An Integrative Review of School-Based Mental Health Interventions and Implications for Psychogenic Nonepileptic Seizures

Abstract

Millions of students with mental health concerns attend school each day. It is unknown how many of those students experience psychogenic nonepileptic seizures (PNES); however, quality of life, academic, and mental health outcomes for students experiencing PNES can be bleak. Currently, no authors have addressed potential school nurse interventions for students with PNES. Because PNES is a mental health condition and is often influenced by underlying anxiety and/or depression, an integrative review of school nurse interventions and outcomes for students with general mental health concerns was conducted. An integrative review resulted in the identification of 13 quantitative and 2 qualitative studies that met inclusion criteria. The findings from this review suggest school nurses, following principles from the Framework for 21st Century School Nursing Practice, play an active role in mental health interventions and should be involved in replicating and testing known mental health interventions to investigate their effectiveness for students with PNES.

Functional seizures across the adult lifespan: female sex, delay to diagnosis and disability

“…While FS have reduced incidence above age 50, delay to video-EEG diagnosis is longer for older patients. Together with the evidence of the powerful association of FS with work and school disability from these and other data [68,79,80], we believe that prompt diagnosis is key to reducing suffering and disability and thereby improve overall prognosis and quality of life. Therefore, providers should avoid age-related biases when considering FS and refer for accurate diagnosis early in the patient's course of disease, irrespective of age.…”

“…Similarly, even though many younger patients remained enrolled in school, a larger proportion reported educational disability. Tanner and colleagues recently discussed the many impacts of FS on school performance more than just attendance or enrollment [68]. Therefore, loss of employment or student status should be viewed as an imperfect and indirect marker of the impact of seizures.…”

A School Nurse Competency Framework for Continuing Education

“…Asthma, attention deficit hyperactivity disorder, and severe allergies were the most common health conditions in schools between 2006 and 2016 [ 21 ]. However, the outcomes of school nurse-led practice regarding mental health [ 22 ] and pain have not been satisfactory [ 23 ]. Furthermore, most school nurses have had no formal training in evidence-based practice [ 24 ].…”

A Qualitative Analysis of School Nurses’ Experience Caring for Students With Psychogenic Nonepileptic Events

“…A recent analysis of school-based mental health interventions identified that school nurses have successfully implemented interventions in the school for other mental health concerns. School nurses armed with evidence-based clinical guidelines and improved staffing levels may be in an excellent position to partner with the PNEE treatment team to implement treatment within the school setting (Tanner, Miller, von Gaudecker, & Buelow, 2019).…”