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Conflicts of Interest The authors declare no conflicts of interest. Data Availability Statement The data that support the findings of this study are available from the corresponding author upon reasonable request. Supporting Information Filename Description josh70257-sup-0001-Supinfo.docxWord 2007 document , 196.3 KB Table S1: Standardized path coefficients predicting community-based referrals in the alternative mediation model.
1 Introduction The mental health needs of children and adolescents are a central concern for schools and communities [1, 2]. Schools are often where concerns are first recognized, crises are managed in real time, and referrals are initiated. School nurses have frequent access to students and may notice changes in physical complaints, attendance patterns, affect, or behavior that signal emotional distress [3, 4].
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