Factors affecting children’s mental health and wellbeing: findings

Executive Summary

Background

The Realigning Children’s Services (RCS) programme has been delivered since 2015 by the Scottish Government to support and challenge Community Planning Partnerships (CPPs) in Scotland to drive improvement in their joint strategic decision making in relation to children’s services. RCS is a two-stranded programme. It delivers an evidence programme centred around quantitative school-based wellbeing surveys with primary and secondary school pupils. The surveys engage children and young people directly to gather information on their perceptions of their health and wellbeing across the following domains: Family, School, Peer, Area and Health. RCS also offers a development and facilitation programme to the CPPs to help local stakeholders to understand and implement evidence based policy making in relation to their children’s services.

In 2015, three CPPs joined the RCS programme: Clackmannanshire, South Lanarkshire and West Lothian. Two further CPPs joined in 2016 as part of the second tranche of RCS: Falkirk and North Lanarkshire. The research for tranche 2 and the primary school element of tranche 1 was conducted by ScotCen Social Research. The research for the secondary school element of tranche 1 was conducted by Ipsos MORI.

Objectives and Research Questions

This report presents quantitative analysis of data from the Children’s Wellbeing Surveys, which were collected between 2015 and 2016 in participating primary and secondary schools in the five Scottish local authority areas named above, as part of the first and second tranches of the RCS programme.

The analysis explores what factors were shown to be associated with emotional and behavioural problems and positive mental wellbeing. It considers potential risk and protective factors in the following domains of children’s lives:

• Family, including quality of parent-child relationships and family time
• School, including teacher-child relationships and enjoyment of school
• Peer, including relationships with friends and experience of bullying
• Area, including perceptions of local area safety and availability of outdoor space
• Health, including subjective general health and physical activity

The report addresses the following research questions:

1. How prevalent are emotional and behavioural problems and positive mental wellbeing amongst different groups of pupils who took part in the surveys?

2. How prevalent are potential risk or protective factors for mental health and wellbeing amongst surveyed pupils?

3. Which of these risk or protective factors are most strongly associated with emotional and behavioural problems or positive mental wellbeing?

4. How do different risk or protective factors work together to influence the likelihood of emotional and behavioural problems or positive mental wellbeing?

Findings

Numerous factors in different domains contributed to mental health and wellbeing outcomes. Protective factors including positive interactions with family members, friends, teachers and school peers were particularly important for positive mental health and wellbeing. Pupils were more vulnerable to emotional and behavioural problems if they were exposed to specific risk factors which included being socially isolated or excluded; feeling negatively towards school or worried by schoolwork; or having a lack of positive family relationships.

Most school pupils had generally positive experiences with their family, school, peers, area and health, however, a relatively small proportion of pupils reported multiple risk factors. Poor mental health was more prevalent in this group compared to those with few or none of these risk factors.

In addition, pupils living in more deprived areas tended to report poorer mental health. However we did not find that this difference was attributable to area deprivation; rather, we found that this was largely explained by the higher prevalence of other risk factors experienced by children and young people living in these areas: e.g. higher instances of children reporting poorer relationships with family and peers, or more negative perceptions of their school and neighbourhood environments.

Therefore, whilst it was found that living in a more deprived area can lead to increased exposure to risk factors that contribute to poorer mental health; deprivation alone was not found to be a driver of poor mental health itself.

Within the secondary school survey, girls were substantially more likely to report emotional problems than boys, even when controlling for other risk factors for negative outcomes. Further investigation is required to better understand what is driving this gender difference.

Recommendations

The findings can help to identify children and young people who are most at risk of poor mental health:

• Practitioners should look out for children who are socially isolated or excluded, who feel negatively towards schoolwork and who have poor interactions with teachers and pupils, or who lack positive family interactions.
• Rather than focusing overly on any single factor, these findings underline the importance of identifying children and young people who have multiple risk factors, as this group are most vulnerable to emotional and behavioural problems.

The findings support the need for a holistic approach to supporting the mental health and wellbeing of children and young people:

• Interventions in family settings should aim to promote positive interactions, open communication and quality time together.
• Interventions in school settings should tackle bullying; promote good relationships between peers and between pupils and school staff; and equip pupils to manage the demands of schoolwork.

The findings highlight issues that merit further investigation in future research:

• Future analysis should make use of longitudinal surveys that follow children over time, to explore how exposure to risk factors influences later mental health and wellbeing.
• Further research is required to understand why girls (especially older girls) are notably more likely to report emotional problems. This could include exploring how boys and girls engage with social media differently.