Social prescribing may help young people awaiting mental health care

 

Social prescribing, in which people are connected with arts and exercise activities and other sources of support, may help adolescents waiting for specialist mental health services by improving their resilience, behaviour and relationships with others, according to a new study led by UCL (University College London) researchers.

The study, published in the journal European Child & Adolescent Psychiatry, involved over 550 adolescents aged 11 to 18 who had been referred to children and adolescent mental health services (CAMHS) in England, comparing those who received bespoke social prescribing referrals while waiting for treatment with those who did not.

The research team found that young people who received social prescribing reported improvements in behaviour (including reductions in conduct difficulties), enhanced relationships with others, and increased resilience, including greater confidence in solving problems and higher self-esteem.

As of late 2024, over 350,000 children and young people were waiting for specialist mental health care in England, with average wait times of just under eight months.

Lead author Dr Daniel Hayes (UCL Behavioural Science & Heath) said: "Previous research from our team has shown that many young people and families find waiting for mental health services difficult and often feel they lack support during that period. Our new study suggests that social prescribing may provide a valuable source of support while young people are waiting, helping them strengthen relationships, build resilience and improve day-to-day functioning."

One of the young people in the trial who received social prescribing said: “I think one of the things that has changed is if my mum or someone at school like a teacher asked me about how I’m feeling, I think I’m a lot more open to discussing it. I wasn’t as much before [social prescribing].”  Another participant said their link worker “really helped me get back into social groups and social settings, so I was more comfortable around people”. A third young person said: “It felt like someone was listening, and [my social prescriber] always turned up and actually cared.”

Activities and resources that young people in the study were connected to by their link workers included karate clubs, art classes, Pokemon tournaments, book clubs and nature wandering clubs. Link workers also helped young people plan days out with friends.

Senior author, Professor Daisy Fancourt (UCL Behavioural Science & Heath), noted that the study did not find evidence of changes in symptoms of depression, anxiety or stress over the six-month follow-up period, although this is partly expected. “Social prescribing should not be seen as a substitute for evidence-based psychological treatments. Instead, the findings suggest its value for young people on waiting lists for mental health services is in supporting day-to-day functioning and strengthening protective factors during this high-risk waiting period. Instead of merely ‘waiting’, young people and their families can engage in activities that may help them be more ‘treatment ready’ when they reach the end of the waiting list.”

Amanda Thompson, Children & Young People's Link Worker at Sunderland Counselling Service, said: “One of the aspects I value most about the social prescribing model is its person-centred approach. It focuses on what is important and meaningful to the young person, placing them at the heart of the process.

“I have seen firsthand how this approach gives young people the opportunity to take ownership of their own journey, while recognising and celebrating the achievements they make along the way. It also extends beyond the individual, often having a positive impact on the wider family unit by reducing pressures, strengthening relationships, and creating a more supportive home environment.

“Seeing a young person who may have previously struggled socially begin to engage in clubs or activities, develop hobbies, learn new skills, build friendships, and grow in confidence is incredibly rewarding. What may seem like small steps to others can represent significant achievements and personal progress for a young person.

“Looking back on a young person's journey and recognising how far they have come is one of the most fulfilling aspects of the role.”

The new study follows on from research earlier this year by members of the same team, published in Nature Health, which found that adults referred for social prescribing (including young people) gained “sizable” improvements in wellbeing in the months after initial referral.

That research looked at data from 19,627 people in the UK who had accessed social prescribing (either through a GP or through community referrals) and who had answered questions about their wellbeing. The team found consistent improvements across all the measures they assessed, including a 20% improvement in general mental wellbeing, alongside additional improvements in happiness, life satisfaction, anxiety levels and a sense of life being worthwhile.

In 2023, more than a million people in England alone were referred for social prescribing services by their GP.

The latest Wellbeing While Waiting study was carried out in partnership with 11 NHS child and adolescent mental health trusts in England. The work was funded by the Prudence Trust, with additional support from Wellcome and the Economic and Social Research Council (ESRC).

The adult social prescribing study was funded by the ESRC, supported by the National Academy for Social Prescribing (NASP) and utilised anonymised patient data from Access Elemental, a social prescribing software provider.

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Journal

European Child & Adolescent Psychiatry

DOI

10.1007/s00787-026-03074-8 

A dedicated health course = modestly lower prevalence of adolescent substance use

 

Despite being largely preventable, adolescent substance use remains a major contributor to morbidity and mortality in the US. Recent increases in overdose deaths among youths highlight the urgency of identifying scalable, population-level prevention strategies.^1,2 Because adolescent substance use commonly involves alcohol, nicotine, and cannabis, population-level prevalence of these behaviors is central to prevention.^3,4

Schools represent a near-universal prevention platform. National data show variation in school mental health and substance use education,⁵ and evidence supports targeted approaches such as school-based screening and brief intervention and personality-targeted prevention programs.^6-8 Less is known about whether routine, policy-driven health education delivered through standard coursework is associated with population-level substance use. This gap is important because routine coursework is scalable and institutionalized.

California law requires schools to provide instruction on alcohol, tobacco, nicotine, and other drugs, but does not prescribe the course structure through which this instruction must be delivered. Districts and schools retain flexibility in whether required content is delivered through a dedicated, transcriptable health course or integrated into other coursework. This policy context creates an opportunity to evaluate whether sustained availability of a dedicated health course is associated with lower adolescent substance use prevalence.

The analytic sample in thii study included 1 942 640 student survey responses from 915 public high schools across 345 districts and 3499 school years; mean (SD) grade was 10.1 (1.0), and 942 180 responses (48.5%) were from female students. Sustained availability of a dedicated health course was associated with lower school year prevalence of vaping (−1.36 [95% CI, −2.15 to −0.57] percentage points), marijuana use (−1.22 [95% CI, −1.95 to −0.49] percentage points), alcohol use (−1.11 [95% CI, −1.91 to −0.30] percentage points), and binge drinking (−0.70 [95% CI, −1.17 to −0.24] percentage points). Estimates for drug use, prescription drug misuse, and cigarette smoking were smaller.

Complete study

Parents direct more threats toward school administrators than teachers

 

Study finds verbal aggression against school staff is prevalent but largely unreported

In K-12 schools across the country, administrators are tasked with keeping everyone safe. New research shows they may be the most in need of protection.

In a study published this week in Psychology of Violence, researchers surveyed school personnel prior to the onset of COVID-19, during the height of COVID restrictions and after most restrictions had been lifted, and their findings surprised them: Administrators were more likely than teachers or school mental health professionals to experience verbal and threatening aggression from parents. After restrictions lifted, 77% of administrators reported such experiences, nearly 3.5 times the rate reported by teachers.

The research was led by Eric Anderman, a professor of educational psychology and vice provost for regional campuses at The Ohio State University. He and colleagues have conducted a number of related studies as members of the American Psychological Association (APA)’s Task Force on Violence Against Teachers and School Personnel.

“We didn't fully expect such a pattern to emerge,” Anderman said. “A lot of us went in with an assumption, including me, that it would be mostly the teachers — they’re the ones who have the most direct contact with students every day.”

The data show that parental aggression against school personnel never went away, even during the height of COVID restrictions. When most schools switched to remote learning, 42% of administrators still reported experiencing verbal or threatening aggression from parents, and rates climbed even higher after schools reopened.

For Anderman, the issue is personal. As a high school teacher early in his career, he experienced a verbal threat from a student and didn’t feel supported by his school’s administration. “That always stuck with me,” he said. “Whenever I write about it, it resurfaces.”

Anderman’s research focuses primarily on academic motivation, which is how he became involved with the APA Task Force nearly two decades ago. Past research from the group found that 49% of teachers nationwide considered quitting or transferring jobs as the result of violence and threats made against them, and that violence against teachers is higher in schools that focus on grades and test scores than in schools that emphasize student learning. 

Although school personnel experience physical assaults, the new study focused on verbal aggression and threats, which a 2022 meta-analysis found to be more commonplace in schools. The researchers measured eight specific types, including obscene remarks or gestures, intimidation, identity-based slurs, verbal threats, bullying, public humiliation, cyberbullying and sexual harassment.

After pandemic restrictions were lifted, more than 1 in 4 teachers said a parent had publicly humiliated them, and more than 1 in 4 reported being cyberbullied. For administrators, more than 4 in 10 were verbally threatened, and around 1 in 5 reported being publicly humiliated or cyberbullied.

The scope of the problem becomes clearer when educators are given the opportunity to describe their experiences anonymously. In earlier research, the task force collected around 3,000 written accounts from teachers describing the worst incidents they had experienced.

“The stuff they told us — you can’t make this stuff up,” Anderman said. “People said things like, ‘Thank you for asking. Nobody ever asked.’ It was therapeutic for some of them.”

Despite how common these experiences are, Anderman describes them as a “silent epidemic” because there is currently no national system for tracking or reporting aggression against school personnel, and it receives little media attention. In addition, many educators don’t report incidents for fear of looking weak or incapable of managing their classrooms. This silence has consequences for the quality of education students receive and for the ongoing national teacher shortage.

There’s good news, though. The study found that maintaining positive relationships between parents and school personnel and providing support for teachers, administrators and mental health professionals at the school and community levels all help reduce parental aggression. School level factors, such as strong administrative support and effective disciplinary policies, were associated with less aggression at all three time points, and community-level factors, such as perceived district investment in education, also made a difference.

The researchers recommend implementing tiered systems of support for all school personnel — including classroom, school and community training — to foster a healthier, safer climate for everyone. The study also noted the importance of proactive and positive communication from school employees to parents. This resonated with Anderman, who still remembers the time his ninth-grade Spanish teacher called his mother — not to report a problem, but to say he was doing well in class. “It made my day,” he said. “But it’s the only time I ever remember it happening.”

Kids received mental health treatment in record numbers after pandemic

 

Rise in psychiatric medication prescriptions, especially for girls, among key takeaways of national study

 When schools closed in the spring of 2020 at the onset of the COVID-19 pandemic, the number of children and adolescents receiving mental health treatment in the United States fell by more than half. By 2022, that number had not only rebounded, it exceeded pre-pandemic levels, according to a new national study by researchers from Penn State College of Medicine.

In an analysis of 13 million health records of children and adolescents, available online now ahead of publication in the Journal of the American Academy of Child and Adolescent Psychiatry Open, the researchers found the rise in pediatric mental health treatment patterns was driven largely by new patients versus existing patients seeking more care. Rates of first-time prescriptions for psychiatric medication increased by 35%, outpacing the rise of both first-time psychiatric diagnoses and psychotherapy courses — 24% and 26%, respectively — compared with the years before the pandemic.

The steepest increases were among girls. Antidepressant prescriptions rose 137% among girls ages six to 12 years and 65% among girls ages 13 to 18 years.

“Youth mental health was already worsening before the pandemic, which further accelerated these trends,” said Raman Baweja, professor of psychiatry and behavioral health and of public health sciences at Penn State College of Medicine and the first author on the study. This suggests that the rise in psychiatric treatment for mental health not only followed the pandemic but also a decade-long rise of heightened emotional distress among young people, documented by the Centers for Disease Control and Prevention’s (CDC) Youth Risk Behavior Survey. “But it didn't hit everyone the same. Some groups, girls especially, were affected more.”

According to Baweja, existing research had focused on pediatric mental health trends during 2020. However, much less was known about what happened after schools reopened and daily life returned to normal, or whether increases in mental health treatment reflected more children entering care for the first time or more intensive treatment for those already receiving services.

To parse the two, the researchers tracked cases from October 2018 to December 2022 using the TriNetX U.S. Collaborative Network, which provided a research database of pooled de-identified records from 72 U.S. health systems. Geographically, the sample spanned participating health systems in all four U.S. census regions with roughly 40% of pediatric patients from the South and the rest spread across the Northeast, Midwest and West.

The team analyzed the dataset through two complementary lenses, isolating new patients — children and adolescents receiving a first diagnosis, prescription or therapy after at least a year without a diagnosis or respective treatment — and treatment-engaged patients, defined as those with at least two behavioral health visits within one of the three 17-month phases in the study: pre-pandemic, from October 2018 through February 2020; pandemic, from March 2020 through July 2021; and post-pandemic, from August 2021 through December 2022.

“We evaluated data from patients new to care and those who were already in care, and both showed that adolescent females and antidepressant prescriptions were the driving force of the increase in psychiatric care,” Baweja said. Scaling their sample to reflect the national population size, the researchers estimated roughly 40,000 additional girls began antidepressant treatment after the pandemic.

Among all pediatric patients in the “treatment-engaged” group, most measures of medication use changed only slightly between 2018 and 2022, with antidepressant climbing from 32% to 36% among adolescent girls.

Medications for attention-deficit/hyperactivity disorder (ADHD) showed smaller increases than antidepressants, with a notable exception among the youngest children in the study. Among those ages three to five years, prescriptions for stimulant medications used to treat new ADHD cases rose 147%, although this group started from a lower baseline and remained far below rates in older children.

The CDC recommends parent training in behavior management as the first-line treatment for children with ADHD under the age of six before trying medication, but pandemic-era disruptions may have left families few alternatives, according to Baweja.

He added that the findings reflect patterns of documented diagnoses and treatment among children and adolescents who received care within the healthcare system, rather than the overall prevalence of mental health conditions among youth.

“Many children experiencing mental health challenges never receive a formal diagnosis or treatment,” Baweja said. “Our study captures those who entered the healthcare system, so these trends reflect changes in healthcare utilization as much as changes in mental health needs.”

The study also found that longstanding racial and ethnic disparities in mental healthcare persisted throughout the pandemic and recovery period. Although telehealth expanded access for many families, it did not eliminate inequities in care, according to Baweja.

“There was hope that telehealth would narrow longstanding gaps in access, particularly for underserved communities,” Baweja said. “Access is not the same for everyone. It is influenced by many factors, including internet connectivity, transportation, family resources, cultural beliefs about mental health, and trust in the healthcare system. Continued efforts are needed to ensure that every child has equitable access to timely, evidence-based care versus simply assuming technology creates access for all.”

The study is one step toward understanding changes in pediatric mental health care among children and adolescents who receive treatment, he added. It fits into a larger line of inquiry from the research team examining how mental health is changing not only for children and adolescents but for adults as well.

“Our ongoing research is examining treatment patterns among both children and adults, including how recent changes — such as medication shortages and evolving clinical practices — have influenced treatment patterns, which groups are more or less likely to receive care and whether disparities in access to evidence-based treatment persist,” Baweja said.

There is a need to inform adolescents about the lethal dangers of fentanyl use

 

Fentanyl is involved in at least 75% of adolescent overdose deaths,¹ often because it is added into other drugs such as counterfeit pills. Rates of overdose mortality among adolescents doubled from 2019 to 2020 and have remained elevated since.^1,2 As a result, drug overdoses are now the third leading cause of death among US youth.³ In 2023, an average of 21 US high school–aged youth died of an overdose each week, approximately the size of a typical high school classroom.^1,4

Although public awareness is a central component of current strategies to prevent overdoses,^5-9 the proportion of US adolescents who perceive great risk of harm from fentanyl use is not known. This study addresses this gap by presenting, to our knowledge, the first nationally representative estimates of perceived risk of fentanyl use among US 8th-, 10th-, and 12th-grade students. This information is important to assess whether additional public awareness efforts are needed, and to identify demographic groups that may warrant targeted prevention strategies going forward.

In this cross-sectional survey study of 3820 students in the 8th, 10th, and 12th grades, the majority (52.2%) of 8th-grade students did not attribute great risk to experimental use (1 or 2 times) and 33.5% did not attribute great risk to regular use. These percentages were significantly greater for older adolescents, although in the 12th grade 30.2% did not attribute great risk to experimental use and 15.2% did not attribute great risk to regular use.

Results of this study suggest that there is a need to inform adolescents about the lethal dangers of fentanyl use.

Full study

Resilience training for children who stutter

 For many children who stutter, one of the biggest challenges to overcome is not the stuttering itself. Teasing, bullying and persistent worry about negative social reactions can affect participation at school and in their social life, said Gregory Snyder, associate professor of communication sciences and disorders.

In a study published in the Journal of Fluency Disorders, Snyder and Ole Miss graduate Emily Williams Thornton examined whether a resilience-focused program could address these challenges.

"As a child, I was told, 'If you can't talk fluently, don't talk at all,'" Snyder said. "When children hear messages like that, they can carry them into every speaking situation.

"Instead of focusing on what they want to say, they may begin to constantly monitory their speech, anticipating judgement and deciding whether speaking is worth the risk."

That mentality can make speaking even harder, he said.

"That's where the idea of resilience comes in," he said. "Resilience is not an instruction to accept bullying or to make a child responsible for other people's behavior.

"It gives children practical ways to regulate emotion, respond to unkindness, ask for support, mentor others, and continue participating in school and social life."

Snyder's research has shown that stuttering is a neurological condition that can reveal itself in handwriting, sign language and other nonspoken forms of communication.

Some 3 million adults in the United States stutter, according to the National Institute on Deafness and Other Communication Disorders. Around 5% of children experience a period of stuttering, and about 1% of the population has persistent stuttering, according to the Stuttering Foundation.

"We know from research that these children are reporting higher rates of bullying, teasing and anxiety related to their speech," said Thornton, who graduated in 2024 with a master's degree in communication sciences and disorders. "Then we see the cycle that quickly establishes: If you're made fun of for your speech, then you'll start to overthink or second-guess everything you have to say in public.

"That creates pressure to speak a certain way, which can actually influence how you do speak, and then either you exhaust yourself trying to avoid stuttering or you open yourself up to additional potentially negative attention by speaking and inevitably stuttering."

Over six weeks, Snyder and Thornton led a team that delivered 12 live online sessions to six children ages 8 to 12. The lessons were loosely adapted from a character education video series from resilience educator Brooks Gibbs and addressed coping strategies, emotional regulation, realistic optimism, empathy and self-advocacy.

Gibbs provided the material free to the research team and encouraged them to adapt it to the pilot program.

"His contribution provided a strong, developmentally appropriate foundation," Snyder said. "We were then able to reconstruct the material around the communication situations children who stutter face, including teasing, classroom participation, self-advocacy, knowing when to seek help, and how to help and mentor others."

At the end of the study, more than two-thirds of the students showed clear improvement in resilience. A larger study is needed to verify results, the researchers said.

Resilience work is not about getting a child to hide stuttering or treating peer mistreatment as the child's responsibility," Snyder said. "It's about helping children stay engaged, recognize when they need support and respond to difficult moments with empowerment, self-advocacy and self-respect."

Because the program was delivered through telepractice, the researchers were able to recruit students from Mississippi and across the country. Modeling the program to a digital platform means it can be an accessible addition to speech therapy, Thornton said.

"It seems to be another great tool for the therapeutic toolbox," she said. "Some kids will have no inhibitions about their stuttering and will not care an iota about what peers or anyone else may say to them about it, and for those, they may not have much to gain from this kind of treatment.

"For others, it will matter a lot. The majority of children will probably fall somewhere in the middle of that spectrum. Resilience training may help those in the latter two categories figure out how to navigate life in the classroom and beyond."

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Journal

Journal of Fluency Disorders

DOI

10.1016/j.jfludis.2026.106216 

Youth experiencing educational opportunities at all ages is the ideal scenario

A new study led by a Boston College researcher found that experiencing educational opportunities in all stages of childhood and adolescence is the best predictor of higher educational attainment and earnings for disadvantaged American youth, as opposed to the impact of learning access during any single phase.

The findings, published in the June 30, 2026, issue of Educational Researcher, point to the critical value of educational opportunities for children from low-income households across their formative years, an alternative belief to the widely held viewpoint of the exceptional importance of exposure during early childhood. 

“We found that experiencing educational opportunities in all phases — early childhood, middle childhood, and adolescence— is the ideal scenario,” said Eric Dearing, principal investigator and a professor in Boston College’s Lynch School of Education and Human Development's Counseling, Development & Educational Psychology department. “Experiencing just one educational opportunity in each stage increased a child’s odds of graduating with a four-year degree by more than threefold.”

The researchers utilized the National Institute of Child Health and Human Development’s Study of Early Child Care and Youth Development — a 26-year longitudinal study of educational opportunity — with an exclusive focus on 226 children born into low-income households. They examined this cohort’s educational attainment and earnings at age 26 as a function of when they experienced educational opportunities, observing both the unique predicative power of opportunities accrued within the three developmental stages, and the additive predicative power of opportunities across stages. 

For early childhood, opportunities included living in an enriching home environment, attending a high-quality childcare facility and/or pre-school, or residing in a socioeconomically advantaged neighborhood. For kindergarten through fifth grade, did they receive high quality elementary school instruction, and participate in organized afterschool activities in addition to an enhanced home and neighborhood?  For adolescence, did they experience upward family economic mobility in addition to the other positive factors? 

According to the researchers, educational opportunities in each development stage demonstrated positive and statistically significant associations with achieving education beyond high school.

“Opportunities in early childhood and adolescence predicted increases in the probability of going beyond high school to gain some college education or a two-year degree, and opportunities in both early and middle childhood predicted increases in the probability of completing a four-year degree or more education,” noted Dearing and his co-investigators Henrik Daae Zachrisson, professor of educational sciences at the University of Oslo; and  University of California, Irvine School of Education Associate Professor Andres S. Bustamante, and Chancellor's Professor of Education Emerita Deborah Lowe Vandell. “While less than 50 percent of low-income children who experienced none of these opportunities in any stage was likely to pursue education beyond high school, this percentage was greater than 60 percent for those with just one opportunity during at least one stage.” 

Furthermore, more than 80 percent of disadvantaged children who experienced at least one opportunity in each of the three stages were likely to pursue education beyond high school, with approximately one-third of these children earning a four-year college degree. 

 “These correlational findings are among the first to point to the importance of educational opportunities during each development stage for outcomes in adulthood,” said Dearing, who also serves as the executive director of the Mary E. Walsh School for Thriving Children at Boston College. “We believe these results can help inform the public about what we, as a society, should expect from educational policies that target a single state of development versus strategies that provide more opportunities for disadvantaged children throughout their foundational years.”