salientvariation over time. Identifying complexity in adverse experiences and their relation to health and well-being is key for developing and implementing effective prevention and early intervention efforts to mitigate negative effects through the life course.

Suicide remains a leading cause of death among adolescents and exists in detectable rates for younger children as well. Underserved ethnic and racial groups face barriers to effective mental health care, making it critical that school psychologists be prepared to incorporate cultural considerations for suicide prevention and intervention. School psychologists play a critical role in suicide prevention and are ethically responsible for maintaining current knowledge of the literature on prevention and intervention strategies for students at risk of suicide. This articles describes how culturally responsive suicide prevention and intervention includes developing an awareness of the disparities which exist in the communities school psychologists serve, engaging in self and systemic evaluations, developing awareness of different options for different populations, and committing to strategic improvements.

Considerable research documents that LGBTQ youth are more likely to experience mental health challenges than their heterosexual peers, including higher rates of depression and suicidal thoughts and behaviors. This first Science-to-Practice Brief summarizes a study on protective factors related to depression and suicidality among U.S. sexual and gender minority adolescents. It emphasizes the need for school professionals to consider the impact of the intersectionality of LGBTQ students' sexual orientation, gender identity, sex, and race/ ethnicity, and it summarizes specific recommendations for implementing multitiered systems of support for LGBTQ youth in schools.

A growing number of college students report mental health concerns including self-harming behaviors, and studies have shown that students with disabilities report an increased number of mental health concerns compared to students without disabilities. While there are many studies informing the risk factors of self-harming behaviors of the general college student population, there are limited studies focused solely on students with disabilities. This study examines the self-harming behaviors of college students with disabilities receiving counseling in the United States, using data provided by the Center for Collegiate Mental Health (CCMH). Participants were 12,132 college students from 140 colleges and universities who were registered with their campus' office of disability services and who completed the Counseling Center Assessment of Psychological Symptoms-62 (CCAPS-62). Three logistic regressions were conducted, predicting self-harming behaviors without suicidal intention, suicidal ideation, and suicide attempts, respectively. The findings suggested that those with psychological disorder/conditions reported more self-harming behaviors than those without psychological disorder/conditions. All psychological symptoms measured in the CCAPS-62 predicted higher rate(s) of self-harming behaviors, while lower academic distress, higher depression, and higher family concerns predicted higher rate(s) of suicidal ideation and attempt for students with disabilities. The discussion describes the importance of early identification and intervention to detect warning signs and/or symptoms and can inform practitioners working with students with disabilities in postsecondary settings in identifying potential students at risk.

There is a social and cultural problem related to suicide in advanced societies. From a professional point of view, social workers intervene to achieve social welfare and health for the people with whom they work without being exempt from suffering suicidal ideation themselves. The present research aims to analyze suicidal ideation in undergraduate students of Social Work. Through a quantitative methodology, this phenomenon is analyzed in a large sample of students belonging to Spanish universities (n=1005). In the statistical study, a frequency analysis, a cross-table analysis, and a binary logistic regression are developed, taking as reference the dependent variable: the risk of suicidal ideation. The predictor variables of suicidal risk are: sex, type of social relationships, bullying in previous stages, consumption of antidepressant medication, increased anxiety after COVID-19, and economic difficulties in continuing studies. Universities should not be oblivious to the problems of their students but should incorporate specific programs for the treatment and prevention of suicidal risk, promoting quality education about the U.N. Sustainable Development Goals.

LGBTQIA students are an important stakeholder group on college and university campuses, especially as both their visibility and expectations for support and empowerment on campus increase. But how ready is the field of higher education for litigation related to LGBTQIA issues, and how should student affairs practitioners prepare to address LGBTQIA students' possible negative campus experiences proactively? By reviewing details of cases that have set an important precedent and signal what might be coming with respect to LGBTQIA students' rights and experiences in higher education, this article seeks to provide detail and analysis of important legal areas that student affairs practitioners should be attuned to as they continue to educate thousands of LGBTQIA students each year. I explore how Title IX may be increasingly a route of redress for LGBTQIA students who have experienced discrimination; how rulings on religious freedom of expression may erode some of LGBTQIA students' rights on college and universities campuses; and the special relationship doctrine and how it may be applied to LGBTQIA students in mental health crisis.

The purpose of this research paper was to highlight the factors students and school staff identify as contributors to mental health issues students attending rural, low socioeconomic high schools experience and the specific mental health issues they witness most. A collective case study was conducted in four rural high schools, two in Kansas and two in West Virginia. Field work at each school involved observations, document collection, and semi-structured focus group interviews with students and school staff. The factors identified as contributors to poor student mental health were pressure, technology, home life, bullying, and stigma. Anxiety, stress, depression, lack of health coping, and suicidal comments emerged as the specific mental health struggles students deal with the most. Recommendations for practice include practical ways to address the identified contributors of poor student mental health in rural schools and strategies to normalize mental health in the rural school environment.

While the conversation in honors about the mental health of students has persisted for over two decades, authors identify a marked increase in the need for student mental health support since the first Generation Z students entered college in 2015. A review of literature in honors indicates upticks in discourse relating to mental health (tn = 66) since 2004, and content analysis shows peaks in publication for 2018 and 2021 (n [not equal to] 11, respectively). This study describes a peer coaching program that focuses on the holistic wellness and support of honors students. Authors observe a decrease in Behavioral Intervention Team meetings and suicide attempts since the program's inception in 2015. Programmatic details, including application and selection, training, expectations of peer coaches, assessment, and improvement initiatives are included so that similar programs can be implemented in and beyond honors.

Bullying is a relevant concept in education, composed by different dimensions and it is significantly associated to other variables. Therefore, there is a need for an instrument which can analyze the level of bullying as a single dimension, as the Cisneros Self-test on Bullying (Oñate & Piñuel, 2005). This instrument analyzes the intensity of bullying and to value its relevance on the different variables mentioned above. Our main goal was to validate this instrument in 531 Dominican secondary students. To validate it, we utilized two instruments: the Emotional Instability Scale (Caprara & Pastorelli, 1993) and the Prosocial Conduct Questionnaire (Caprara & Pastorelli, 1993). Several competitive structural models were estimated, and results supported the reliability and validity of this instrument. Therefore, we can conclude that the Cisneros's scale is a good instrument to measure global bullying. We highlight its influence on future interventions considering the relevance that bullying has on many other variables as aggressiveness, prosocial behavior or suicide ideation.

Suicide had traditionally been silenced in the media until the beginning of the 21st century, when the World Health Organization (WHO) changed its recommendation not to report on it in order to disseminate this serious social problem and contribute to its prevention. Work has been done to define how and with what limits the media should report, but there are no codes dealing with social networks, which require specific treatment given their great capacity for influence. This research analyses the information on suicide published on social networks by the Spanish media with the greatest interaction on Twitter and the feedback from audiences, during the first six months of 2022, applying the different ethical codes and consulting the seven state organizations specialized in suicide. This work aims to examine the connection and interaction between the selected media and their audience in social networks, participation, the type of content created by the media and the exchange produced with their audiences. In the results, it is observed that the interaction of the audience regarding the different approaches of the media on Twitter on suicide is associated with the idea of sharing, commenting or bookmarking those messages related to prevention.

The authors present a case report for an adolescent student with a learning disability who has academic, behavioral, and intensive mental health needs. A therapeutic package to support and maintain student progress is discussed. The case report outlines specifically how the student's mental health needs were supported through the implementation of Acceptance Commitment Therapy and a Check-In, Check-Out procedure. The authors discuss how the interventions are applied to the student's academic engagement, emotional stability, and improved quality of life. Major takeaways and implications for school teams are discussed.

The purpose of this qualitative study was to identify and prioritize the mental health needs of rural communities in Texas Public Health Region 11 utilizing the Delphi method. Rural individuals face unique challenges when attempting to receive treatment for serious mental illness and mental health care. Stigma, a lack of privacy when seeking treatment, a shortage of mental health workforce professionals, a lack of culturally competent care, affordability, and transportation are all factors that complicate the need for treatment. This study utilized the Delphi method to engage rural community members in identifying and addressing critical issues related to mental healthcare delivery in their county. The sample for this study was selected from the population which comprise Texas Public Health Region 11 communities that were identified as rural communities within Health Professional Shortage Areas (HPSA) using an exponential nondiscriminatory snowball sampling method. Knowledge gained from the study will help to address challenges and critical issues in mental healthcare delivery in rural communities, such as workforce shortages, access issues, anonymity, stigma, integration of mental health services into primary care, and suicide prevention. The study's implications for refining, developing, and increasing rural mental health research, and implications for practice for mental health treatment providers in rural communities are discussed.

Tutors in higher education are receiving and responding to student disclosures that include racism, anxiety, loneliness, legal disputes, family upheavals, physical, emotional, and mental health, bereavement, legal battles, and harassment. In many cases, this caring aspect of the tutor role is not acknowledged, allocated time in job descriptions, or accurately remunerated. This qualitative study explored how tutors experienced and managed student disclosures, the personal and professional impact of responding to disclosures, and how tutors believed they could be better supported. Data was collected from two cohorts of participants tutoring at a University in Aotearoa New Zealand. Using interviews and questionnaires and analysed by reflexive thematic analysis. Our findings showed that our participants believed they were positioned vulnerably between a rock and a hard place. At the rock, tutors were told to follow university guidelines and refer distressed students to over-loaded course coordinators or over-subscribed support services. At the hard place, tutors were often the first to be disclosed to, because of their front-facing positioning at the university and once they had heard the disclosure felt it was unethical not to try and help. Tutors believed they could assist students with personal challenges if their precarious positioning within the university was protected and strengthened and if appropriate support was provided by their university through training, time, and remuneration. Findings have implications for higher education providers to reconsider how tutors are supported to support students.

Assessment and management of youth suicide risk is a key role for school psychologists. However, prior research indicates that psychologists commonly lack confidence and feel unprepared when they graduated to conduct risk assessments. This qualitative study explored nine Victorian early-career school psychologists' role in risk assessment, and their self-perceived preparedness, self-efficacy, postgraduate training experiences and methods used to assess risk. Results identified that the frequency of student suicidal ideation and acute mental health presentations exceeded participants' expectations. Participants identified confidence in assessing risk, but less confidence in the follow-up actions. Participants reported employing comprehensive risk assessment practices and most received exposure to risk assessment during training. Key factors identified for building risk assessment preparedness and confidence were supervision, experience, professional development and research. As participants identified core risk assessment competencies that may require further coverage in curricula, these findings have important implications for universities to maximise graduates' risk assessment preparedness.

Supervision is an essential part of school counsellor education training, particularly during internship and practicum experiences, as it plays a crucial role in assisting counsellor trainees in adapting to their new roles and identities. While essential to the profession, supervision literature lacks comparison studies across countries, leaving a significant gap in our understanding of whether, and to what extent, supervision is being effectively practised cross-nationally. In the current study, authors utilized a multisite analytic approach as a form of case study method to investigate similarities and differences in counsellor educators' school counselling supervision practices in the US and Türkiye. The study sample included a total of four counsellor education programmes, consisting of two programmes from each country. The results indicated that while counsellor educators in the US pay more attention to crisis management, suicide assessment, feedback acceptance, multicultural issues, school counsellor self-care, and mindfulness, their counterparts in Türkiye focus on creating counselling goals, counselling micro-skills, theories, and techniques. The results also provided further support for an independent counsellor education accreditation body that could oversee the supervision practices across counsellor education programmes in Türkiye for a united counsellor training, supervision, and professional counsellor identity.

Students and practicum instructors in a primarily rural state were surveyed about suicide prevention practice and training opportunities provided to social work trainees during their practicum placements. A cross-sectional, electronic survey was administered to N = 86 students and N = 64 practicum instructors and descriptive statistics were analyzed. Most students (87.1%) and practicum instructors (86.6%) felt that students should have the opportunity to engage with suicidal clients while in practicum. Many students reported having had contact with a suicidal client while in practicum (70.6%) and had engaged in some sort of practice related to suicide prevention (82.6%). The most frequently reported practice behaviors were suicidal inquiry (62.8%), risk assessment (60.7%), disposition planning (51.0%), and safety planning (49.0%). Over half (52.9%) had not used any evidence-based tools for screening and follow-up and only one quarter (25.5%) had provided postvention services. Many students (72.9%) were concerned about iatrogenic risk. Although most practicum instructors felt comfortable addressing suicide prevention in supervision (74.4%), many (64.1%) also reported the desire for additional training. Although students appear to have opportunities to engage in suicide prevention in practicum, there are specific knowledge and practice gaps regarding evidence-based tools, postvention, and the "myth" of iatrogenic risk.

Suicide prevention training programs have spread rapidly within child and public-serving organizations, due to the alarming increase in youth suicide rates. Yet, within these organizations, roles and responsibilities can shape attitudes and intentions related to suicide prevention, thereby influencing the uptake of prevention efforts. As such, various organizational and individual factors can predict uptake, adoption, and maintenance of prevention efforts (Fixsen et al., 2005). To date, few studies have examined the service delivery context in understanding training effectiveness, especially as it relates to QPR (Question Persuade and Refer), one of the most widely disseminated suicide prevention gatekeeper programs. The purpose of this longitudinal study was to evaluate whether individual and organizational characteristics influenced the effectiveness and sustainability of training outcomes, and whether such differences existed among diverse child and public-serving delivery sectors. Several training outcomes that align with the Theory of Planned Behavior (Ajzen, 1991) were examined, including confidence, attitudes, social norms, and suicide prevention behaviors. Measures were assessed prior to and 90 days after the QPR program among a sample of 858 professionals. Community support personnel uniquely showed improvements on social norms while juvenile justice and child welfare workers engaged in more suicide prevention behaviors post training. While trainees across sectors had improved suicide prevention attitudes, law enforcement personnel were the exception. Organizational climate predicted change in suicide prevention attitudes, confidence, and social norms. Trainees who were older, Latinx, and Black had the most improvement on several training outcome variables, but these findings also varied within service sectors.

There is a noticeable absence of scholarship on student-on-student bullying at institutes of higher education in the Caribbean. As a result, this study investigated the phenomenon at a national university in Trinidad and Tobago using a phenomenological case study approach to gather data via semi-structured interviews from five undergraduate and graduate students and a within-case analysis conducted. Thematic analyses revealed nine themes (loneliness, fear, intimidation, low self-esteem, embarrassment, power imbalance, lack of immediate action/indifference, harassment, and quitting). The findings indicated that bullied students feared attending lectures, felt intimidated, disheartened, depressed, anxious, disenchanted, disillusioned, had trouble concentrating on their course of study and had suicidal ideations. These findings inform understandings of student bullying at institutes of higher education and how Caribbean universities can better support students who experience student-on-student bullying on campus. This study has the potential to advance knowledge and improve policy and practice in higher education in the region.

Objective: This study examined joint trends over time in associations between substance use (heavy drinking, cannabis, and cigarette smoking) and mental health concerns (depression, anxiety, and suicidal ideation) among US post-secondary students. Participants: Data came from 323,896 students participating in the Healthy Minds Study from 2009 to 2019, a national cross-sectional survey of US post-secondary students. Weighted two-level logistic regression models with a time by substance interaction term were used to predict mental health status. Results: Use of each substance was associated with a greater odds of students endorsing depression, anxiety, and suicidal ideation. Over time, the association with mental health concerns strengthened substantially for cannabis, modestly for heavy drinking, and remained stable for smoking. Conclusion: Given co-occurrence is common and increasing among post-secondary students, college and university health systems should prioritize early identification, psychoeducation, harm-reduction, and brief interventions to support students at risk.

In recent years, the rates of children and adolescents hospitalized for suicidal thoughts and behaviors have increased, necessitating that schools be prepared to support students as they return to school after hospitalization. Yet, recent research shows that most schools do not have formalized policies and procedures to support students during their re-entry and reintegration. Further, although school counselors are often the members of the school community charged with organizing and implementing accommodations and interventions in support of these students, the field of school counseling has not adequately addressed the need for formalized re-entry and reintegration plans or the role that school counselors have in leading this process. To meet the needs of students returning after hospitalization for suicidal thoughts and behaviors, schools benefit from formalized and individualized re-entry and reintegration plans that are grounded in a larger framework of support. Further, school counselors are well positioned to take a leadership role in this process, and specific and practical strategies are available to guide them. We organize these recommendations using the evidence-based school counseling model.

This study seeks to understand the reality and psychological difficulties faced by university graduates in Wuhan after the COVID-19 epidemic was controlled. Methods: A total of 6,417 graduate students were surveyed through an online questionnaire from late May to early June 2020. The questionnaire asked questions on depression, anxiety, insomnia, and suicidal behavior. In addition, self-administered epidemic-related questionnaires consisting of eight items were collected from university graduates. Results: Participants' positive detection rates for depression, anxiety, insomnia, and suicidal behavior are 13.4%, 8.3%, 4.4%, and 12.1%, respectively. The three biggest challenges faced by graduates are future development, economic difficulties, and employment problems. Conclusion: The detectable rate of depression, anxiety, and insomnia is low, and the detectable rate of suicide symptoms should be given more attention. The biggest problem of this group is their future development, and what they want to solve the most is the economic difficulty.

Purpose: The main objective of this study is to determine the patterns of suicidal ideation among undergraduate students of Obafemi Awolowo University, Ile-Ife, Osun State. Design/methodology/approach: The study examined the pattern of suicidal ideation among undergraduate students of Obafemi Awolowo University, Ile-Ife, Nigeria. The study adopted a survey research design. The study population comprised all the 28,673 undergraduate students of the university out of which 800 students were selected by stratified random sampling for the study. A questionnaire was used in gathering data for this study. Data collected were analysed using descriptive statistics, cluster and factor analyses. The study concluded that the patterns of suicide ideation among undergraduate students of Obafemi Awolowo University are passive. It is recommended that Obafemi Awolowo University students adopt the physical and online counselling services provided by the institution to aid their mental and psychological well-being. Findings: Findings revealed that the prevalence of suicidal ideation among the students was low (89.9%). Result also showed that pattern of suicidal ideation was passive (85.2%). In addition, result showed that social isolation (31.3%), hopelessness (29.4%), disappointment with school result (26.5%) and unmet expectation (12.9%) were possible factors of suicidal ideation among undergraduate students of Obafemi Awolowo University, Ile-Ife, Nigeria. Research limitations/implications: This study only established the patterns of suicidal ideation among students of Obafemi Awolowo University Ile-Ife, without any reference to treatment of students with suicidal ideation. Since the patterns of suicidal ideation had been established, it is suggested that further research be conducted on the treatment and prevention of suicide among the students. Originality/value: The research was conducted by the researchers, and data were adequately collected and prepared following research ethics and guidelines. Results were presented as revealed by the analysis of the data.

Objective: This study examined symptoms of anxiety, depression and suicidality in a national sample of college students. Participants: Using national survey data from the Healthy Minds Study (HMS), a random sample from 184 U.S. campuses from fall 2016 to spring 2019 was analyzed (N = 119,875). Methods: Prevalence rates were examined with the Generalized Anxiety Disorder 7-Item scale, Patient Health Questionnaire-9 and suicidality questions. Relationships between anxiety, depression and suicidality were assessed through Spearman's correlations, the Kruskal-Wallis H test and logistic regressions. Results: Findings revealed that screening only for depression would pick up 23% of suicidal ideation, increasing to 35% when also screening for anxiety. Those with anxiety and no to minimal depression had the second highest likelihood of suicide attempt, following those with anxiety and depression. The symptom "feeling afraid something awful might happen" doubled the odds of suicidal ideation. Conclusions: College campuses may benefit from assessing particular anxiety symptoms in relation to suicide.