{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T12:58:43Z","timestamp":1791291523335,"version":"4.3.0"},"reference-count":36,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of School Health"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>School nurses frequently encounter student mental health concerns, but little is known about how they prioritize mental health responsibilities relative to other nursing duties and local team structures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This Q methodology study examined shared viewpoints about school nurse duties that most support positive student and school outcomes. Seventy nurses from six rural, high\u2010poverty US school districts ranked 25 duties aligned with the National Association of School Nurses framework. Q sorts were analyzed using centroid extraction and Varimax rotation; post\u2010sort comments informed viewpoint interpretation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A three\u2010viewpoint solution explained 71% of the variance, with 52 nurses loading significantly. Viewpoint 1 prioritized suicide\u2010risk response and mental health work as safety responsibilities. Viewpoint 2 emphasized medical expertise and crisis\u2010oriented mental health involvement. Viewpoint 3 prioritized planning and care coordination while ranking direct mental health duties lower.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for School Health Policy, Practice, and Equity<\/jats:title>\n                    <jats:p>Findings support clear role expectations, aligned referral and crisis protocols, appropriate staffing, and targeted professional learning for school nurse participation in mental health teams.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Nurses agreed on core safety duties but differed in how mental health responsibilities fit within routine school nursing practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/josh.70242","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:39:06Z","timestamp":1790689146000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["School Nurses' Perceptions of Mental Health Responsibilities Within School Nursing Practice: A Q Methodology Study"],"prefix":"10.1111","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5229-6390","authenticated-orcid":false,"given":"Travis E.","family":"Lewis","sequence":"first","affiliation":[{"name":"College of Education East Carolina University  Greenville North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9030-2464","authenticated-orcid":false,"given":"Deby E.","family":"Tyndall","sequence":"additional","affiliation":[{"name":"School of Nursing University of North Carolina at Wilmington  Wilmington North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9299-8389","authenticated-orcid":false,"given":"Mitzi C.","family":"Pestaner","sequence":"additional","affiliation":[{"name":"College of Nursing East Carolina University  Greenville North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"Centers for Disease Control and Prevention \u201cYouth Risk Behavior Survey Data Summary & Trends Report: 2011\u20132021 \u201daccessed February 15 2026 https:\/\/www.cdc.gov\/healthyyouth\/data\/yrbs\/pdf\/YRBS_Data\u2010Summary\u2010Trends_Report2023_508.pdf."},{"issue":"4","key":"e_1_2_12_3_1","first-page":"1","article-title":"Deaths: Leading Causes for 2021","volume":"73","author":"Curtin S. 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