Predicting School Difficulties for Culturally Diverse Adolescents Referred to Mental Health Treatment Deanna L. Stammer1, Phillip D. Akutsu2, & Arely M. Hurtado1 1Uplift Family Services & 2California State University, Sacramento

introduction Adolescents with mental health disorders Report with school problems (Schulte-Korne, 2016; McLeod et al., 2013) Only 40% graduate (U.S.: 76%) (U.S. Dept. of Education, 2001) Higher drop out rates (14-21 y/o) (National Center for Education Statistics, 2016) Lower life functioning (Forsman et al., 2016) Dropouts: 3.5x more likely to be incarcerated (Sum et al., 2009) 45% were unemployed (MA Dept. Elementary & Secondary Education, 2007) Insufficient income (MA Dept. Elementary & Secondary Education, 2007)

MENTAL HEALTH PROBLEMS School under-achievement Ex: Delinquency, substance use, depression (Humensky et al., 2010; McLeod et al., 2013) Nonattendance Ex: Depression, suicidality, aggression (Humensky et al., 2010; Kearney, 2008) Problem behaviors Ex: Impulsivity/hyperactivity, aggression (Child Mind Institute, 2019)

Strengths and deficits Demographic variables African Americans and Latino adolescents: ↑ Risk (Palardy et al., 2015) Older youth: ↑ Nonattendance (Balfanz et al., 2012; Gottfried, 2013) Adolescent strengths Ex: Resiliency, interpersonal skills, family connections (Sim et al., 2015; Sim et al., 2016) Limitation to past research Integrative approach: multiple variables

Under-achievement, Nonattendance, and Problem Behaviors hypothesEs Predictors of school difficulties for adolescents referred to mental health treatment? Under-achievement, Nonattendance, and Problem Behaviors Positive Negative African Americans and Latinos Males Older Non-English language preference Temporary living situation Higher need for intensive services Higher clinical issues Depression Impulsivity/hyperactivity Delinquent behaviors Substance use Suicide risk Violence to others Aggression Asian and White American Female Younger English language preference Permanent living situation Parental involvement Adolescent strengths

Method Participants (N =1850) 1st admissions (12-19 y/o) in a mental health agency network in CA (2012-2017) Table 1. Mean/Percentage and Standard Deviations for Demographic Variables M or % (SD) Sex: Female 46.4% Age 14.95 (1.68) Living Situation – Permanent 79.5% Language Preference – English 89.9% Ethnicity African American 19.0% Asian American 3.6% Latino 51.8% White American 25.6% Ethnicity breakdown – African American (19%) Asian American (3.6%) Latino (51.9%) White American (25.6%) Is this table necessary if you did not report any ethnic differences? That is, you are just looking at ethnicity as dummy codes, right? And you are not looking at an interaction effect with these demographics, right? So do you want to include a N under the ethnic labels in the table. Should you report the overall N Overall Demographics Sex Female- 46.4% Lang English– 89.9% MHN – 2.42 (1.26) Age 14.95 (1.68) Living situation (permanent) – 79.5% Ethnic – AF (19%) AS (3.6%) L (51.9%) WA (25.6%)

Measures Scales/Measures Child and Adolescent Needs and Strengths (CANS) scale (Lyons, 2009) Range: 0 = Not a problem to 3 = Severe problem Parental Involvement Higher scores: ↑ Involvement Strengths Higher scores: ↑ Adolescent strengths Clinical intake data (e.g., demographic data) Need for more intensive services: 1 = Low to 4 = High

Results: descriptives Table 2. Mean and Standard Deviations for Independent and Dependent Variables Independent variables M SD Need for Intensive Services 2.42 1.26 Depression 1.20 .89 Impulsivity/Hyperactivity .78 .88 Delinquent Behavior .33 .63 Substance Use .16 .45 Suicide risk .04 .64 Violence to others .26 .55 Aggression 1.30 .90 Parental Involvement .70 Adolescent Strengths 1.52 .59 Dependent variables School Under-Achievement 1.38 1.03 School Nonattendance .75 1.01 School Behavioral Problems 1.08 .99

School underachievement Table 3. Multiple Regression Analysis for School Underachievement. B SE B β Sex: Female -.19*** .05 -.09 Age .03* .01 Living Situation: Permanent -.87* .04 -.05 Impulsivity/hyperactivity .17*** .03 .15 Aggression Parental Involvement -.10** -.07 Adolescent Strengths -.42*** -.24 Significance of the model F(21, 1850) = 20.87, p < .001, R2 = .19 *p < .05, **p < .01, ***p < .001

School nonattendance B SE B β Age .11*** .01 .18 Table 4. Multiple Regression Analysis for School Nonattendance B SE B β Age .11*** .01 .18 Need for Intensive Services .06** .02 .07 Delinquent Behavior .30*** .04 .19 Aggression .12*** .03 .10 Parental Involvement -.15*** -.10 Adolescent Strengths -.29*** -.17 Significance of the model F(21, 1850) = 22.35, p < .001, R2 = .20 *p < .05, **p < .01, ***p < .001

School behavioral problems Table 5. Multiple Regression Analysis for School Behavioral Problems. B SE B β Sex: Female -.24*** .04 -.12 Age -.07*** .01 Need for Intensive Services .04* .02 .06 Depression -.05* -.05 Impulsivity/hyperactivity .21*** .03 .18 Delinquent Behavior .13*** .08 Aggression .28*** .25 Parental Involvement -11*** -.08 Adolescent Strengths -.25*** -.15 Significance of the model F(21, 1850) = 45.15, p < .001, R2 = .34 *p < .05, **p < .01, ***p < .001

Discussion Hypotheses: Partially supported Level of school difficulties Low to moderate Strongest predictors Dependent variables M SD School Under-Achievement 1.38 1.03 School Nonattendance .75 1.01 School Behavioral Problems 1.08 .99 Under-Achievement Nonattendance Behavioral Problems Adolescent Strengths (-) (1) Adolescent Strengths (-) (3) Aggression (+) (2) Delinquent Behavior (+) (1) Aggression (+) (1) Impulsivity/Hyperactivity (+) (3) Age (Older) (2) Impulsivity/Hyperactivity (+) (2)

limitations & recommendations Single item scales 1st client episode or multiple episode Recommendations Impulsivity/Hyperactivity and aggression ↑ Impulse control and pro-social behaviors Adolescent strengths Utilize strength-based approach

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