Mental Health Services Provided by Nurses in Schools and Higher Education Institutions in the Post COVID-19 Era: Impeding Factors From a National Online Survey.

Aim (s): To examine competencies, attitudes, barriers and factors that influence the provision of mental health services by nurses in schools and higher education institutions in the post COVID-19 era in Taiwan.

Design: This cross-sectional study used nationwide proportionate stratified random sampling to recruit nurses from K-12 schools and higher education institutions.

Methods: Data were collected through an online survey administered between July and December 2024, with 305 responses received (response rate = 46.4%).

Results: Among the respondents, 55.1% provided advanced mental health services, while 38.3% delivered basic mental health services. The main barriers to the delivery of mental health services were lack of mental health-screening training (63.3%), insufficient brief screening tools (46.2%) and time constraints (42.6%). Nurses in junior and senior high schools were 5.78 and 3.07 times more likely, respectively, to provide advanced mental health services compared to those in universities. Furthermore, significant predictors of the provision of advanced mental health services included working in junior or senior high school, higher competence, and more positive attitudes; perceiving time constraints was a significant barrier.

Conclusion: Working in junior and senior high school settings was the most significant predictor of delivering advanced mental health services. These results underscore the need for targeted professional training, enhanced resources, and inter-professional collaboration to improve the quality of school-based mental health services.

Implications for nursing practice: Enhancing the attitudes and competencies of nurses in schools and higher education institutions towards mental health care is essential. Training should target nurses working in junior and senior high schools. Administrators must improve workflows, provide better tools and address barriers such as time constraints and limited referrals to support students' mental well-being.

Reporting method: This study adhered to the relevant cross-sectional EQUATOR STROBE guidelines.

Patient or public contribution: No Patient or Public Contribution.

Impact: This study examined the barriers to mental health service delivery among nurses in schools and higher education institutions and identified key determinants influencing their provision of such services. Nurses in schools and higher education institutions face challenges in providing mental health services due to a lack of mental health training, insufficient brief screening tools and time constraints. Advanced services were more common in junior and senior high schools, with competence and attitude being key predictors of their delivery.