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Participants provided verbal assent for participation. Parental consent requirements were waived to ensure confidentiality, facilitate access to mental health services, encourage honest disclosures without concern for parental repercussions, and comply with relevant state and federal regulations related to mental health care. Nevertheless, informational sheets detailing study procedures were provided to both youth and their parents. Interested participants received comprehensive consent forms, and research staff were on-site to answer any queries. Minimal risk to participants was anticipated. Information on mental health and substance use support services was offered, and participants were informed they could withdraw at any stage without penalty.","order":1,"name":"Ethics","label":"Ethics Approval and Consent to Participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for Publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflicts of interest\/competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}