From 2008 to 2020, US schools reported significant increases in emotional/mental health education (from 83.8% to 89.8%) and suicide prevention programs (from 70.1% to 81.8%), while substance use prevention declined from 94.5% to 88.6%, particularly in middle schools.

"Substance use during early adolescence is associated with risk for long-term addiction, and middle schools may be underused for prevention," wrote the authors of the study.

The study was led by Chloe Gao, BHSc, Division of Adolescent and Young Adult Medicine, Boston Children's Hospital in Boston. It was published online on December 12 in JAMA.

The researchers noted several key limitations, including potentially inaccurate self-reporting, use of prepandemic data, lack of school characteristics, and questions overlooking informal/elective courses. Additionally, the cross-sectional nature of the study meant that the same schools may have been sampled multiple times across years.

Scott Hadland, MD, MPH, MS, reported receiving grants from the National Institute on Drug Abuse and the Patient-Centered Outcomes Research Institute. No other disclosures were reported.