Eun Sang Jun
Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, Korea.
Epidemiol Health. 2025;47:e2025011. doi: 10.4178/epih.e2025011. Epub 2025 Mar 1.
To actively protect and enhance students' human rights, student human rights ordinances (SHROs) have been enforced in seven provinces in South Korea at different times since 2010. Although human rights are closely linked to mental health, there has been no research on the effectiveness of human rights legislation on adolescent mental health. This study evaluated the effects of SHROs on the mental health of middle and high school students.
Repeated cross-sectional data were used, including 1,148,257 respondents from the Korea Youth Risk Behavior Web-based Survey between 2006 and 2023. Probabilities of perceived stress, sleep insufficiency, depressive mood, suicide ideation, and suicide attempt in treated provinces were estimated through a difference-in-differences approach that accounts for treatment effect heterogeneity across groups over time.
SHROs had no consistently significant effects on any mental health outcomes, except for slightly increased suicide ideation in total students (0.7%, 95% confidence interval 0.3% to 1.1%). Suicide attempts in total and male students and perceived stress and sleep insufficiency in female students tended to decrease, while other mental health outcomes tended to increase. Uncertainty in the effect estimates of SHROs increased for all mental health outcomes with possible violations of parallel trends, rendering originally significant effects insignificant.
SHROs failed to improve mental health of middle and high school students in treated provinces, possibly due to the absence of enforcement mechanisms. Further research is needed on the effectiveness of and effect mechanisms for legal measures to improve human rights on adolescent mental health.
为积极保护和增强学生的人权，自2010年以来，韩国七个省份在不同时间实施了学生人权条例（SHROs）。尽管人权与心理健康密切相关，但尚未有关于人权立法对青少年心理健康有效性的研究。本研究评估了学生人权条例对初高中学生心理健康的影响。
使用重复横断面数据，包括2006年至2023年韩国青少年危险行为网络调查的1,148,257名受访者。通过差异中的差异方法估计了受治疗省份中感知压力、睡眠不足、抑郁情绪、自杀意念和自杀未遂的概率，该方法考虑了不同组随时间的治疗效果异质性。
学生人权条例对任何心理健康结果均无一致的显著影响，除了全体学生的自杀意念略有增加（0.7%，95%置信区间0.3%至1.1%）。全体学生和男学生的自杀未遂以及女学生的感知压力和睡眠不足有下降趋势，而其他心理健康结果有上升趋势。随着可能违反平行趋势，学生人权条例对所有心理健康结果的效应估计不确定性增加，使得原本显著的效应变得不显著。
学生人权条例未能改善受治疗省份初高中学生的心理健康，可能是由于缺乏执行机制。需要进一步研究改善人权的法律措施对青少年心理健康的有效性和作用机制。
