Bullying, Suicide, Substance Use, and Mass Harm: Patterns of Overlapping Threats Reported to a Statewide Anonymous Technology-Facilitated Reporting System.

Technology-facilitated anonymous/confidential reporting systems (TFRS; tip lines) are used in K-12 schools statewide in 34/50 states to enhance youth safety and prevent interpersonal and self-directed harm. Leveraging discreet and digitally relevant reporting modes including Apps, websites and call-in submission options, states receive thousands of tips annually representing a variety of concerns (e.g., suicidal ideation, substance use, weapons access, bullying, potential school shootings). Though overseers of TFRS systems anecdotally note that multiple concerns are often present in a single tip, the unstructured nature and volume of the tip data have been barriers to systems understanding the prevalence and patterns of overlap, and implications of multiple concerning behaviors on severity of the threat. Using mixed methods, this research team manually coded a random sample of just over 10% of tips submitted between November 2019 and May 2023 for concerning behaviors (n = 2739; coder inter-rater reliability = 0.92) from a statewide system, then utilized descriptive, bivariate and multivariable regression models and latent class analyses to provide estimates on prevalence, patterns of overlap, and differential effects of multiple concerns reported in a tip with the tip being identified as life-threatening. One-third of tips (32%) described multiple concerning behaviors. The most common concern reported in tips were suicide (21.2%), bullying (20.2%), and aggressive behaviors (19.3%). Regardless of the risk, multiple risk factors in a tip consistently increased the odds that a tip would be classified as life-threatening and require emergency responders. Latent patterns of overlap were best represented by a 6-class solution; patterns of overlap included aggressive behaviors or bullying with identity-based violence; suicide with non-school concerns and substance use; and mass-harm events with more generalized weapon concerns (not related to mass harm events) and other aggressive behaviors. This statewide tip line is used for a variety of reasons, and a third of tips contain reference to multiple concerning behaviors that exacerbated features of risk. The patterns identified in the present analysis can be used to further tailor the implementation of these systems, including informing training materials for students to maximize the effectiveness of these tools.