Millions of people all over the world are experiencing mental health problems. And though the causes vary, we know that half of all these illnesses will have started in childhood or the teenage years.
In the UK, referrals for and reports of teenagers with depression and anxiety and other mental issues have risen significantly in recent decades – reportedly increasing by 70% in the 25 years to 2016.
Researchers have known for many years that education and mental health are strongly linked and that doing well in school gives children a strong sense of feeling good about themselves – which in turn is linked to higher levels of well-being in adulthood.
Depression, on the other hand, is linked to poor future academic success, and this link between depression and school failure is stronger for girls than for boys.
However, while depression leads to poor academic success, it is not clear if poor academic success leads to depression. So, for our recent study, we looked to see if the risk of future mental health problems could be predicted from school key stage test results.
Achievement and depression
We looked at the education and health records (consisting of GP and hospital admission files) from more than 600,000 children from across Wales, and at their school test results. These children were aged between 11 and 18, so that we were looking just at teenage mental health. And they were born or living in Wales between 1990 and 2014.
Looking at these records, we found that children who “declined” in school were more likely to be depressed as a teenager. The children were identified as doing well in school at age seven, but after that were not meeting their key stage milestones in reading, writing and numeracy. So, by age 11, they were not achieving well – or “declining”. During their teenage years, they were then diagnosed with depression.
It is unclear whether the children had depression in primary school which wasn’t picked up until they are teenagers, or if not doing well in primary school leads to depression. Either way, our study suggests that helping children who are declining in primary school could help to identify and prevent depression at the early stages.
In addition, we found that seven per cent of all girls and three per cent of all boys were treated or diagnosed with depression by age 19. That is 33,500 children just from these records that were treated for depression. Not only is this difficult for the individuals and families involved, but can be a great cost to the NHS, too.
The research also uncovered that teenagers who self harm show lower school achievement just before they are identified by a GP as self-harming. This means they decline in school and start self-harming around the same time. However, teenagers who self-harm are not more likely to be declining in primary school. So self-harming is not linked to experience in primary school, but is linked to experiences in the teenage years.
Our study has important implications which suggest that depression symptoms may be being missed in primary school children, and that support for emotional and social development in primary school could improve and reduce future mental health problems.
There is also a case for more support for teachers and families in helping children understand emotions and dealing with difficulties. Parenting skills, supportive school environments and community programmes may be more cost effective for the NHS as well, and prevent the young people ever having to experience a mental health problem.