In new research in the journal Addictive Behaviors, public health researchers find that the prevalence of school discipline and school policing—core elements of the school-to-prison pipeline—predict subsequent school-average levels of substance use and developmental risk.

First author Seth Prins, PhD, a researcher at Columbia University Mailman School of Public Health, and co-authors analyzed 11 years of data from 4,800 schools and more than 4,950,000 students in California. They found that the prevalence of exclusionary school discipline (suspension and expulsion) and school-based police contact predicted higher school levels of binge drinking, drinking, smoking, using cannabis, using other drugs, and violence/harassment. They found also that the prevalence of school discipline also predicted lower levels of reported community support, feeling safe in school, and school support.

“Our findings are surprising to nobody who has been on the front lines of the fight against the mass criminalization of kids, especially in communities that have faced systematic disinvestment in social infrastructure and enormous investments in policing,” says Prins, an assistant professor of epidemiology and sociomedical sciences.

Prins and his co-authors argue that school discipline is not developmentally appropriate or responsive (and may be harmful) to adolescent health and developmental need. Furthermore, they say, heavy investments in school securitization and policing divert resources from school and community supports and services that might address the root causes of student disciplinary and health problems.

According to a report by the ACLU, more than 10 million students attend schools with police but no counselor, nurse, psychologist, or social worker. And 90 percent of students in public schools experience staffing ratios for those positions that fail to meet professional standards.

According to a report by the Substance Abuse Mental Health Services Administration, in 2019, of the 1.1 million adolescents ages 12-17 who needed substance use treatment, only 6 percent received treatment in a specialty facility, and fewer than 1 in 10 adolescents and young adults with a substance use disorder reported any past-year treatment.

Within this context of low treatment access, a 2019 study found that more than a third of adolescents who do access any mental health treatment access it only at school (they are disproportionately Black and low-income).

The latest study by Prins and colleagues builds on a study they published last year finding the schools with students who have higher levels of substance use and depressed feelings have a higher prevalence of school discipline and school-based police contact, and that schools with students who felt less safe in school and reported lower school and community support had a higher prevalence of school discipline. 

“We need to invest in kids, not cops. We need to prevent and treat substance use problems and the conditions that generate them, not criminalize and punish kids’ health,” says Prins.

Study co-authors include Ruth T. Shefner, Sandhya Kajeepet, Charles Branas, and Lisa Metsch at Columbia Mailman School; Mark L.Hatzenbuehler at Harvard University; and Stephen T.Russell at University of Texas, Austin.

Funding for the study was provided by a grant from the National Institute on Drug Abuse (DA045955, DA037801). The authors declare no competing interests.

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By Columbia Mailman School of Public Health

Substance abuse among U.S. adolescents is diminishing, except for an uptick in cannabis and vaping use, according to a new study by researchers at Columbia University Mailman School of Public Health. High levels of free social time, especially with low engagement in structured activities or low supervision, was linked to substance use. The results are published online in the journal Substance Use and Misuse.

Examining data from 536,291 adolescents between 1991 and 2019, a team of researchers suggests that while the reasons for this phenomenon are not entirely clear, they appear to correlate to several social factors. These include increased parental monitoring and decreased partying and dating notable among them.

According to lead author, Noah Kreski, MPH, in the Department of Epidemiology at Columbia Mailman School, several demographic factors seem to correlate to increased substance abuse even today.

“Substance use prevalence decreases across decades were largest for the groups defined by significant paid employment or high levels of social time, either with low engagement in other activities or lower levels of supervision, though these groups had the highest initial prevalence of each variety of substance use,” says Kreski.

Using data from the National Institute on Drug Abuse (NIDA)’s Monitoring the Future survey, the researchers tracked trends in use of cigarettes, alcohol, cannabis, vaping of both nicotine and cannabis, and other substances for school-age students in grades 8 (13-14 years old), 10 (15-16 years old) and 12 (17–18 years old), and cross-referenced these habits against demographic factors such as level of social engagement, participation in structured activities, level of adult supervision, and employment. They further analyzed these patterns across race, sex, parental education, along with other demographics.

Conversely, substance abuse was higher overall in the highly social and highly engaged groups with less supervision. Time at a paid job was also a significant factor in increasing the chances of trying illicit substances.

Cannabis use increased among all groups, but especially among adolescent workers. Nicotine vaping increased the most among the highly social and engaged group that was less supervised, and cannabis vaping increased most among social but disengaged teens.

“Social settings where adolescents interact with peers, at parties, for example, provide opportunities for substance use, especially in the absence of adult supervision,” Kreski says. “These social settings may produce peer pressure for adolescents to engage in substance use in order to fit in.”

This may be particularly true of employed adolescents, who regularly interact with older teens and adults. Employed adolescents often come from lower income brackets and are thus propelled into an early “pseudo-adulthood,” leading them to adopt the habits more typical of people older than they are. Further, cannabis users, in particular, appear to seek out other cannabis users, leading to social circles in which the drug plays a significant role. Vaping was similarly correlated to social influence.

Analyzing the data further, results show:
    • 15 percent of respondents reported any past two-week binge drinking
    • 27 percent drank alcohol in the past month
    • 15 percent of adolescents smoked cigarettes in the past month
    • 13 percent reported any past-month cannabis use
    •  9 percent reported past-month use of other substances
    • 12 percent reported nicotine vaping
    •  6 percent reported cannabis vaping from 2017 onward

In summary, Kreski noted: “Uncovering these links between complex patterns of time use and substance use outcomes could reveal new opportunities for intervention and education of adolescents surrounding substances, helping to promote declines in use. Taken together, while the prevalence of substance use varied drastically between the groups, the trends in substance use tended to be relatively consistent across groups. Further research is now needed to investigate the factors driving these universal trends in adolescent substance use.”

The authors suggest that a variety of peer-led and community-based programs may be effective in diminishing use across a broad spectrum of adolescent demographics. They urge further examination of mental health conditions that may lead to substance abuse.

Co-authors are Magdalena Cerdá, NYU Grossman School of Medicine; Qixuan Chen, Deborah Hasin, Silvia Martins, Pia Mauro, Mark Olfson, and Katherine Keyes, Columbia Mailman School of Public Health.

The study was supported by the National Institute on Drug Abuse (grant DA048853).

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gov.ca.gov | Contributed

The nation is experiencing a mental health crisis. Today, California announced $518.5 million in grants to help provide services and housing options to those with severe mental illness or substance abuse problems, including for those who are living on the streets. The latest funding will help Governor Newsom’s CARE Court proposal, taking a new approach to homelessness and taking stronger action to get people off the streets and into a place where they can get the care they need.

The funding will provide treatment beds for more than 1,000 people at a time, plus behavioral health services for many more. It is part of a $2.2 billion effort to expand mental health housing and services across California, especially for people experiencing homelessness.

The Governor announced the latest grants during a meeting with families who have loved ones dealing with serious mental illness, many of whom have been homeless.

“The crisis on our streets is at a breaking point. Too many Californians are struggling with mental illness and substance abuse, and many of them end up on our streets. We need to change the way we deliver help to those who need it, and these grants are an important step in changing our approach to homelessness and serious mental illness,” Governor Newsom said. “California won’t look away any longer; we’re helping our fellow Californians now. That’s the California Way.”

The Governor’s meeting in Sacramento with members of the National Alliance on Mental Illness (NAMI) included families who are caring for loved ones struggling with behavioral or mental health disorders and could be helped by CARE Court. The Governor heard their stories and talked about the historic actions that California is taking to address this crisis.

CARE Court will provide Californians suffering from untreated schizophrenia spectrum and other psychotic disorders with community-based treatment, services, and housing, and is intended to serve as an upstream intervention for the most severely impaired Californians.

“Governor Newsom has NAMI’s full support in getting CARE Court across the finish line,” said Jessica Cruz, NAMI CA CEO. “We’re here today to show our commitment to providing help, hope and health for those affected by serious mental illness by supporting initiatives like CARE Court which will provide much-needed help to Californians who need it most.”

“CARE Court has the potential to change the lives of thousands of families across the state,” said Harold Turner, Executive Director of NAMI Urban Los Angeles. “Organizations like NAMI urgently need this support so we can quickly begin helping our loved ones who are struggling with untreated mental and behavioral issues.”

The awards announced today are delivered through the Department of Health Care Services’ (DHCS) Behavioral Health Continuum Infrastructure Program (BHCIP) Round 3: Launch Ready grants. In all, $2.2 billion was provided by the Legislature and the Governor to construct, acquire, and expand behavioral health facilities and community- based care options while investing in mobile crisis infrastructure.

Grants were awarded in the following counties:

Alameda County – $18,405,122

El Dorado County – $2,852,182

Humboldt County – $4,170,560

Kern County – $3,138,065

Los Angeles County – $155,172,811

Madera County – $2,035,512

Mendocino County – $7,711,800

Monterey County – $3,558,670

Nevada County – $4,458,799

Orange County – $10,000,000

Placer County – $6,519,015

Riverside County – $103,181,728

Sacramento County – $30,553,889

San Diego County – $30,874,411

San Francisco County – $6,750,000

Santa Barbara County – $2,914,224

Santa Clara County – $54,074,660

Solano County – $14,332,411

Sonoma County – $9,751,915

Stanislaus County – $33,369,900

Yolo County – $12,500,000

Recipients of BHCIP Launch Ready grants include cities, counties, Tribal entities, nonprofits, and for-profit organizations statewide that serve target populations. Additional information on BHCIP Round: 3 Launch Ready awardees is available at BHCIP Grant Award Information.

The next round of funding will include more than $480 million focused on Children and Youth behavioral health issues. Awards will be made this fall. For more information about these grants, as well as other BHCIP rounds of funding, please visit the Improving California’s Infrastructure BHCIP grant information.

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