School Mental Health Education Rises While Substance Use Prevention Declines in US Schools

TOPLINE:

From 2008 to 2020, US schools reported significant increases in emotional/mental health education (from 83.8% to 89.8%) and suicide prevention programs (from 70.1% to 81.8%), while substance use prevention declined from 94.5% to 88.6%, particularly in middle schools.

METHODOLOGY:

• Analysis included seven cycles (2008-2020) of the School Health Profiles, a cross-sectional, biennial national surveillance system of US middle and high schools (grades 6-12).
• A total of 76,826 schools participated, with 9865-12,387 schools responding annually from 2008 to 2018, achieving 70%-94% response rates per state.
• Researchers utilized systematic, equal-probability sampling with random starts to produce representative samples for each state, with one lead health educator per school completing self-administered questionnaires.
• Data analysis focused on weighted proportions for affirmative responses regarding school programming and teacher professional development in emotional/mental health, suicide prevention, and substance use prevention.

TAKEAWAY:

• According to the researchers, teacher professional development in emotional/mental health increased significantly from 36.1% in 2012 to 67.7% in 2020 (P < .001 for trend).
• The authors reported that suicide prevention training for teachers rose from 29.4% in 2008 to 61.1% in 2020 (P < .001 for trend).
• Middle schools experienced a steeper decline in substance use programming compared to high schools, dropping from 92.5% in 2008 to 83.2% in 2016 (P < .001 for interaction by school level).
• Researchers found that teacher professional development for substance use prevention remained unchanged at 45.3% in 2008 and 46.3% in 2020 (P = .90).

IN PRACTICE:

“Substance use during early adolescence is associated with risk for long-term addiction, and middle schools may be underused for prevention,” wrote the authors of the study.

SOURCE:

The study was led by Chloe Gao, BHSc, Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital in Boston. It was published online on December 12 in JAMA.

LIMITATIONS:

The researchers noted several key limitations, including potentially inaccurate self-reporting, use of prepandemic data, lack of school characteristics, and questions overlooking informal/elective courses. Additionally, the cross-sectional nature of the study meant that the same schools may have been sampled multiple times across years.

DISCLOSURES:

Scott Hadland, MD, MPH, MS, reported receiving grants from the National Institute on Drug Abuse and the Patient-Centered Outcomes Research Institute. No other disclosures were reported.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.