Social
Public health consequences of the mass criminalization of adolescence: Does school discipline mediate the relationship between community policing and adolescent psychiatric hospitalization? Seth Prins* Seth Prins Megan Marziali Erin Annunziato Krish Bhatt
Background. The school-to-prison pipeline describes a set of policies and practices that discipline and punish adolescents rather than provide support for their underlying educational and developmental needs. Over 10 million students in the US attend schools with police but no counselor, nurse, psychologist, or social worker. Since the 1990s, suspensions and expulsions have doubled, and school-based arrests have increased 300-500%. The school-to-prison pipeline parallels wider trends in policing and punishment, in which schools’ surrounding communities experienced rises in aggressive policing. Yet, the pathway from community policing to school discipline to adolescent mental health outcomes remains underexplored.
Methods. To determine whether this pathway exists in New York City, we aggregated (by Zip Code Tabulation Area and month) policing incidents from New York City Open Data, school discipline incidents from the Civil Rights Data Collection, and adolescent psychiatric hospitalizations from New York’s Statewide Planning and Research Cooperative System (SPARCS), from 2006 – 2014. We employed the parametric mediational g-formula approach to estimate randomized analogues of natural direct (rNDE) and indirect effects (rNIE) for various hypothetical interventions to reduce school discipline, in the presence of exposure-induced mediator-outcome confounding, a potential issue in this setting. Confounders of exposure-outcome, exposure-mediator, and -mediator-outcome relationships included zip-code-level measures of poverty, unemployment, educational attainment, percentage of residents self-identifying as Black, percentage of the population below 24 years of age, and mean distance to inpatient hospital services.
Preliminary results. A total of 11,900,192 policing incidents, 225,682 school discipline incidents, and 2,118,481 person-days of hospitalization were aggregated to 19,440 ZCTA-months. After adjusting for neighborhood-level sociodemographic characteristic, an increase in one policing incident per 1,000 residents was associated with a 0.3% increase in the rate of youth psychiatric hospitalization time (IRR 1.003 [1.001 – 1.005]). Results from the mediation analysis are forthcoming.
Conclusions. If we find that school discipline mediates the relationship between policing and adolescent psychiatric hospitalizations at the zip code level, our study will be among the first to demonstrate a concrete pathway from the mass criminalization of adolescence and adolescent mental health. The study will bolster efforts to modify school discipline policies to reduce adolescent criminalization and improve adolescent mental health.