Youth Experiences and Needs of a School-Based Mental Health Training: Implications for School Mental Health Services.

School-based mental health training can improve students' help-seeking behaviors, yet young people's voices are often underrepresented in program design and evaluation of these programs. Meaningfully integrating student-identified needs and lived experiences enables school-based mental and behavioral health team members, especially nurses, who are often the first point of contact, to better support youth. This study used a pre-post descriptive design to assess the implementation of Teen Mental Health First Aid (tMHFA) in schools that had not previously adopted tMHFA. Post-training findings indicated significant positive changes in culturally and linguistically diverse students. Focus groups with students ages 15-18 years revealed four key themes. Students strongly advocated for the widespread incorporation of tMHFA into schools, emphasizing the need to make the training more accessible. Additionally, students' comfort in seeking help was greatly influenced by adults' attitudes toward mental health concerns, their cultural awareness, and broader systemic barriers. Findings underscore the potential for school nurses to expand their roles in alignment with the National Association of School Nurses School Nursing Practice Framework, advocating for tMHFA integration into health education curricula, promoting culturally responsive approaches, and strengthening equitable, sustainable pathways to mental health support.