Gender-based generalisations in school nurses’ appraisals of and interventions addressing students’ mental health

Abstract

BackgroundThere has been an increase of reports describing mental health problems in adolescents, especially girls. School nurses play an important role in supporting young people with health problems. Few studies have considered how the nurses’ gender norms may influence their discussions.MethodsTo investigate this issue, semi-structured interviews focusing on school nurses’ work with students who have mental health problems were conducted. Transcripts of interviews with Swedish school nurses (n = 15) from the Help overcoming pain early project (HOPE) were analysed using theories on gender as a theoretical framework and then organised into themes related to the school nurses’ provision of contact and intervention. The interviewees were all women, aged between 42–63 years, who had worked as nurses for 13–45 years, and as school nurses for 2–28 years. Five worked in upper secondary schools (for students aged 16–19) and 10 in secondary schools (for students aged 12–16).ResultsThe results show that school nurses more commonly associated mental health problems with girls. When the school nurses discussed students that were difficult to reach, boys in particular were mentioned. However, very few nurses mentioned specific intervention to address students’ mental health problems, and all of the mentioned interventions were focused on girls. Some of the school nurses reported that it was more difficult to initiate a health dialogue with boys, yet none of the nurses had organized interventions for the boys.ConclusionsWe conclude that generalisations can sometimes be analytically helpful, facilitating, for instance, the identification of problems in school nurses’ work methods and interventions. However, the most important conclusion from our research, which applied a design that is not commonly used, is that more varied approaches, as well as a greater awareness of potential gender stereotype pitfalls, are necessary to meet the needs of diverse student groups.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1710-1) contains supplementary material, which is available to authorized users.

Perspectives of students with mental health problems on improving the school environment and practice

“…A previous pilot study, part of a wider interventional project called Help overcoming pain early (HOPE), confirmed previous findings that school nurses can play important roles in countering students' mental health and recurrent pain problems (Rosvall & Nilsson, 2016a, 2016b for similar results see Odenbring, 2019). It also highlighted the importance of nurses collaborating with other school staff, including all teachers (especially those involved in physical education and special needs specialists) and heads.…”

Effectiveness of holistic group health promotion program on educational stress, anxiety, and depression among adolescent girls – A pilot study

“…[9] They are more vulnerable to stress than adolescent boys[10] because of the inherent physiological changes, their social upbringing,[11] and a feeling of greater pressure to achieve good academic grades at an early age. [12] Although anxiety and depression affect boys and girls almost similarly, the adolescent girls are much more vulnerable. Recently, subjective stress related mental health complaints such as pain, sleeping problems, and anxiety have increased among older adolescents, especially girls.…”

Development of the Help Overcoming Pain Early (HOPE) Programme Built on a Person-Centred Approach to Support School Nurses in the Care of Adolescents with Chronic Pain—A Feasibility Study

“…One of the initial studies in the development of the HOPE programme reported stereotyped values arising from school nurses’ views of gender [47]. These stereotypes can hinder dialogue with adolescents, which renders an increased awareness of gender perspectives necessary.…”

“…The HOPE programme contains a lecture and a film about gender perspectives for about 35 min. Besides, school nurses read an article that compares the HOPE and DISA programmes [47]. DISA has been criticised for reinforcing the stereotypical notions that girls are depressive and have low self-esteem [63].…”

“…One part in the educational programme was to strengthen the nurses’ knowledge about chronic pain conditions among adolescents and a physician with long experiences of working with adolescents with chronic pain took part in the education programme. Another important field was the gender perspective [47]. The second step was to develop an intervention for adolescents.…”