Understanding adolescent mental health symptom progression in school-based settings: The Substance Use and Risk Factors (SURF) longitudinal survey.

Abstract

The adolescent mental health crisis has prompted a need for an improved understanding of developmental trajectories of psychopathology to promote understanding of risk and protective factors and bolster prevention and intervention efforts. The present study describes the Substance Use and Risk Factors Survey, a universal screener of mental health, substance use, and school and contextual factors administered in public middle and high schools in Massachusetts (N₂₀₂₀ = 3,522, N₂₀₂₁ = 6,484, N₂₀₂₂ = 23,915). Using a seven-question linking code approach, a subset of students were longitudinally linked across administrations (N_2020-2022 = 563, 58% female sex, 30.4% minoritized racial/ethnic identity, M_age = 13.2 years; N_2021-2022 = 1,545, 51% female sex, 28.9% minoritized racial identity, M_age = 14.3 years). Linking using minimally invasive questions such as the ones presented here may reduce risk, increase privacy, and offer a low-burden opportunity to link observations across time. This work aims to characterize longitudinal trajectories of mental health including substance use in large, community-based samples, as well as the individual-, school-, and community-level risk and protective factors that may modulate the expression of mental health symptoms over time. (PsycInfo Database Record (c) 2025 APA, all rights reserved).