State-level restorative justice policies and mental health disparities among girl dating violence survivors in the US: A lagged cross-sectional study

BMC Public Health. 2026 Jul 13. doi: 10.1186/s12889-026-28413-x. Online ahead of print.

ABSTRACT

INTRODUCTION: Adolescent dating violence (ADV) is highly prevalent among girls in the United States (US) and increases risk for depression, suicide ideation, and suicide attempts. Restorative justice (RJ), a policy-based, survivor-centered approach to harm repair and accountability, may be a structural intervention to promote mental health among ADV girl survivors. However, little is known about whether and how state-level RJ policies are associated with mental health or whether these associations differ by ethnoracial identity. Therefore, this study examined (1) associations between adolescent-focused, state-level RJ policies and depressive symptoms, suicide ideation, and suicide attempts among ADV girl survivors and (2) differences across ethnoracial identities.

METHODS: Individual-level data were from the 2013-2019 waves of the Youth Risk Behavior Survey, a state-representative, cross-sectional survey conducted biennially among public and private schools with adolescents who are in 9th to 12th grade in the US (N = 30,330). State-level policy data were from a US RJ legislative database. Generalized estimating equations using log binomial regression were used to examine lagged associations between state RJ policy adoption and mental health outcomes among ADV girl survivors and test for effect measure modification by ethnoracial identity.

RESULTS: There were no associations between residing in a state with an RJ policy (vs. without) and depressive symptoms, suicide ideation, or suicide attempts among ADV girl survivors. The associations for depressive symptoms and suicide ideation did not vary by ethnoracial identity. However, the association between residing in a state with an RJ policy (vs. without) and attempting suicide varied by ethnoracial identity (b [95% CI] = 0.21 [0.05, 0.37], p = .008), such that Black ADV girl survivors had an increased risk, and white ADV girls survivors had a decreased risk of attempting suicide; the association did not vary for Hispanic ADV girl survivors.

CONCLUSIONS: State-level RJ policies may reduce suicide attempts for white ADV girl survivors, but addressing structural gendered racism in policy implementation may be necessary to promote mental health equity for Black and Hispanic ADV girl survivors.

PMID:42443828 | DOI:10.1186/s12889-026-28413-x