TEEN SELF-HARM, CHRONIC SADNESS, AND SCHOOL CONNECTEDNESS

Both chronic sadness and hopelessness can be risk factors for self-harm. Additionally, within the last 10 years, low school connectedness has been identified as a risk factor for self-harm.

Mapping ED visits for self-harm along with chronic sadness/hopelessness and school connectedness begins to show the role that mental health and a student’s environment – including both school and home – has in their decision-making to self-harm and/or commit suicide.

25% OF STUDENTS FEEL CHRONICALLY SAD OR HOPELESS

Consistent with the literature, the maps on the following pages show regions within Orange County where there is alignment between higher frequency of ED visits for self-harm among teens and high chronic sadness and low school connectedness, including certain areas of Westminster, Anaheim, and Lake Forest. In contrast, higher school connectedness and low chronic sadness appears to be associated with low self-harm ED visits, as seen in parts of Irvine, for example. Low chronic sadness was associated with low self-harm ED visits in regions of Newport Beach and north Lake Forest.

Areas of interest emerge that reveal exceptions to these linkages. For example, parts of Rancho Santa Margarita show high levels of school connectedness and low chronic sadness, yet have high numbers of self-harm ED visits among teens.

45% OF STUDENTS DO NOT HAVE A HIGH LEVEL OF SCHOOL CONNECTEDNESS

Regions of the city of Orange have low school connectedness and high chronic sadness, yet low number of self-harm ED visits among teens. Parts of Garden Grove and Brea have reports of high chronic sadness yet low ED visits. A deeper dive into these areas of interest suggests other factors that may influence these outcomes (see next page).

Indicator Definitions

Self-Harm ED Visits: Injuries from self-cutting, self-poisoning (e.g., overdosing on opioid or other medications), as well as other less common mechanisms

Chronic Sadness/Hopelessness: Being so sad or hopeless every day for two weeks or more that they stop doing some usual activities in the previous year

School Connectedness: Being treated fairly, feeling close to people, feeling happy, feeling a part of, and feeling safe at school

E.D. (2014). Correlates of Suicide Attempts among self-injurers: A meta-analysis. Clinical Psychology Review, 34(4), 282-297. Retrieved from https://doi.org/10.1016/j.cpr.2014.03.005. 5 Self Harm ED Visit rates data are from the California Office of Statewide Health Planning and Development (OSHPD) Emergency Department and Patient Discharge Data from years 2012 to 2016. 6 Young, R., Sweeting, H. & Ellaway, A. (2011). Do schools differ in suicide risk? the influence of school and neighbourhood on attempted suicide, suicidal ideation and self-harm among secondary school pupils. BMS Public Health, 11:874. DOI: 10.1186/1471-2458-11-874. 7 The California Healthy Kids Survey (CHKS) is the data source for chronic sadness and school connectedness. CHKS is an anonymous and voluntary survey to measure school health, including school climate, safety and overall wellness. The California Department of Education (CDE) encourages districts serving grades 5-12 to administer the CHKS as part of the California School Climate, Health, and Learning Survey (Cal-SCHLS) System

Recognizing that the relationship among the three selected indicators is complicated, it is important to acknowledge that other indicators or conditions influence how children live, play and go to school. The table presents a subset of the report’s indicators that are potential risk factors for self-harm. A review of these additional factors may help to uncover reasons for why the experiences of children differ across Orange County when it comes to teen self-harm, chronic sadness/hopelessness, and low school connectedness. Readers are encouraged to look at these additional indicators and the extent to which a comparison of the overlay map aligns or does not align with the mapping of these additional indicators.