Rebecka Persson

Background
Adolescent mental health has declined internationally, prompting increased investment in school-based services. However, whether such investments benefit all students equally remains unclear. We examined whether municipal spending on school mental health services is differentially associated with dual-factor mental health profiles, which distinguish psychiatric symptoms from subjective well-being, among Swedish adolescents.

Methods
Data were drawn from Stockholmsenkäten (the Stockholm Survey), a biennial population-based survey of 9th-grade students (approximately 15 years) in Region Stockholm, Sweden. The analytic sample comprised 63 190 students across 26 municipalities surveyed between 2006 and 2024. Latent profile analysis identified four mental health profiles based on psychiatric symptoms and school well-being: Complete Mental Health, Troubled (high symptoms, low well-being), Vulnerable (low symptoms, low well-being), and Symptomatic but Content (high symptoms, adequate well-being). Municipal spending on school health services (per student, lagged two years) was decomposed into within-municipality (year-to-year change) and between-municipality (stable differences) components. Multilevel multinomial logistic regression estimated associations between spending and profile membership, controlling for gender and secular trends.

Results
Complete Mental Health declined from 55.6% (2006) to 45.4% (2024), while the Troubled profile more than doubled (3.4% to 7.2%). The Vulnerable profile remained stable at approximately 17%. Within-municipality spending increases were associated with 16% lower odds of the Troubled profile (OR = 0.84, 95% CI 0.73–0.95, p = .007) but showed no significant association with the Vulnerable profile (OR = 1.08, 95% CI 0.99–1.17, p = .084). Spending was associated with 9% higher odds of the Symptomatic but Content profile (OR = 1.09, 95% CI 1.01–1.17, p = .026), possibly reflecting transitions from Troubled to Symptomatic.

Conclusions
Increased investment in school mental health services appears protective for students with visible psychiatric symptoms but does not reach those whose struggles manifest as low well-being without psychiatric symptoms. From a precision public health perspective, current service models may require reorientation to identify and support the Vulnerable subgroup, who comprise one in six adolescents and remain unaffected by spending increases.

Från hela landet rapporteras nedskärningar inom förskola, skola, gymnasium, fritidshem och vuxenutbildning. Media har under det gångna halvåret rapporterat att besparingar på skolan görs genom till exempel nedskärningar av elevassistenter, kuratorer och andra kringfunktioner. I rapporten ”Döden för svenska skolan” av Sveriges Lärare uppger 62% av de intervjuade att det genomförs nedskärningar på deras skola. I Sveriges Skolledares undersökning ”Stora skolledarenkäten 2023” angav 64% av rektorerna i grundskolan att de tvingas till besparingar som påverkar elevernas möjligheter att nå målen, och bara 7% av rektorerna i utsatta områden anser att huvudmannen anslår tillräckliga resurser till elever i behov av extra anpassningar och särskilt stöd.

Past studies have found that people tend to distance themselves from outgroup partisans and from policies suggested by outgroup politicians. The current research demonstrates that people indirectly distance themselves even from completely neutral and apolitical consumer products that have been “contaminated” by being preferred by the political outgroup. Using representative samples of Swedish adults, we investigated how aesthetic judgments of clothes (Study 1), evaluations of chocolate bars (Study 2), and allocations to charitable organizations (Study 3) were influenced by the introduction of an irrelevant association between these products and the leader or supporters of the participants’ least- or most-liked party. Products liked by the least-liked party became less attractive in all three studies, and products liked by the most-liked party became more attractive in two studies, indicating that there were both outgroup and ingroup effects. Traditional measures of affective polarization predicted distancing of politically associated products. The ingroup effect was stronger among rightist than among leftist participants in Study 1, but there were no clear ideological asymmetries in the other studies.

Skalor från två svenska skolmyndigheter, som använts för att mäta rektorers pedagogiska ledarskap, undersöktes i syfte att utvärdera reliabilitet och validitet. Skalorna kommer från Skolverket och Skolinspektionen och har använts för självskattningar på Rektorsprogrammet respektive för lärares skattningar av rektorers ledarskap i Skolenkäten. Med data både från Rektorsprogrammet och från Skolenkäten, samt en ny datainsamling där alla skalor användes tillsammans, hittades stöd för att skalorna uppfyller konventionella krav om reliabilitet och validitet. Det innefattar att skalorna verkar mäta samma sak, har tillräckligt god precision och extern validitet i relation till läraromsättning. Skalorna bedömdes vara användbara både i praktisk verksamhet och i forskning, vilket dock villkoras av att hänsyn tas till att mätningar om rektors pedagogiska ledarskap beträffar två analysnivåer; lärare och skolor.