Factors affecting children’s mental health and wellbeing: findings

4 Primary school findings

This chapter presents the findings of the primary school survey analysis. It contains three sections, which cover the research questions outlined in Section 1.3.

Section 4.1 addresses research question 1. It presents the prevalence rates for each mental health outcome (low mood and high life satisfaction, including a breakdown by school year, gender and area deprivation.

Section 4.2 addresses research question 2. It presents the prevalence rates for each individual risk factor.

Section 4.3 addresses research questions 3 and 4. It considers each mental health outcome in turn. For each outcome, it presents associations with risk and protective factors when these are considered: (a) individually; (b) after accounting for the influence of other factors^[32].

Unlike the secondary school analysis, the primary school analysis does not examine prevalence rates or associations for the total number of risk factors in each domain, since the primary school survey has different numbers of questions in each domain.

4.1 Prevalence of mental health and wellbeing outcomes

Both outcomes (low mood and high life satisfaction) are defined relative to the average mood and life satisfaction of the primary school survey sample. Therefore the overall prevalence rates would change according to the cut-off used for ‘above/below average’^[33]. However, it is still possible to explore patterns in prevalence rates according to school year, gender or deprivation.

4.1.1 Prevalence of low mood

Overall, 22% of P5-P7 pupils were classed as having lower than average mood. Figure 11 shows the percentage of pupils with low mood by school year, gender and deprivation. It shows that low mood was most common amongst P5 pupils and improved with age.

Figure 11: Prevalence of low mood

There was no significant gender difference in low mood. Pupils in the most deprived areas were more likely to have low mood than those in the less deprived areas.

4.1.2 Prevalence of high life satisfaction

Overall, 40% of P5-P7 pupils were classed as having higher than average life satisfaction. Figure 12 presents the percentage of pupils with high life satisfaction by school year, gender and deprivation. It shows that pupils were equally likely to have above average life satisfaction regardless of age or area deprivation.

Summary: Gender differences in primary school pupils’ mental health and wellbeing are small or non-existent. Low mood is more prevalent among more deprived pupils, but high life satisfaction does not differ.There was a statistically significant but small gender difference: overall, slightly more girls reported high life satisfaction than boys.

Figure 12: Prevalence of high life satisfaction

4.2 Prevalence of risk and protective factors

Table 5 presents the prevalence of each potential risk factor. The least common risk factor was child-rated poor general health (2%). The most common risk factor was worrying about doing well on schoolwork (36%).

Several risk factors were more common amongst pupils from more deprived areas and younger children (Table 7 in Section 4.3 illustrates some examples). Some risk factors were common amongst boys (e.g. family conflict, poor relationships with parents and teachers, and being a bully victim or perpetrator). Others were more common amongst girls (worrying about schoolwork and poor peer relationships).

Table 6: Prevalence of individual risk factors in each domain

Domain	Risk factor	% of children
Family	Family rarely or never shares meals	19%
	Family members shout a lot	16%
	Poor quality parent-child relationship (lower than average)	25%
	Child does not enjoy spending time with family	5%
School	Poor teacher-child relationship (lower than average)	31%
	Child worries about schoolwork	36%
Peer	High experience of bullying (higher than average)	28%
	Child bullies others	6%
	Friends are rarely nice to child	16%
	Child has few or no friends	15%
Area	Child does not like area	12%
	No outdoor space to play in area	3%
Health	Child rates own health as ‘bad’ or ‘very bad’	2%
	Child is rarely or never physically active	4%

4.2.1 Note on protective factors

As with the secondary school analysis, the primary school analysis examined whether these negative experiences were ‘risk factors’ associated with low mood, and whether the opposite (positive) experiences were ‘protective factors’ associated with high life satisfaction. For example 31% of pupils were classed as having a poor (below average) teacher-child relationship: a potential ‘risk factor’. This also means, however, that 69% were classed as having a good (average or above average) teacher-child relationship: a potential ‘protective factor’.

Summary: Most primary school pupils have generally positive experiences with their family, school, peers, area and health. However, a common risk factor was worrying about schoolwork.

4.3 Mental health associations of risk and protective factors

4.3.1 Low mood

Individual risk factors for low mood

Pupils were more likely to have low mood if they had the risk factors summarised in Figure 13. Numerous factors shows strong associations with mood. For example, pupils who worried about schoolwork were 3 times more likely to have lower than average mood than similar pupils who did not feel worried by schoolwork.

Figure 13: Individual risk factors for low mood^[34]

Risk factors for low mood accounting for other influences

When examining these factors together^[35], all risk factors remained significantly associated with low mood after accounting for the combined influence of other factors – except for having no outdoor spaces to play nearby, which was no longer significant. The strongest indicators were negative experiences with family (conflict and not enjoying family time), school (worrying about schoolwork), peers (experiencing bullying), as well as poor general health.

Together these factors explained the deprivation gap in low mood. After accounting for whether or not pupils had each of these risk factors, those from more deprived areas were no longer more likely to have low mood. This indicates that the deprivation gap in low mood can be explained by the fact that pupils from more deprived areas are more likely to have these risk factors. To illustrate this, Table 7 takes the risk factors most strongly associated with low mood (see Figure 13) and presents the percentage of pupils in the most and least deprived areas with each risk factor.

Table 7: Exposure to top risk factors for low mood in the most vs. least deprived areas

Risk factor for low mood	% of pupils with risk factor
	SIMD1 – most deprived		SIMD5 – least deprived
Family members shout a lot		17.5	15.9
Child does not enjoy spending time with family		6.1	4.9
Child worries about schoolwork		41.0	33.0
High experience of bullying		32.2	25.3
Friends are rarely nice to child		18.3	13.4
Child rates own health as bad or very bad		2.9	1.7

4.3.2 Life satisfaction

Individual protective factors for high life satisfaction

Pupils were more likely to have higher than average life satisfaction if they had the protective factors summarised in Figure 14.

Figure 14: Individual protective factors for high life satisfaction^[36]

Enjoying time with family was by far the strongest predictor of high life satisfaction. Other positive aspects of the family environment were also important, such as low family conflict and good relationships between parents and children.

Protective factors for life satisfaction accounting for other influences

Looking at associations between life satisfaction and these protective factors simultaneously^[37], most associations remained significant (except for bullying other children and having no outdoor space to play). The strongest predictor was enjoying time with family, followed by good parent-child relationships and low family conflict.

Pupils from the most and least deprived areas reported the same rates of high life satisfaction. However, when comparing pupils with similar protective factors, those from more deprived areas were slightly more likely to have high life satisfaction than those from less deprived areas who had similar experiences. This difference in effect can be explained by the fact that deprived pupils in general were less likely to have various protective factors. For example, fewer deprived pupils reported low family conflict (82% in most deprived quintile vs. 84% in least deprived quintile). After accounting for whether or not pupils had low family conflict (and other protective factors), more deprived pupils were slightly more likely to have high life satisfaction than less deprived pupils with similar experiences. This effect was small and may be due to chance. Alternatively, it might reflect increased resilience amongst more deprived pupils, and this possibility merits further investigation.

More girls than boys reported high life satisfaction. However, when comparing girls and boys with similar protective factors, girls were less likely to have high life satisfaction than boys with similar experiences. This difference in effect can be explained by the fact that boys in general were less likely to have various protective factors. For example, fewer boys report low family conflict (82% of boys vs. 86% of girls). After accounting for whether or not pupils have low family conflict (and other protective factors), girls were less likely to have high life satisfaction than boys with similar experiences.

Summary: Various factors across different domains of life contribute to primary school pupils’ mood and life satisfaction. Positive family relationships are particularly important for life satisfaction.