How Oregon laws tackle teen mental health and suicide risk

Cora Breuner, MD, MPH, FAAP

Sometimes, it’s not just the body that needs a break. Recognizing that students often face mental health challenges that can make learning difficult and can take time to address, Oregon leaders enacted a new law that allows students to take up to 5 excused absences in a 3-month period for mental health reasons.

“It is important for adolescents to have a voice for their mental health needs and to make sure that they get the help they need before it is a crisis,” says Cora Breuner, MD, MPH, FAAP, professor of pediatrics in the adolescent medicine division and adjunct professor pediatrics in the department of orthopedics and sports medicine at the University of Washington in Seattle. Breuner also serves as a member of the forum management committee at the American Academy of Pediatrics (AAP).

Breuner says this new law is extremely important. “It prioritizes the mental health needs of a community that desperately needs them now,” she says.

The new law took effect July 1, 2019, alongside Adi’s Act, which Oregon Governor Kate Brown signed into law in June 2019. Adi’s Act requires all Oregon school districts to develop comprehensive suicide prevention policies. These new efforts are aimed at stifling the increasing number of suicides, which reached a record high of 825 in Oregon in 2017. Suicide was the second leading cause of death for Oregon residents aged 15 to 24 years, and the third leading cause of death for children aged 5 to 14 years, according to the Oregon Health Authority.

The new mental health days law was proposed by students inspired by the political activism of the Parkland, Florida, mass shooting survivors. Prior to the law, which will take effect for the first time with the new school year, students were only allowed to miss school for their own or a family members’ physical illness, doctor or dentist appointments, or emergencies.

Oregon isn’t the first to take suicide prevention to the legislature, though. Utah enacted a law last year that changed the definition of a valid excuse to miss school to include both mental and physical illness.

Suicide rates for children have been rising nationwide, with the Centers of Disease Control and Prevention (CDC) ranking it as the second leading cause of death for 10- to 34-year-olds. From 1999 to 2016, suicide rates increased in all 50 states, according to CDC, with some regions facing bigger problems than others. In North Dakota, suicide rates increased the most-by 57.6%, CDC reveals, with several other states following close behind. Suicide rates increased in Utah by 46.5% and in Oregon by 28.2.

These 2 new laws may be seen as trend-setting, but Minnesota also passed a bill back in 2009 that excused students for absences related to ongoing treatment for a mental health diagnosis when accompanied by a note from a healthcare professional.

Other important statistics to remember in practice are that boys are 4 times more likely than girls to die by suicide, although girls are more likely to attempt suicide, Bruener says. Guns are used in more than half of suicides, she adds. The question that remains, she says, is what causes teenagers to commit suicide?

“The adolescent years are a stressful time. They are filled with major changes. These include body changes, changes in thoughts, and changes in feelings, Breuner says. “Strong feelings of stress, confusion, fear, and doubt may affect a teenager’s problem solving and decision-making. He or she might also feel pressure to succeed.”

Breuner says she hopes laws like that passed in Oregon and Utah help to improve mental health for teenagers overall and change the outlook of those who care for them.

“This is not only a priority, but a necessity,” she says.