Colorado opts out of federal program to survey teen behavior as youth mental health worsens

As the COVID-19 pandemic worsened a mental health crisis among America’s young people, a small group of states quietly withdrew from the nation’s largest public effort to track high school student behavior.

Colorado, Florida and Idaho will not participate in a key portion of the Centers for Disease Control and Prevention’s youth-at-risk behavior surveys, which reach more than 80,000 students. For the past 30 years, the state-level surveys, conducted anonymously every odd year, have helped elucidate the psychological distress and safety risks faced by high school students.

Each state has its own reasons for rejecting it, but their withdrawal — when suicides and feelings of hopelessness surface — has drawn the attention of school psychologists and federal and state health officials.

Some questions in the state-level surveys—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 to teachers and school curricula has led to a reluctance among educators to have students participate in what was once considered routine mental and behavioral health assessments, some experts fear.

Reducing the number of states participating in the CDC state-level survey will make it more difficult for those states to track the conditions and behaviors that indicate poor mental health, such as depression, drug and alcohol abuse, and suicidal thoughts, they said Experts.

“When we have this kind of data, we can say, ‘Do this, not 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 Adolescent Risk behavior monitoring system. “For any state that loses the ability to have this data and use this data to understand what is happening to young people in their state is a tremendous 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 consists of a nationally representative survey of students in grades 9 through 12 and separate questionnaires at the state and local school district levels. Questions focus on behaviors that lead to accidental injury, violence, sexually transmitted infections, pregnancy, drug and alcohol abuse, physical inactivity and more.

The decisions of Colorado, Florida and Idaho not to participate in the state-level surveys will not affect the CDC’s national survey or the local school district surveys in the states in which they are conducted.

Part of what makes the survey a powerful tool is the variety of information it collects, said Norín Dollard, senior analyst at the Florida Policy Institute, a nonprofit research and advocacy group. “It allows data to be analyzed by subgroups, including LGBTQ+ youth, so the needs of these students, who are at higher risk of depression, suicide and substance abuse than their peers, can be understood and supported by schools and community providers” , said Dollard, who is also a 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 data for 2021 and has not released the results because of delays caused by the pandemic, said Paul Fulton, a spokesman for the agency. However, national survey trends from 2009 to 2019 showed that the mental health of young people had deteriorated over the past decade.

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

The pandemic has further exacerbated young people’s mental health problems, 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 had a negative impact on their child’s mental health. Most said they were concerned problems like self-harm and loneliness could affect teenagers due to the pandemic.

However, the CDC’s survey has flaws, said health officials from some states who have withdrawn from it. For example, not all high schools are included. And the sample of students from each state is so small that some state officials said their schools received little actionable data despite decades of participation.

Such was the case in Colorado, which decided not to participate next year, said Emily Fine, director of the school and youth survey at the Colorado Department of Health. Instead, she said, the state will focus on improving a separate study, titled Healthy Kids Colorado, which includes questions similar to those in the CDC survey and questions specific to Colorado. The Colorado survey, which has been running for about a decade, includes about 100,000 students statewide — almost 100 times the number who took part in the CDC’s 2019 state-level survey.

Minnesota, Oregon, Washington and Wyoming, which also 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 option is more beneficial because schools get their own results.

In Leadville, a mountain town in Colorado, a coalition of youth used the results of the Healthy Kids Colorado survey to conclude that the county had a higher than average drug use rate. They also learned that Hispanic students, in particular, were uncomfortable sharing serious issues, such as suicidal thoughts, with adults, suggesting opportunities to report issues early were missed.

“I feel like most kids in these polls are telling the truth, so I think it’s a reliable source,” said high schooler Daisey Monge, who is part of the youth coalition that proposed a policy to educate adults in the Educate the community so they can better connect with youth.

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 not clear what questions will be asked or what data will be collected.

Cassandra Palelis, a spokeswoman for the Florida Department of Education, said in an email that Florida intends to put together a “working group” to design its new system.

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

“This is concerning,” said Eric Studebaker, director of student engagement and safety coordination at the Idaho State Department of Education. Still, he said, the state is concerned that it is taking up class time interviewing students and crossing borders by asking questions that are not parent-approved.

Whatever the rationale, youth mental health advocates call the opt-out myopic and potentially harmful as the exodus undermines national data collection. The pandemic exacerbated mental health stress for all high school students, particularly those from racial or ethnic minorities 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 Act, which bans teaching about sexual orientation and gender identity in kindergarten through third grade.

The law, which critics are calling “Don’t Say Gay,” and the intense political attention it has drawn to teachers and school curriculum, is having a chilling effect on all age groups, said juvenile advocates like Mann, the Florida school psychologist. “Some of these discussions about schools indoctrinating children have morphed into discussions about mental health services in schools,” she said.

Since the law passed, some Florida school administrators have removed “Safe Space” rainbow flag stickers that indicate support for LGBTQ students. Some teachers have resigned in protest at the law, while others have expressed confusion over what they are allowed to discuss in class.

Now, with data showing students need more mental health services, declining the state polls may do more harm than good, said Franci Crepeau-Hobson, a professor of school psychology at the University of Colorado-Denver, who used the national data to report Adolescent risk behaviors to analyze trends.

“That’s going to make it harder to really get a handle on what’s happening nationally,” she said.