Statistics released by the NHS Digital today suggest that one in eight 5-19 year olds in England has a clinically impairing mental health condition.
All teachers should be interested, as this equates to three pupils in an average UK class of 26.
Additionally, most recent reports about mental health in young people draw on brief questionnaires or service contact data, while this study rigorously assessed a range of mental health diagnoses and is the long-awaited third survey in a series commenced in 1999, which therefore allows the study of trends.
Adolescent mental health
Children and young people were sampled to be as representative of children and young people across England as possible. All participating children and young people underwent a standardised diagnostic assessment.
This involved interviews with the parent, young people aged 11 plus and, provided the family agreed, a questionnaire from teachers. The assessment combined highly structured questions that had set responses with open-ended questions about difficulties.
A team of mental health practitioners from the University of Exeter and Kings College London reviewed all the information provided by parents, young people and teachers to assign mental health diagnoses according to the World Health Organisation’s International Classification of Diseases (10th edition).
So what did the survey find?
- Comparison with earlier surveys was necessarily restricted to the narrowest age range studied (5-15 years in 1999), and shows a slight increase in the proportion of children with any mental health condition from 9.7% in 1999 and 10.1% in 2004 to 11.2% in 2017.
- This increase was explained by a higher number of young people with clinically impairing anxiety or depression, which increased from 3.9% in 2004 to 5.8% in 2017. The proportion of children with behavioural difficulties, ADHD and other disorders was broadly similar to that detected by the earlier surveys.
- Overall, the proportion of boys and girls with mental health conditions was similar, although the rate of any mental health condition was highest (23.9%) among young women aged 17-19 years. This suggests that on average a class may contain at least one child who is struggling with an emotional disorder and educators involved with Key Stage 5 may face a particular challenge.
- The survey collected a range of other information about children, young people and their families. White British children and young people (14.9%) were three times more likely to have a mental health condition than their Black / Black British (5.6%) or Asian/ Asian British (5.2%) peers. There were also regional variations in the proportion of children with mental health conditions that might be of interest.
- Children with mental health conditions were more likely to have poor general health, live in a low-income household, and to have less healthy family functioning or a parent in poor health. As both the mental health and background information were collected at the same time, we can only report an association, and cannot infer causality. While poor family function, physical ill health or poor parental mental health may adversely influence the mental health of children, parenting a child in poor mental health may equally adversely influence family function and parental mental health.
- As in the previous surveys, teachers were the most commonly cited professional source of support among those with mental health conditions (48.5%), while more than a fifth (22.6%) had contacted an educational support service within the last year. The latter achieved the highest level of satisfaction (73.1%) reported for any service. Despite concerns about increases in the prescription of medication for mental health reasons among young people recently, only one in six (16.4%) children with a mental health condition was taking psychotropic medication.
- The overlap between poor mental health and difficulty coping with school is emphasised by the high proportion of children with a mental health condition (35.6%) with recognised special educational needs. This reached almost two thirds among those with neurodevelopmental disorders such as ADHD and autism spectrum conditions, although the survey did not establish whether these special educational needs related directly to the mental health condition. Half of children (49.6%) with recognised special educational needs had an Education, Health and Care Plan, which emphasises the extent to which they needed support to cope in school. Children who had a mental health condition were approximately ten times more likely to have played truant or to have been excluded from school than their peers without a disorder.
Look out for a more in depth discussion of these findings and what they mean for your practice in the issue of the TES to be published on the 30th November.
Tamsin Ford, University of Exeter College of Medicine and Health on behalf of the survey team.