Youth Suicide Prevention and Zero-Tolerance School Policies

    A phone call from an old friend saved my life. When he asked if I was ok, I told him I was fine. It took him just three more words to flip the switch that changed everything: “Are you sure?”

    Suddenly, I realized I wasn’t ok. I wanted to die.

    It feels like death by suicide has been holding my hand for a long time, leading me to an end that is irreversible and hard for anyone to understand. Three years after that phone call, I still contend with it regularly.

    Too many adverse childhood experiences have contributed to my poor mental health. My safe harbor from those was my grandfather, who was my hero. I was lost and devastated when smoking took him away from me.

    All of this helps to explain how two causes—mental health and reducing death and disease from smoking—have become central to my life. My dream is to help save other people’s lives in these areas. They are causes that constantly intersect.

    Suicide is the second leading leading cause of death for people aged 10-24. Youth who struggle in school, particularly, are facing increased vulnerability.

    September is Suicide Prevention Month. While middle-aged and older people are heavily impacted, suicide is the second leading leading cause of death for people aged 10-24 in the United States. Suicide rates for this age group increased by 52 percent from 2000-2021. In the US, there are 3,703 suicide attempts by kids in grades 9-12 per day. Of youth who die from suicide, 60 percent were living with depression. Youth who struggle in school, particularly, are facing increased vulnerability.

    In the 2021 US Youth Risk Behavior Survey (YRBS), 42 percent of students reported experiencing persistent sadness or hopelessness, with 22 percent seriously contemplating suicide. Additionally, 18 percent formulated suicide plans and 10 percent attempted suicide.

    As I look in the mirror and think about those numbers, I see the youthful me staring back. I’m painfully aware that the adults in my life thought they were doing the right things to raise a “productive member of society,” but many of their good intentions were the paving stones to Hell. My childhood home had a zero-tolerance mentality. Discipline was doled out quickly, harshly and often violently. I was hurt in ways that are hard to heal from. Those numbers could easily have included me.

    US Surgeon General Vivek Murthy has flagged the mental health crisis among youth. “If we seize this moment, step up for our children and their families in their moment of need, and lead with inclusion, kindness, and respect, we can lay the foundation for a healthier, more resilient, and more fulfilled nation,” reads the introduction of his 2021 advisory.

    I agree with his words. But considering my two causes, I cannot help but notice a stark disconnect with another area of nationwide policy—to which fear-based misinformation spread by the same surgeon general’s office has contributed.

    It’s deeply concerning that we have an unbalanced focus on stopping kids from vaping at almost any cost, while we ignore why they may be vaping.

    The 2021 US National Youth Tobacco Survey shows that over 43 percent of students said they vaped because they felt stressed, anxious or depressed. Although the 2021 YRBS indicates that past 30-day vaping has seen a 45 percent decline since its 2019 peak, youth vaping continues to grab headlines and drive policy. It has frequently been portrayed as a cause of depression—despite evidence that it is better understood as a symptom.

    In reviewing how schools enforce anti-vaping policies and how that affects children, I was left with the impression of many people who may have good intentions but whose efforts cause great harm.

    It’s deeply concerning that we have an unbalanced focus on stopping kids from vaping at almost any cost—never mind that nicotine vapes are a far safer substitute for many kids who may otherwise be predisposed to smoke—while we ignore why they may be vaping.

    Many of our schools have discipline policies rooted in a zero-tolerance strategy akin to the one I was raised with. That approach can inadvertently worsen mental health and foster substance use. Too many schools are focusing on punitive measures instead of emphasizing empathy and education, and vaping, together with other drug use, is often treated like a criminal issue.

    Those zero-tolerance policies entail consequences such as suspension and expulsion. And we know that Black and Brown students are far more likely than white students to be suspended or expelled.

    Instances involving on-campus law enforcement have resulted in kids caught vaping being arrested, tased and beaten.

    Schools across the US are using law enforcement as “resource officers.” Police working on school grounds are often used to deal with non-criminal activities, such as student behavior issues like vaping. Instances involving on-campus law enforcement have resulted in kids caught vaping being arrested, tased and beaten.

    Involving law enforcement in this way exacerbates negative mental health outcomes and increases “student shame, alienation, rejection, and breaking of healthy adult bonds,” as the American Psychological Association has noted. Impacted students are more likely to exhibit antisocial behavior, drop out of school and suffer from depression.

    These actions contribute to a phenomenon known as the school-to-prison pipeline. Students of color and other marginalized youth face higher risks of being ensnared in this pipeline, which pushes them out of the classroom and criminalizes them.

    With the so-called “War on Drugs” and other factors, this has been a disturbing reality since long before kids started vaping. But vaping has become a new funnel into that pipeline.

    There are cases of schools using the police to ticket and fine students. In some cases, students are required to go to court if they’re caught vaping. This means they miss school, and their parents must take the day off from work. Fines and loss of work are detrimental to low-income families. Some school districts send unpaid fines to collection agencies, including those for vaping. These actions can lead to wage garnishments and loss of driving privileges. Additional financial strains on these families can affect the mental health of all family members.

    We must avoid punitive measures that exclude, humiliate and harm mental health.

    Some schools, like those in Texas, mandate alternative education programs for students caught vaping. While these actions aim to protect students’ physical and mental health, their efficacy remains unproven.

    Schools use various methods to determine if children are vaping—methods I don’t recall hearing about when many youth were smoking, with far higher health risks to themselves and others. School staff use security cameras, peer under stall walls, or remove entrance and stall doors to monitor for potential vaping. This amounts to surveillance and denial of privacy, with more mental health implications.

    Reading about several cases of kids being strip-searched at school when staff suspects a student has a vape has been heartbreaking. Strip searches are mostly conducted without parental consent and can have long-lasting traumatic effects on students. The American Bar Association notes that they can cause children to “experience anxiety, depression, loss of concentration, sleep disturbances, difficulty performing in school, phobic reactions, shame, guilt, and other lasting emotional scars.”

    Due to my own traumatic childhood experiences, I find it easy to relate to these kids standing half-naked and shivering as they were being searched. I can feel their humiliation. And while this will make some people uncomfortable to hear, I know that for some of those kids, it feels like a form of “visual rape.”

    The 2023 theme for World Suicide Prevention Day is “Creating Hope Through Action.” Suicide prevention is complex and has many strands, but there are some clear steps we can take.

    One of them is to reassess zero-tolerance school policies and their enforcement. We must ensure that policies prioritize the well-being of students, avoiding punitive measures that exclude, humiliate and harm mental health.



    Photograph via Rawpixel/Public Domain 

    • Skip started smoking when she was 10, and quit through vaping in 2015. She is an enthusiastic tobacco harm reduction advocate. She works as a direct service professional at a group home providing services for people living with disabilities. Skip also lives with a disability and was diagnosed with autism, ADHD and depression in 2020. She is the co-founder and a research volunteer for the Safer Nicotine Wiki. She previously owned a vape shop and served as the research fellow for the Consumer Center of the Taxpayers Protection Alliance. She lives in Minnesota.

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