Participatory adaptation of mental health screening tools for school-aged children: a qualitative study in Slovakia

Mental health difficulties affect many school-aged children worldwide, yet culturally validated tools for early screening remain limited. This study reports the initial phase of adapting mental health screening tools for Slovak schools, focusing on translation, cultural adaptation, and children's perspectives to enhance relevance and comprehension.

Using a research-practice partnership model, we conducted participatory focus group discussions to explore children's understanding of the Me and My Feelings, Student Resilience Survey, and Short Warwick-Edinburgh Mental Wellbeing Scale. Participants (N = 108) from three school levels provided feedback on wording, examples, and formatting, which informed iterative revisions and assessed the acceptability and feasibility of the Slovak versions.

Children struggled with abstract concepts and culturally specific items. Revisions improved linguistic, semantic, and operational equivalence, clarified response formats, and incorporated more relatable examples. Variations in prior experiences with self-report questionnaires, as well as observed challenges in completing items, highlighted the accessibility and feasibility considerations for younger pupils, non-native Slovak speakers, and children with special educational needs.

Participatory methods and research-practice partnerships enhance clarity, cultural relevance, and practical usability of screening tools. These adaptations provide a foundation for subsequent psychometric validation and context-sensitive implementation in Slovakia and similar educational contexts.