Increasingly, the potential for school mental health programming to enhance the well-being of children and youth is being recognized and realized. When evidence-based practices in mental health promotion and prevention are adopted in a whole school manner, students show positive social emotional and academic benefits. These findings have stimulated a proliferation of mental well-being programming for Canadian schools, with variability across offerings in terms of supporting evidence, costs and ease of implementation. In the absence of coordination and guidance, there has been uneven uptake of high-quality programming, resulting in a patchwork of sometimes competing efforts across our country. In order to build cohesive and sustainable evidence-based programming, intentional, explicit and systematic effort must be afforded to matters of implementation and scale-up. In Canada, School Mental Health ASSIST has been developed to provide leadership, implementation support and embeddable resources to the province of Ontario's 72 school districts, and 5000 schools, with a view to ensuring long-term sustainability of best-in-class school mental health practices. Key elements for uptake and scale-up are described, with an implementation science lens and an emphasis on aspects that are generalizable across jurisdictions.

To assess differences in psychosocial wellbeing between recent orphans and non-orphans, we followed a cohort of 157 school-going orphans and 480 non-orphans ages 9-15 in a context of high HIV/AIDS mortality in South Africa from 2004 to 2007. Several findings were contrary to published evidence to date, as we found no difference between orphans and non-orphans in anxiety/depression symptoms, oppositional behavior, self-esteem, or resilience. Female gender, self-reported poor health, and food insecurity were the most important predictors of children's psychosocial wellbeing. Notably, girls had greater odds of reporting anxiety/depression symptoms than boys, and scored lower on self-esteem and resilience scales. Food insecurity predicted greater anxiety/depression symptoms and lower resilience. Perceived social support was a protective factor, as it was associated with lower odds of anxiety/depression symptoms, lower oppositional scores, and greater self-esteem and resilience. Our findings suggest a need to identify and strengthen psychosocial supports for girls, and for all children in contexts of AIDS-affected and economic adversity.

Evidence-based assessment (EBA) comprises the use of research and theory to select methods and processes that have demonstrated reliability, validity, and clinical usefulness for prescribed populations. EBA can lead to positive clinical change, and recent work has suggested that it is perceived to be useful by school mental health providers. However, virtually nothing is known about student perceptions of assessment use. Semi-structured interviews were conducted with 31 ethnically diverse middle and high school students (71% female) receiving mental health services in school-based health centers. Findings indicated that the majority of students found assessments to be useful, and perceived three primary functions of assessments: structuring the therapy session, increasing students' self-awareness, and improving communication with the provider. Barriers to acceptability were also found for a minority of respondents. Some students found the nature of standardized assessments to be confining, and others expressed that they wanted more feedback from their counselors about their responses. Idiographic assessments demonstrated especially high acceptability in this sample, with students reporting that tracking idiographic outcomes increased self-awareness, spurred problem-solving, and helped them to reach behavioral goals. Implications for school mental health service improvements are discussed.