The Power of Policy

By Liz Thorne

Last week brought two experiences that showed the promise of policy to actualize a positive change to support young people. Suicide is the second leading cause of death among young people aged 15-24. Sexual minority youth are at increased risk of suicide attempts- in 2015 29% of LGB youth in the US attempted suicide in the last year, compared to 6% of their heterosexual counterparts (the Youth Risk Behavior Surveillance Surveydoes not ask about gender-identity).   

Schools are a really important setting to build protective factors against suicide risk, identify struggling students early, and support those who have attempted re-enter school in a safe and supportive way. Cairn Guidance is currently funded by the Oregon Health Authority to support schools to develop and strengthen their protocols around suicide, and connect staff to an excellent online training called Kognito.

What message does it send to young people when their state, their government, tells them their right to love and marry who they choose is the same as everyone else’s? That they are valued. That they belong.

Last week, I sat around a table with representatives from a large school district in Oregon. We were working through an inventory to assess the presence and strength of their school protocols, identifying gaps and action steps to address the gaps. Every professional sitting at that table brought a different perspective to the ways in which students are supported. Strengthening the systems and protocols will have a direct impact on the experience of students in this district who are struggling, and how they can access support they need. But we also questioned: What are the broader, whole school, whole community approaches to creating school environments that are safe where young people feel valued and loved?

That’s where this week’s second policy news comes in. A study published in JAMA Pediatrics this week found that found that state same-sex marriage policies were associated with a 7% reduction in the proportion of all high school students reporting a suicide attempt within the past year. The effect was concentrated among adolescents who were sexual minorities. For gay, lesbian and bisexual students in particular, the decrease was more pronounced. Rates of suicide attempts decreased from 28.5 percent to 24.5 percent (a 14 percent reduction in suicide attempts). There was no change in states that did not legalize same-sex marriage before January 2015. The effect persisted for 2 years after legalization.

While there are limitations to the study, and the exact mechanisms by which legalization impacted risk of suicide attempt, these findings show the power of public policy to effect change on the lives of young people. One hypothesis is that marriage equality laws reduce stigma- an underlying factor. Reducing rates of attempted suicide were not reasons cited for passing marriage equality. But it makes sense. What message does it send to young people when their state, their government, tells them their right to love and marry who they choose is the same as everyone else’s? That they are valued. That they belong.

Having a sense of belonging is a key protective factor for a host of issues, like substance use, mental health issues, and even supports engagement in school. These early findings reinforce that all policies are health policies.