School-Based Discrimination, Bias-Based Bullying, and Adolescent Mental Health and Risk Behaviors: A Scoping Review

Objective School-based discrimination and bias-based bullying may contribute to disparities in adolescent mental health and risk behaviors, particularly among youth experiencing marginalization based on race/ethnicity, sexual orientation, gender identity, disability, or health status. This scoping review mapped the recent U.S. evidence on in-school discrimination and bias-based bullying or harassment and their relationships with adolescent mental health and risk behaviors. Methods Following the Arksey and O'Malley framework, and PRISMA-ScR, we searched PubMed, PsycInfo, CINAHL, and ERIC for peer-reviewed studies published between 2019 and 2025. Eligible studies focused on students in U.S. high schools, including studies with participants aged 14–18 years or participants enrolled in high school, and examined in-school discrimination or bias-based bullying/harassment and related mental health or behavioral outcomes. Reference lists were also screened to identify additional eligible studies. Results A total of 56 studies met the inclusion criteria. Across studies, school-based discrimination and bias-based bullying were associated with adverse mental health outcomes, including depression, anxiety, suicidality, and psychological distress, as well as risk behaviors including substance use and weapon carrying. Qualitative findings further highlighted the emotional and social consequences of discriminatory and bullying experiences and the importance of school climate and supportive relationships. Studies examining multiple marginalized identities suggested that intersecting forms of discrimination may compound adverse outcomes. Conclusion Findings support multilevel school-based prevention and mental health strategies that address discriminatory and bullying experiences, strengthen inclusive school climates, and provide targeted support for students experiencing multiple forms of marginalization.