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Abstract
Mental health challenges continue to be a major concern for children and adolescents. In 2016, over 7 million (16.5%) youth between the ages of 6-17 experienced a mental health disorder (National Alliance on Mental Illness [NAMI], 2021). More concerning, the prevalence rate of suicide among Black youth has increased exponentially over the past two decades (Emergency Taskforce on Black Youth Suicide and Mental Health, 2019; Lindsey et al., 2013). While school mental health services are praised for meeting the mental and behavioral health needs of students, less is known about factors impacting access and utilization of school mental health services and the increasing rate of suicide within the Black youth community in addition to the variability in utilization rates indicates a need for an exploration of barriers and facilitators to accessing and utilizing school mental health services. Despite recognition and documentation in research on the importance of peer relationships and the repeated calls to leverage those relationships to facilitate access and utilization of school mental health services few peer-to-peer intervention programs targeting accessing and utilizing school mental health services exist.
The current studies explored the barriers and facilitators to accessing school mental health services for Black youth, the importance of peer relationships within the context of school mental health for Black middle school youth, and the desirability, feasibility, and required components of a peer-to-peer medicated intervention program to expand the reach of school mental health services. Black middle school youth (n = 20) completed the Strengths and Difficulties Questionnaire and additional surveys examining their level of knowledge of school mental health providers in addition to their peer relationships and mental health. Black youth and school mental health providers (n = 6) also participated in focus group discussions and interviews.
Black youth primarily knew their school counselor and students in the eighth grade reported higher levels of overall stress compared to 6th and 7th graders. More than half of Black youth scored within the high or very high range on the peer relationships scale, suggesting peer relationship problems. Across studies, Black youth and school mental health providers discussed positive adult-student relationships as key factors in accessing and utilizing school mental health services. Additional qualitative findings for studies 1 and 2 are discussed in more detail in each study.