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States pull out of federal teen inquiry even as youth mental health deteriorates

As the COVID-19 pandemic has worsened mental health crisis among young americansa small group of states have quietly withdrawn from the nation’s largest public effort to track concerning behaviors of high school students.

Colorado, Florida and Idaho will not participate in a key part of the Centers for Disease Control and Prevention program Youth Risk Behavior Surveys that affect more than 80,000 students. For the past 30 years, state-level surveys, conducted anonymously in every odd-numbered year, have helped elucidate mental health stressors and safety risks for high school students.

Each state has its own rationale for pulling out, but their pullout — when suicides and feelings of hopelessness are on the rise — has caught the attention of school psychologists and federal and state health officials.

Some questions in state-level surveys — which may also ask students about their sexual orientation, gender identity, sexual activity and drug use — conflict with laws passed in conservative states. The intense political attention on teachers and school curricula has led to a reluctance by educators to engage students in what were once considered routine mental and behavioral health assessments, some experts worry.

Reducing the number of states participating in the CDC’s state-level survey will make it harder for those states to track conditions and behaviors that signal poor mental health, such as depression, drug abuse and alcohol and suicidal ideation, experts said.

“Having this kind of data allows us to say ‘do this, not that’ in a very important way,” said Kathleen Ethier, director of the CDC’s Division of Adolescent and School Health, which is overseeing the series of surveys. on health known as the Youth Risk Behavioral Surveillance System. “For any state to lose the ability to have that data and use it to understand what’s happening with young people in their state is a huge loss.”

The CDC developed the Youth Risk Behavior Surveillance System in 1990 to track the leading causes of death and injury among young people. It is comprised of a nationally representative survey of students in grades nine through 12 and separate questionnaires at the state and local school district levels. The focus on issues on behaviors that lead to unintentional injuries, violence, sexually transmitted infections, pregnancy, drug and alcohol abuse, physical inactivity, etc.

Decisions by Colorado, Florida, and Idaho not to participate in state-level questionnaires will not affect the CDC’s national survey or local school district surveys in states that have them.

Part of what makes the survey a powerful tool is the diversity of information collected, said Norín Dollard, senior analyst at the Florida Policy Institute, a nonprofit research and advocacy group. “It allows for the analysis of data by subgroups, including LGBTQ+ youth, so that the needs of these students, who are at higher risk for depression, suicide and substance abuse than their peers, are understood and can be addressed. supported by schools and community providers,” said Dollard, who is also director of Florida kids matterwhich is part of a nationwide network of child-focused nonprofit programs in the United States.

The CDC is still processing the 2021 data and has not released the results due to pandemic-related delays, said agency spokesman Paul Fulton. But the trends national surveys from 2009 to 2019 showed that the mental health of young people had deteriorated during the previous decade.

“So we started planning,” Ethier said. “When the pandemic hit, we were able to say, ‘Here are the things you should pay attention to. “”

The pandemic has further exacerbated mental health issues facing young people, said Angela Mann, president of the Florida Association of School Psychologists.

Almost half of the parents who responded to a recent KFF/CNN Mental Health Survey said the pandemic had a negative impact on their child’s mental health. Most said they worried that issues like self-harm and loneliness resulting from the pandemic would affect teens.

But the CDC’s investigation has flaws, said health officials in some states that opted out. Not all secondary schools are included, for example. And each state’s sample of students is so small that some state officials said their schools received little actionable data despite decades of participation.

That was the case in Colorado, which decided not to participate next year, said Emily Fine, school and youth survey manager at the Colorado Department of Health. Instead, she said, the state will focus on improving a separate study called Healthy Kids Colorado, which includes questions similar to those in the CDC survey and questions specific to Colorado. . Colorado’s roughly decade-long survey covers about 100,000 students across the state, nearly 100 times the number of those who participated in the CDC’s statewide survey in 2019. .

Minnesota, Oregon, Washington and Wyoming, which also have their own youth surveys, either never participated or decided to skip the two previous CDC assessments. At least seven states will not participate in the 2023 state-level survey.

Well said state-run option is more beneficial because schools receive their own results.

In Leadville, a mountain town in Colorado, a coalition of young people used the results of the Healthy Kids Colorado survey to conclude that the county had higher than average rates of substance use. They also learned that Hispanic students in particular did not feel comfortable sharing serious issues like suicidal thoughts with adults, suggesting that opportunities to report issues early were being missed.

“I feel like most kids are telling the truth in these surveys, so I feel like it’s a reliable source,” said high school student Daisey Monge, who is part of the youth coalition , who proposed a policy to train adults in the community to improve links with young people.

Education officials in Florida and Idaho said they plan to collect more state-specific data using newly created questionnaires. But neither state has designed a new survey, and it’s unclear what questions will be asked or what data will be collected.

Cassandra Palelis, spokeswoman for the Florida Department of Education, said in an email that Florida intends to form a “task force” to design its new system.

In recent years, Idaho officials cited CDC survey data when requesting and receiving $11 million. in grants for a new youth suicide prevention program called Idaho Lives Project. Data showed that the proportion of high school students who had seriously considered attempting suicide rose from 15% in 2011 to 22% in 2019.

“It’s concerning,” said Eric Studebaker, director of student engagement and safety coordination for the Idaho State Department of Education. Yet, he said, the state is concerned about taking time in class to survey students and overstepping boundaries by asking questions that aren’t approved by parents.

Whatever the justification, youth mental health advocates call the pullout short-sighted and potentially dangerous as the exodus erodes national data collection. The pandemic exacerbated mental health stress for all high school students, especially those who are members of racial or ethnic minority groups and those who identify as LGBTQ.

But since April at least a dozen states have proposed bills that mirror Florida’s Parental Rights in Education Actwhich prohibits the teaching of sexual orientation and gender identity in kindergarten through third grade.

The law, which critics call “Don’t Say Gay”, and the intense political attention it has brought to teachers and school curricula is having a chilling effect on all age groups, youth advocates say like Mann, the school psychologist from Florida. “Some of these discussions of schools indoctrinating children have turned into discussions of mental health services in schools,” she said.

Since the law was passed, some Florida school administrators have “safe space” stickers removed with the rainbow flag indicating support for LGBTQ students. Some teachers have resigned in protest of the law, while others have confusion expressed about what they are allowed to discuss in class.

With data showing students need more mental health services, opting out of state-level investigations now may do more harm than good, said Franci Crepeau-Hobson, professor of school psychology at the University of Colorado-Denver, which used national youth risk behavior data to analyze trends.

“It’s going to make it harder to really understand what’s going on nationally,” she said.

KHN Colorado correspondent Rae Ellen Bichell contributed to this report.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. Along with policy analysis and polling, KHN is one of the three main operating programs of KFF (Kaiser Family Foundation). KFF is an endowed non-profit organization providing information on health issues to the nation.



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