Perceived School Safety Among Washington State Adolescents: Prevalence Trends and Association with Depressive Symptoms

Abstract

Background: National trends suggest that the prevalence of school safety concerns may be increasing among high school students. Previous studies provide evidence that feeling unsafe in school may be associated with poor mental health, including depression. However, important gaps remain in understanding Washington State-specific prevalence trends in perceived school safety and its association with depressive symptoms. We investigated trends in perceived school safety across time, and by student characteristics, among adolescents in Washington State. We also examined the association of perceived school safety with depressive symptoms among Washington adolescents.Methods: We used Washington State Healthy Youth Survey (HYS) data from 8th, 10th, and 12th graders, collected biennially between 2002-2023, for the current study. Student-reported perceived school safety and depression symptoms were each assessed with a single survey question (yes/no responses). Presence of depression symptoms was based on an affirmative response to the question on feeling sad or hopeless for two weeks or more that interfered with usual activities during the past 12 months. We estimated the prevalence of feeling unsafe in school by grade and survey year overall, and by student-reported sex and racial and ethnic identity. We also fit survey design-adjusted Poisson regression models to estimate unadjusted and adjusted prevalence ratios (aPRs) and corresponding 95% confidence intervals (CIs) relating feeling unsafe in school to depressive symptoms. For survey year 2023, stratified and interaction models were fit to assess potential effect modification of the association by sex assigned at birth, racial and ethnic identity, and sexual and gender diversity (SGD). Results: The total study sample (2002-2023) consisted of 239,566 students (8th grade = 93,224; 10th grade = 84,474; 12th grade = 61,868). The prevalence of feeling unsafe among 8th graders, 10th graders, and 12th graders ranged from 14% (2014) to 20.3% (2002), 14.9% (2010) to 22.5% (2006), and 11.5% (2010) to 19.6% (2018), respectively. Across all years, the prevalence of feeling unsafe was consistently lower among students self-identifying as White non-Hispanic, compared with students identifying as another racial and ethnic identity. Female students experienced a slightly higher prevalence of feeling unsafe between 2018-2023, compared with male students, while male students experienced slightly higher burden prior to 2014. In 2023, feeling unsafe in school was associated with a 1.69-fold (95% CI: 1.51-1.90), 1.53-fold (95% CI: 1.34-1.76), and 1.58-fold (95% CI: 1.34-1.86) higher prevalence of depressive symptoms among 8th, 10th, and 12th graders, respectively. Associations were generally similar among female and male students across grades 10th and 12th (interaction p-values >0.05), but not grade 8th (aPR: 2.39; 95% CI: 1.85-3.08 for males and aPR: 1.50; 95% CI: 1.34-1.69 for females; interaction p-value <0.01). The association between feeling unsafe and depressive symptoms among groups defined by race and ethnicity, across 8th, and 10th grade students were similar (interaction p-values >0.05), while associations seemed to differ for students in 12th grade where associations were positive and statistically significant for all race and ethnicity groups except for Hispanic (aPR=1.32, 95% CI: 0.98-1.78) and Another, NH students (aPR=1.08, 95% CI: 0.76-1.53) (interaction p-value <0.01). Among all grades, SGD status significantly modified the association between feeling unsafe and depressive symptoms (all p-values for interactions <0.01). Associations were consistently stronger among students who identified as not SGD (aPR ranging between 1.85 and 1.93), compared with similar associations among students who identified as SGD (aPR ranging between 1.21 and 1.44). Conclusion: Prevalence of feeling unsafe in school may differ by student identities, with female and non-White students experiencing a disproportionately high burden. Feeling unsafe in school is also associated with depressive symptoms, and this association may differ by sex (8th grade), racial and ethnic identity (12th grade), and SGD status (all three grades). Identifying Washington State-specific trends of perceived school safety and its association with depressive symptoms may help guide school policies, inform the design of future rigorous research, and support the advancement of early intervention strategies to improve school safety and mental health among Washington State adolescents.