Neighborhood Deprivation and Adolescent Mental Health: The Protective Role of School Staffing Patterns.

Objective: Schools are key for advancing adolescent well-being, yet the role of school-level factors in supporting student mental health in the context of neighborhood deprivation is unknown.

Method: Students (N = 30,469, age: mean = 15.11 years, SD = 1.75 years) in 62 middle and high schools in Massachusetts completed the Substance Use and Risk Factors (SURF) Survey to assess psychiatric symptoms. Neighborhood deprivation was assessed through the census-extracted Area Deprivation Index (ADI). School-level moderators included school staffing patterns (teacher and mental health staff-to-student ratios, teaching staff increases) and characteristics that may support belonging and inclusion (school written commitment to inclusivity, proportion of teachers of shared race/ethnic minority status). Linear mixed models clustered by school examined links between neighborhood deprivation and psychiatric symptoms and tested school moderators, covarying for student age and sex as well as neighborhood density of substance retailers and crime.

Results: Higher neighborhood deprivation related to higher psychiatric symptom endorsement (β values = 0.04-0.08, p_FDR values <.04). Higher mental health staff ratios weakened the associations of neighborhood deprivation with anxiety and depressive symptoms (β [SE] = -0.03 [0.01], p_FDR = .04), suicidal thoughts and behaviors (β [SE] = -0.03[0.01], p_FDR = .04), and substance use (β [SE] = -0.04 [0.02], p_FDR = .04). Interactions were not observed for other school staffing patterns or characteristics supporting belonging and inclusion.

Conclusion: School mental health staffing patterns may represent a modifiable protective factor with the potential to address mental health needs in disadvantaged communities and neighborhood contexts.

Study registration information: School-level protective factors for mental health distress and substance use in youth exposed to systemic neighborhood deprivation; https://osf.io/qkp25.

Diversity & inclusion statement: We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure sex and gender balance in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as living with a disability. One or more of the authors of this paper received support from a program designed to increase minority representation in science. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.