Shifting Perspectives on Student Substance Use, Mental Health
February 27, 2025
• Needham Public Health officials discussed patterns in student mental well-being and substance use, as well as how to support youth, at the Select Board’s Tuesday meeting.
Most Needham students don’t vape, smoke, drink or misuse prescription drugs, but survey results indicate that many of them think their classmates do.
That disconnect, as well as reported mental health struggles and substance abuse, are things local public health officials hope to address following the results from the 2023 MetroWest Adolescent Health Survey.
The biennial survey provides a “robust data set” on the prevalence of substance use and poor mental health indicators, Needham Epidemiologist Julie McCarthy told the Select Board on Tuesday. The vast majority of middle school and high school students take the survey. The survey results were previously shared with the School Committee in November.
Substance use overall is relatively low — and is on the decline compared to 2021 — and it’s the job of the Substance Prevention Alliance of Needham, or SPAN, to share that data with the community.
Karen Shannon, the town’s substance use prevention program coordinator, said their work aims to shift perspectives and help students understand substance use isn’t “a rite of passage.”
“Most students believe that their peers are using substances at greater rates than what is actually reported,” Shannon said. “And this misperception can actually shape attitudes favorably toward substance use and can have a normalizing effect among young people.”
To combat those beliefs, Needham Public Health created photo banners spelling out the facts, including that “underage drinking is not the Needham norm” and that “most Needham High students have never used marijuana.” Correcting students’ misconceptions could help lead to a decrease in substance use, Shannon said.
Needham High School students report higher lifetime use of alcohol compared to peers in the other 24 communities surveyed. A reported 48% of NHS students have had alcohol in their lifetime, while the average in the Metrowest is 40%.
There’s also a sharp rise in lifetime alcohol consumption between 8th and 9th graders, from 11.9% to 31.9%, according to survey results. A similar pattern tracks with marijuana, electronic vapor products and prescription drugs, McCarthy noted, though they don’t gather qualitative data on why that might be.
Many of the statistics trend back to the pandemic, which dramatically impacted mental health, McCarthy said. In 2021, the survey indicated “a really sharp increase in poor mental health patterns,” she said, framing the current numbers into context.
“We’re happy to see a decrease,” McCarthy said, “but I think it’s just an important reminder that the decrease really brings us back to this high baseline that we were at before, or even slightly higher rates than we were at previously, despite seeing a decrease from 2021.”
Middle school students reported higher rates of suicidality than their older peers, which McCarthy said “was just jarring to see.” Lingering consequences of the pandemic, tied with an ongoing mental health crisis, may have been the cause, she added.
In her conversations with college-aged youth, Vice Chair Heidi Frail said their anxiety and depression seems to stem from feelings of uncertainty that are fueled by “national chaos.” Asked how the outside world may play a role in students’ well-being, Needham Youth and Family Services Director Sara Shine pointed to technology.
“I think with the introduction of the smartphone, and everyone has the ability to look at anything on their phone, I think the environmental factors, the things that are happening in the world, the unknown, I think is right at your fingertips,” Shine said. “And so I think that can have a huge impact on mental well-being.”
At the high school level, 2% of students — roughly 28 students — reported attempting suicide, according to the survey. About 25% of them indicated feeling lonely and did not say they had at least one teacher or adult at school to talk to about their problems. Having that support, Shannon said, is “a really powerful protective factor.”
Those numbers reminded Select Board member Marianne Cooley of her time on the School Committee. Following a middle school student’s suicide, teachers were shown a list of every student and asked to put their name next to those they knew well enough to speak to. In the end, the space next to some students’ names remained blank, she said.
“To me, that was such a powerful exercise to help people think about every student as an individual member of the community, and how they were seen or not seen,” Cooley said. “It strikes me as something that I’ve often wished we would do again at some interval.”
Students Advocating Life without Substance Use, known as SALSA, provides another protective factor, Shannon said. Members connect with Pollard students, and peer-to-peer connection is proven effective, she said.
Needham Youth and Family Services implements that same strategy. Its youth mental health first aid training teaches both adults and now 10th graders how to assist during a mental crisis. The department is also considering a peer mentoring program, given the difficulty students face transitioning between schools.
“We think that’s equally as important, because teens mostly talk to their friends when they’re struggling with something,” Shine said, “so if their friends know how to respond to them and help connect them to an adult, we think that that is crucially important, especially given the rates of depression and suicidal ideation.”
Shine’s department also manages clinical programming, family counseling and case management. They also receive referrals from the Needham Public Schools.
Taking “a public health approach to prevention” helps ensure students stay safe and healthy, Shannon said.
“Scaring young people, scaring the health into them doesn’t typically work,” Shannon said, “versus providing them with the brain science and being able to explain the data, for example, can be more effective.”
