Mental health research findings demonstrate greater prevalence of disorders among adolescents than either children or adults (National Institutes of Mental Health, 2015a; National Institutes of Mental Health, 2015b). In fact, the National Comorbidity Study Adolescent Supplement (NCS-A) reported that 21.4% of 13-18 year olds have had or currently have a severe psychiatric disorder, while 46.3% will experience one at some point in their lives (Merikangas et al., 2010). Mental disorders are especially prevalent among low-income and urban adolescents due to environmental stressors stemming from poverty (Byck, Bolland, Dick, Ashbeck, Mustanski, 2013; Rasmussen, Aber, & Bhana, 2004; Sareen, Afifi, McMillan, & Asmundson, 2011). Of all students in the United States, over ten million require mental health intervention with over 70% relying on public schools as the location to receive care (National Center for Health Statistics, 2011). However, it is posited that mental health concerns in urban schools are not treated with high priority and resources for such concerns are lacking (Atkins et al., 2015). These findings capture the importance of school mental health services for all students, but especially for those in the urban setting where mental disorders are more prevalent.
Due to the pervasiveness of psychosocial issues for urban students, the term urban hassles was coined in the development of the Urban Hassles Index to identify a wide range of daily stressors germane to urban communities (UHI; Miller & Townsend, 2005). These stressors range from minor, irritating events such as nosy neighbors or dirty bus stops to more serious circumstances, like feeling pressured to join a gang or hearing gunshots at night (2005). In developing the UHI, Miller and Townsend (2005) examined the effects of urban hassles on several mental health issues such as depression, anxiety, and post-traumatic stress disorder, finding that higher UHI scores correlate with poorer psychosocial outcomes. Due to evident ties between urban hassles and psychosocial issues, and due to the schools' foremost role in providing mental health services, further investigation of stressors in the urban school system is vital. By understanding the implications of urban hassles on mental health, practitioners may adopt new contextual perspectives when intervening. In addition, this knowledge will support the tailoring of interventions to urban students with differing stressors and levels of psychosocial need.
Urban hassles - commonly referred to as urban stressors - consist of struggles "germane to adolescents living in urban environments" (Miller, Webster, & MacIntosh, 2002, p. 305). Some of the experiences associated with urban hassles include, but are not limited to, gang violence, drug trafficking, discrimination, and poor housing conditions. Urban hassles such as these manifest as frequent, daily stressors that accumulate to play a strong role in learning outcomes as well as social and emotional functioning (Fergusson & Woodward, 2002; Miller & Townsend, 2005). In fact, daily hassles are thought to be a better indicator of stress than major life events, which tell us little about the accumulation of stress that lead to major life events (2005). This accumulation of stress translates into significant disadvantages for urban youth who transition into adulthood, impacting overall life satisfaction (Burger & Samuel, 2017). Thus, it has become increasingly important to identify urban hassles, particularly for at-risk youth who are more susceptible to adverse life outcomes. Once identified, urban hassles can provide contextual information about co-existing psychosocial barriers prevalent among urban high school students which may hinder academic performance (Miller & Townsend, 2005).
Psychosocial needs are typically assessed to determine the state of social, emotional, and psychological functioning within a given community with intention to potentially address those needs. An individual's interaction with his or her environment predicts psychosocial well-being, and negative interactions like urban hassles have the ability to produce poor outcomes and complications. Psychosocial complications prevalent among urban high school students have been examined in many cases, including varying elements of psychological functioning - some exhibiting a broader definition, and some more myopic in nature than others. Several examples of psychosocial issues disseminated in past studies include internalized issues such as: hope (Harley, 2015), self-esteem (Guo et al., 2015), resiliency (Saulsberry et al., 2012), and simply stress (Dariotis et al., 2016), whereas external symptoms such as aggression and delinquency have been investigated as well (Katz, Esparza, Carter, Grant, & Meyerson, 2012). Moreover, studies connecting psychosocial issues to high school dropout (Rasmussen et al., 2004) are consistent with scholarship that find urban hassles predict poor educational trajectory (Fergusson & Woodward, 2002).
While the relations between urban stressors and mental health are well studied using a wide range of methodologies, the authors are unaware of research that has utilized school-wide needs assessments to investigate urban hassles and psychosocial issues for urban high schoolers by severity of psychosocial need. Thus, the present study aims to 1) examine relationships between urban hassles and frequency of psychosocial need and 2) identify differences in urban hassles for urban adolescents by level, or by severity of psychosocial need through the means of a school-wide needs assessment containing the Urban Hassles Index (UHI; Miller & Townsend, 2005) and a Frequency of Psychosocial Needs self-assessment. Using a school-wide needs assessment as a data collection tool elicits the responses of urban students while producing results relevant to both urban high schoolers and practitioners.
This study uses a dataset compiled from survey responses collected during a school-wide needs assessment conducted during the 2014-2015 school year at an urban Midwestern high school. Led and facilitated by the school counselor, school social workers, and teachers, the needs assessment was a one-shot survey administered during the daily school-wide study hall period. The survey was inputted into the Survey Monkey website and every student present that day was provided with school-issued iPads to complete the survey. The survey took approximately 15-20 minutes to complete. The data is owned by the school district, who contacted the research team to assist in analysis.
While we, the research team, provided some consultation in regards to measures, response options, and obtaining permission for using certain measures on behalf of the school prior to survey administration, the school and its faculty and staff created the final survey and administered it. We only became directly involved with this project during analysis. As such, we obtained institutional review board approval to analyze the de-identified dataset we received. The dataset included 256 fields, including demographic information and questions on perceptions of school climate, urban hassles, hope, and a checklist of mental health and physical needs. The dataset was originally in MS Excel and was exported to the SPSS (v. 22) software for analyses.
Urban Hassles. The Urban Hassle Index (UHI) has been validated in several studies in the literature (Miller & Townsend, 2005; Bennett & Miller, 2006). The measure is a 32-item questionnaire that asks children and youth how often they encounter a given hassle. For example, respondents are asked to report how often they have been "Asked for money by drug addicts," "Taken a longer way to school/work to avoid trouble," and "Nervous about gunshots at night." The scale was originally on a four-point Likert-scale, but to add some variability in the responses, the UHI was expanded to a five-point scale ranging from "Never" to "Very Often" in this study. While the UHI has shown promise in reliability and validity, previous validation studies tested and confirmed different factor structures. This made it difficult to analyze relationships with aggregated hassles or hassle types; therefore, we analyzed each hassle individually because the items still met criterion for face and content validity in previous studies.
Frequency of Psychosocial Needs. A section of...