School Policing, School Discipline, and Depressive Symptoms Among 15-Year-Old Adolescents in a Multi-City U.S. Birth Cohort: A School-to-Patient Nexus Framework Analysis

This study examined five school policing and discipline exposures simultaneously in relation to depressive symptoms among 15-year-old adolescents in the Future of Families and Child Wellbeing Study, a birth cohort drawn from large U.S. cities. The exposures differ in kind rather than degree, distinguishing institutional presence from adolescents’ direct and vicarious encounters with coercive practice and from school discipline. Ordinary least squares regression estimated associations before and after adjustment for school climate. Supplementary analyses tested sex and race moderation, estimated indirect associations through five school climate dimensions using structural equation modeling, and evaluated robustness using propensity score matching. Witnessing another student stopped by school police (b = 0.43, p < 0.001) and suspension or expulsion (b = 0.29, p = 0.03) were associated with higher depressive symptoms after adjusting for school climate. The association between school discipline and depressive symptoms was stronger for girls than boys (b = −0.63, p = 0.018). Indirect associations consistent with the hypothesized pathway ran through happiness at school and perceived teacher respect for witnessing and through four climate dimensions for suspension or expulsion. Neither police presence nor security presence was associated with depressive symptoms after adjusting for school climate. The associations were confined to exposures involving an actual encounter, whether experienced directly, witnessed, or imposed through exclusion. Interpreted through the School-to-Patient Nexus framework, adolescent depressive symptoms are positioned as early life course evidence of health burden originating in carceral school environments.