States are opting out of a federal program that tracks juvenile behavior as youth mental

As the Covid-19 pandemic worsens the mental health crisis among America’s youth, a small group of states has quietly withdrawn from the nation’s largest public effort to track the behavior of high school students.

Colorado, Florida and Idaho will not participate in a key part of the Centers for Disease Control and Prevention’s Youth Risk Behavior Survey, which reaches more than 80,000 students. Over the past 30 years, state-level surveys, conducted anonymously every odd-numbered year, have helped explain mental health stressors and safety risks for high school students.

Each state has its own rationale for opting out, but their withdrawal — when feelings of suicidality and depression rise — has drawn the attention of school psychologists and federal and state health officials.

Some of the questions on the state-level survey — which may also ask students about their sexual orientation, gender identity, sexual activity and drug use — clash with laws passed in conservative states. Intense political attention on teachers and school curricula has led to student reluctance to participate in what was once considered routine mental and behavioral health assessments, some experts worry.

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

“Having this kind of data allows us to say ‘do this, don’t do that’ in a really important way,” said Kathleen Ethier, director of the CDC’s Division of Adolescent and School Health, which oversees the series of health surveys known as Youth Risk. Behavior monitoring system. “Losing the ability for any state to have that data and use that data to understand what’s happening with young people in their state is a huge loss.”

The CDC created the Youth Risk Behavior Surveillance System in 1990 to track the leading causes of death and injury among youth. It consists of a nationally representative poll of students in grades 9 through 12 and individual state and local school district-level questionnaires. Questions focus on behaviors that lead to unintentional injury, violence, sexually transmitted infections, pregnancy, drug and alcohol abuse, physical inactivity, and more.

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

Noreen Dollard, a senior analyst at the Florida Policy Institute, a nonprofit research and advocacy group, said the diversity of data collected makes the survey a powerful tool. “This allows data to be analyzed by subgroups, including LGBTQ+ youth, so that the needs of these students, who are at greater risk of depression, suicide and substance abuse than their peers, can be understood and supported by schools. community providers,” said Dollard, who is also the director of Florida Kids Count, part of a national network of nonprofit programs focused on children in the United States.

The CDC is still processing the 2021 data and has not released the results because of pandemic-related delays, agency spokesman Paul Fulton said. But national survey trends from 2009 to 2019 show that youth mental health has worsened compared to previous decades.

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

Angela Mann, president of the Florida Association of School Psychologists, said the epidemic has exacerbated youth mental health issues.

Nearly half of parents who responded to a recent KFF/CNN mental health survey said the pandemic has had a negative impact on their child’s mental health. Most said they were concerned that issues such as self-harm and loneliness stemming from the epidemic could affect teenagers.

But there are flaws in the CDC’s study, which health officials in some states have said have backed away from it. For example, not all high schools are included. And each state’s sample of students is so small that some state officials say their schools have little actionable data despite decades of participation.

It was in Colorado, which decided not to participate the following year, according to Emily Fine, Colorado Health Department school and youth survey manager. Instead, he said, the state will focus on improving a separate study called Healthy Kids Colorado, which includes questions similar to the CDC survey and Colorado-specific questions. The Colorado survey, which has been running for nearly a decade, covers nearly 100,000 students across the state — about 100 times the number who participated in the CDC’s state-level survey in 2019.

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

Fine said the state-run option is more beneficial because schools get their own results.

In Leadville, a Colorado mountain town, used results from a youth coalition The Healthy Kids Colorado survey concluded that the county had higher than average rates of substance use. They also learned that Hispanic students in particular are not comfortable sharing serious problems such as suicidal thoughts with adults, suggesting that opportunities to identify problems early are being missed.

“I think most of the kids are telling the truth in those surveys, so I think it’s a reliable source,” said high school student Daisy Monge, who is part of the Youth Coalition, which proposed a policy to train adults in the community to better work with young people. connection

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

Florida Department of Education spokeswoman Cassandra Palelis said in an email that Florida intends to assemble a “workgroup” to design its new system.

In recent years, Idaho officials cited CDC survey data when they applied for and received an $11 million grant for a new youth suicide prevention program called the Idaho Lives Project. The data shows that the share of high school students who seriously considered suicide attempts increased from 15% in 2011 to 22% in 2019.

“It’s alarming,” said Eric Studebaker, director of student engagement and safety coordination for the state Department of Education. Still, he said, the state is concerned about taking class time to survey students and crossing the line by asking non-parent-approved questions.

Whatever the rationale, youth mental health advocates call the selection short-sighted and potentially harmful because attrition erodes national data collection. The pandemic has increased 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 Educational Rights Act, which bans instruction about 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 focused on teachers and school curriculum, is having a chilling effect on all age groups, said youth advocates such as Mann, a Florida school psychologist. “Some of this discussion about schools motivating children has bled into discussions about mental health services in schools,” she said.

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

University of Colorado-Denver school psychology professor Francie Crapeau-Hobson said students needing more mental health services, leaving state-level surveys now, could do more harm than good. National Youth Risk Behavior Data for Trend Analysis.

“It’s going to make it harder to get a handle on what’s going on nationally,” he said.

KHN Colorado correspondent Rae Ellen Bichel contributed to this report.

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