As a result of the lack of investment by our country in mental health services, schools have, for years, been the de facto providers of mental health supports for kids and youth. When school buildings across the nation were closed with students learning remotely during the last school year, concerns about students’ mental health skyrocketed, and persist even as school buildings reopen. Many families are in need, and the rates of mental health issues have risen higher than they were pre-pandemic. These truths, coupled with the tragedy of youth dying by suicide, have fueled a push for schools to open in person and for surveillance technology to be adopted to “keep students safe”. This narrative was featured in a January New York Times article focused on Clark County, Nevada.
Schools should not have to go it alone.
The problem with the “opening schools will improve mental health” narrative is that it centers schools as the solution to wide spread desperation. While schools play an important role in communities, other sectors — like healthcare and social services — must be part of preventing suicide. It’s not new that politicians and others expect schools to take a lead role on a major societal issue. It’s also not new that some school districts adopt surveillance of youth in the name of providing care and safety for students.
We’ve seen this pattern before. For example, our ineffective national response to school shootings did nothing to reduce school shootings even though violence prevention professionals briefed policy makers on effective strategies. As a result, schools did what they could on their own. For some, this included using a range of surveillance-based strategies such as police officers in schools, cameras, and software to track student internet use and emails.
COVID-19 is a drastically different issue but has a similar impact on schools. At a time when families and students are experiencing catastrophic losses, both human and material, politicians, the media, and others, demand that schools deliver in person learning in order to provide food, childcare, and mental health support. Despite crowding in schools, government guidance stresses that schools need to ensure physical distance. Despite a well-documented digital divide, schools need to assure that students can learn remotely. Despite a lack of mental health services, schools work to identify and address student needs.
Fear, grief, and the push to “open schools”.
The New York Times piece about Clark County Nevada, features the agony of youth suicide, the importance of in-person school, and the supposed benefits of surveillance technology. This article includes reporting about a heart-breaking group of suicides that took place in Clark County in 2020. It also presents the interruption of in school learning as a probable cause of rising rates of youth suicide.
One suicide is too many and members of this community need to, collectively, address youth mental health. With this said, being clear about methodology related to suicide data is important because a central premise of the NYT article is that the rate of suicides increased due to a lack of in-person instruction.
When it comes to suicide and epidemiology the details matter. Because suicide is a relatively rare event, comparing only two years of data can make it seem that the suicide rate has greatly increased or decreased. Dr. Tyler Black wrote an important thread on Twitter about variance and suicide reporting. His comments about the Clark County story reiterate that comparing the number of suicides to just the preceding year of data – as was done in the NYT article – is problematic because it takes more than two years to identify a trend or an outlier.
Unproven surveillance technology is not the solution.
The New York Times story presents surveillance technology as a way to prevent suicides. The product, cited in the article, monitors students’ internet browsers and uses a combination of artificial intelligence and human beings to send alerts to a school official. This is the same technology that grew from a societal unwillingness to adopt evidence-based gun violence prevention strategies coupled with schools being held responsible for stopping massacres. The technology is intended to prevent violence, including suicide, by scanning content (texts, emails, websites) for evidence of bullying, threats, suicidal ideation, or self-harm.
Companies that make this tech cite the number of alerts given to school districts as a measure of success. However, a deeper look reveals that sorting through data generated by this surveillance takes a lot of time, energy, and it does not identify health and safety priorities. In addition, this technology has not been evaluated to determine if it prevents death by suicide.
Privacy professionals, as well as people who work in adolescent health, worry that this technology trains youth to be monitored as adults. While some producers of surveillance technology see this as a benefit, it has far reaching and negative outcomes for adolescent development. Adolescence is a key developmental time when people need to have the freedom to make mistakes and recover.
Youth need social support, and tech can play a role in connecting youth to their peers and to information about their health and well-being. Surveillance can cause people to self-censor— to not explore. This can be the difference between a kid who gets mental health information or not. Conditioning caused by surveillance interrupts free thought and inquisitive action. In a range of ways, surveillance technology can result in a person not exercising their rights and becoming more isolated. This has the potential to dull a young person’s life trajectory.
The impact of network surveillance technology will be felt most by youth that rely on district provided technology. The Pew Research Center collected data in 2020 that shows that 59% of parents with lower incomes who have children in schools that were remote faced tech based obstacles to remote learning. While some school districts have done a great job with supporting students to access the internet with a school computer, students relying on school tech are more likely to be subjected to school network surveillance. This will result in more low income students, as compared to higher income students, being flagged by surveillance technology. This pattern is likely to contribute to surveillance disparities impacting low income students.
Context matters.
Robust suicide prevention efforts require a multi-pronged approach that addresses risks to mental health and access to lethal means. Clark County School District needs to be viewed in the larger context of Las Vegas and of Nevada. The hospitality and gaming industries fuel the Las Vegas economy. In this area, many parents and guardians lost work due to closures in these sectors. Without wages or governmental support, workers in these sectors are at high risk for experiencing hunger, homelessness, and the stress that this deprivation causes.
Another factor that relates to this story is the lethality of and access to firearms in Nevada. Suicides committed with a gun are more likely to be fatal than attempts by other means. Access to firearms increases suicide risk, and Nevada’s firearm death rate ranks 15th out of all 50 states (Alaska ranks 1st with the highest firearm death rate).
Access to lethal means coupled with lack of access to mental health resources creates an environment were people considering suicide have more risk and less help. Mental Health America rates all 50 states and the District of Columbia based on 7 criteria that include prevalence of mental health problems and access to mental health services. Related to youth needs and access Nevada comes in last at 51.
While the rates of suicide in Nevada might not be higher than past years, certainly the Clark County School District does have a group of suicides. Youth mental health needs in Clark County were documented in a 2019 status report of the Clark County Consortium on Mental Health’s 10 Year Strategic Plan. The report included updates on key strategies to support mental health in the region. The Consortium reported “minimal progress” in building the kinds of school community partnerships that would bring support to students that need help.
So what should school leaders do?
- Go to trusted sources that are focused on helping schools address youth suicide in a comprehensive way.
- Seek out respected organizations that promote evidence-based school mental health strategies.
- Take a trauma-informed approach or renew your commitment to trauma informed schools.
- Take every opportunity to provide food assistance to students and families.
- Increase access to the tools and technology needed to support remote learning.
- Be mindful of student data privacy guardrails as more online tools and apps are used.
- Use school buildings to serve students most in need of in-person education.
- Share information from community partners related to mental health support, rental assistance, and other health and social service offerings.
- Promote information from your state about Medicaid enrollment.
- Share information from your local health department and state health department about COVID-19 testing and vaccination opportunities.
- Double down on engaging families.
- Support staff safety and well-being.
- Be wary of organizations or products offering solutions that have not been evaluated.
The public should understand both the tragedy of youth suicide and the effective strategies to reduce the risk of suicide. These strategies include schools, social service providers, healthcare, and public policy – and they do not include surveillance tech leveraged against an entire school population. Narrowing the focus of reporting on suicide, to schools alone, makes for a story that people can quickly understand. However, this narrow story is incomplete, and prevents the development of a shared understanding of how we work together to support children, youth, families, and learning.
Isabelle Barbour is the Director of Truthteller Consulting where she provides leadership and support to public health strategies that forward equity. For a significant part of her over 20 year career, Isabelle worked with youth, educators, and administrators to address critical school health challenges. During her work at the Oregon Health Authority, Isabelle expanded the State’s Coordinated School Health Project by developing and implementing an evidence-based school mental health program for K-12 public schools.
