Mental health and wellbeing among adolescents in Scotland: profile and trends

3 Profile of mental health and wellbeing in 2013

Key Findings

• Many factors showed an association with emotional and behavioural problems and, in most cases, an inverse relationship with mental health and wellbeing. However, there were two main areas that emerged as key to pupils' mental health and wellbeing:
  
  • The number and nature of pupils' friendships - those who had fewer friends had poorer mental health and wellbeing e.g. 75% of girls with no close friends had a borderline or abnormal overall SDQ score, as did those with older friends e.g. 17% of pupils who had friends their own age had a borderline or abnormal conduct problems score compared with 41% of pupils with mostly older friends.
  • The pupils' relationship with school - those that disliked school, felt pressured by school work, truanted on multiple occasions or had been excluded had poorer mental health and wellbeing than those that did not.

• Other factors that were associated with poorer mental health and wellbeing included:
  • Below average maternal knowledge of activity
  • Spending 6-7 nights out with friends per week
  • Doing nothing, hanging out in the street or going to concerts gigs at least weekly.

• There were also variables that were linked to better mental health and wellbeing:
  • Living with both parents
  • Expecting to go to university after leaving school
  • Belonging to a group or club

• Playing a sport, seeing friends or reading a book at least once a week.

Geography

Existing findings from other sources

• Previous research found that there was a relationship between population density and mental health - young people living in urban areas were more likely to report mental health problems. (6)

3.1 There was no clear difference in overall SDQ score by urban/rural classification. This was also the case for the individual scales that make up the Strengths and Difficulties questionnaire (Figure 3.1).

Figure 3.1 Individual SDQ scores by urban/rural classification (% borderline or abnormal score) (2013)

3.2 In line with the SDQ measures of emotional and behavioural difficulties, mental wellbeing showed no relationship with urban/rural classification.

3.3 Figures C.1-C.5 in Appendix C show the trends over time for the individual SDQ scales for each local authority^[3] (Tables C.1-C.5 show the bases).

3.4 Pupils were most likely to have a borderline or abnormal scores on the overall SDQ score in Stirling and South Ayrshire (36% and 35% of pupils had a borderline or abnormal score, respectively). Pupils were least likely to have emotional or behavioural problems in Eilean Siar (24% of pupils had a borderline or abnormal score), East Renfrewshire (24%) and Perth & Kinross (21%). The Scottish average borderline or abnormal score was (29%) (See Table C.6 in Appendix C for full results).

Family

Existing findings from other sources

• Over half (55%) of children with an emotional disorder had parents who had separated (7)
• The prevalence of mental disorders was higher in lone parent families than in two parent families and in reconstituted families, compared with families containing no step children (6

Figure 3.8 Overall SDQ score by family status and sex (% borderline or abnormal score) (2013)

3.5 Overall SDQ scores were associated with family status (Figure 3.8). Those living with both parents were least likely to have a borderline or abnormal score. Those living in single or step families had higher borderline or abnormal scores, while those that lived in 'other' (without either parent) family situations were the most likely to have borderline or abnormal scores. While this pattern was evident in both boys and girls, it was stronger among girls.

Figure 3.9 Individual SDQ scores by family status (% borderline or abnormal score) (2013)

3.6 While those living with both parents had the lowest level of difficulties across all of the individual SDQ scales, there was some variation among the other groups (Figure 3.9). As with the overall SDQ measure, those living in 'other' family situations were most likely to have conduct, peer or pro-social problems. However, those living in step families were most likely to have emotional or hyperactivity problems.

Table 3.2 Average WEMWBS score by family status (2013)

Family status	Average WEMWBS score	Bases
Both parents	49.7	18771
Single parent	47.2	6760
Step parent (and one parent)	46.7	2539
Other	46.4	1217

3.7 Mental wellbeing showed a similar pattern to overall SDQ scores (Table 3.2). Those living with both parents had the highest average WEMWBS scores, followed by those in single parent families and step families. Those living in 'other' family situations had the poorest mental health and wellbeing.

Figure 3.10 Overall SDQ score by sex and mother's knowledge^[4] (2013)

3.8 Pupils whose mother knew an above average amount about their activities were less likely to have a borderline or abnormal SDQ score. This association was stronger among girls than boys (Figure 3.10).

Figure 3.11 Individual scores by mother's knowledge (% borderline or abnormal scores) (2013)

3.9 The amount a pupil's mother knew about their activities was associated with all of the individual SDQ scales, although to differing extents. Mother's knowledge was most strongly associated with conduct problems and least strongly associated with peer problems (Figure 3.11).

Table 3.3 Average WEMWBS score by mother's knowledge (2013)

Mother's knowledge of activities	Average WEMWBS score	Bases
Below average knowledge	46.2	12524
Average knowledge or above	50.8	16412

3.10 Those whose mother knew an average or above average amount about their activities were more likely to have higher levels of mental health and wellbeing (Table 3.3).

Friends

Existing findings from other sources

• In England, a fifth (22 %) of children with emotional disorders found it more difficult than average to keep friends compared with only 5% of other children (8).
• Again, in England young people aged 11-16 with difficulty making and keeping friends increased their prevalence of developing emotional disorders such as anxiety and depression by 33% (8).
• A Finnish cohort study in 1981 found that children who had been bullied when they were 8 years old were more likely to have internalising and externalising problems and 3.5 times more likely to be referred for mental health services in later years (9).

Figure 3.12 Overall SDQ score by age of friends and sex (% borderline or abnormal scores) (2013)

3.11 Pupils who said that their friends were the same age as them were the most likely to have normal overall SDQ scores, followed by those with friends of mixed ages and those with mostly younger friends (Figure 3.12). Those with mostly older friends were most likely to have borderline or abnormal scores. This pattern was the same among both sexes but was present in a greater degree among girls.

Figure 3.13 Individual SDQ scores by age of friends (% borderline or abnormal scores) (2013)

3.12 The age of pupils' friends showed a similar pattern across most of the individuals SDQ scales. However, having younger friends was more closely related to both peer problems and pro-social problems (Figure 3.13).

Table 3.4 Average WEMWBS score by friends' age (2013)

Age of friends	Average WEMWBS score	Bases
About the same age as me	49.6	19031
Younger than me	48.2	435
Mixed ages	47.7	8099
Older than me	45.2	1140

3.13 Average WEMWBS score also showed a relationship with age of friends. As with overall SDQ score, mental wellbeing was higher among those who had friends that were the same age as them. Those with mostly older friends had the lowest average mental health and wellbeing (Table 3.3).

Figure 3.14 Overall SDQ score by number of friends and sex (2013)

3.14 Those who said that they had no close friends were much more likely to have a borderline or abnormal overall SDQ score. This was particularly the case among girls - three quarters of those with no close friends had a borderline or abnormal score (Figure 3.14).

Figure 3.15 Individual SDQ scores by number of friends (% borderline or abnormal scores) (2013)

3.15 Although all of the individual SDQ scales were related to the number of friends a pupil had, unsurprisingly, the strongest association was with peer problems. Hyperactivity was the least strongly related to number of friends (Figure 3.15).

Table 3.5 Average WEMWBS score by number of friends (2013)

Number of close friends	Average WEMWBS score	Bases
None	39.7	441
One	43.8	922
Two	46.4	3604
Three or more	49.6	22771

3.16 As the number of friends a pupil had increased, so did the average WEMWBS score. Those with three or more friends had the highest average mental health and wellbeing (Table 3.5).

Figure 3.16 Overall SDQ score by number evenings spent with friends and sex (% borderline or abnormal scores) (2013)

3.17 Spending a lot of time out with friends was associated with greater difficulties - pupils who spend 6-7 nights a week out with friends were most likely to have borderline or abnormal overall SDQ score. However, pupils who spent little or no time out with friends also were more likely to have higher borderline or abnormal scores. (Figure 3.16). In contrast, those who spent between 2 and 5 evenings with friends were the least likely to have a borderline or abnormal score.

Figure 3.17 Individual scores by number of evenings out with friends (% borderline or abnormal scores) (2013)

3.18 The individual SDQ scales did not all interact with evenings spent out with friends in the same way. While conduct problems and hyperactivity were associated most strongly with spending 6-7 nights out a week, peer problems, emotional problems and pro-social problems were most closely related to spending 0-1 nights out with friends a week (Figure 3.17).

Table 3.6 Average WEMWBS score by number of evenings spent with friends (2013)

Number of evenings spent out with friends	Average WEMWBS score	Bases
0-1 evenings	47.4	5508
2-3 evenings	49.2	10371
4-5 evenings	49.6	8392
6-7 evenings	48.2	4233

3.19 Spending little or no time out with friends was related to lower levels of mental wellbeing - the lowest average WEMWBS score was among those that spent 0-1 evenings out with friends per week (Table 3.6).

School

Existing findings from other sources

• Absenteeism and truancy rates were particularly high among those with socialised conduct disorder: 87% of young people with a conduct disorder had been absent in the previous term (6).

Figure 3.18 Overall SDQ score by sex and by whether like school (% borderline or abnormal score) (2013)

3.20 Whether or not a pupil liked school had a very clear relationship with overall SDQ score. Those that disliked school were far more likely to have a borderline or abnormal SDQ score. As with many of the other variables, this relationship was more evident among girls than boys (Figure 3.18). Girls who said that they did not like school at all were nearly five times more likely to have a borderline or abnormal score as those who said that they liked school a lot.

Figure 3.19 Individual scores by whether like school (% borderline or abnormal scores) (2013)

3.21 Whether or not a pupil liked school was strongly associated with all of the individual SDQ scales, particularly conduct problems (Figure 3.19).

Table 3.7 Average WEMWBS score by whether like school (2013)

Whether like school	Average WEMWBS score	Bases
I like it a lot	54.6	5537
I like it a bit	49.8	14857
I don't like it very much	44.8	5451
I don't like it at all	39.8	2697

3.22 In line with the emotional and behaviour difficulties scores, mental health and wellbeing was linked to liking school - pupils that disliked school the most had the lowest average WEMWBS score (Table 3.7).

Figure 3.20 Overall SDQ score by sex and by school pressure (% borderline or abnormal score) (2013)

3.23 Pupils who felt pressured by school work a lot of the time were much more likely to report borderline or abnormal overall SDQ scores (Figure 3.20). Girls who felt pressured a lot of the time were three times more likely to have a borderline or abnormal score than those who never felt pressure.

Figure 3.21 Individual scores by school pressure (% borderline or abnormal scores) (2013)

3.24 The individual SDQ scales were also related to feeling pressure from schoolwork, with the exception of the pro-social scale. The relationship was most evident in relation to emotional problems - those that felt a lot of pressure were more than four times more likely to have a borderline or abnormal score than those that never feel pressure (Figure 3.21).

Table 3.8 Average WEMWBS score by school pressure (2013)

Whether feel pressured by school work	Average WEMWBS score	Bases
Never	52.7	4444
Sometimes	50.2	16107
A lot of the time	44.2	8126

3.25 As with the SDQ scales, mental wellbeing was related to feeling pressure from schoolwork. Those that felt pressure a lot of the time had the lowest average WEMWBS scores (Table 3.8).

Figure 3.22 Overall SDQ score by sex and by number of times truanted (2013) (% borderline or abnormal score)

3.26 In line with the other school related variables, truanting was associated with overall difficulties. The more frequently a pupil truanted, the more likely they were to have a borderline or abnormal overall SDQ score (Figure 3.22).

Figure 3.23 Individual SDQ scores by number of times truanted (% borderline or abnormal scores) (2013)

3.27 Truanting was most strongly correlated with conduct problems. Those that had truanted were four times as likely to have a borderline or abnormal score as those who had never truanted. However, all of the individual SDQ scales had a relationship with truanting (Figure 3.23).

Table 3.9 Average WEMWBS score by truanting (2013)

Number of times truanted	Average WEMWBS score	Bases
None	50.1	19147
1-3 times	47.5	6642
4-10 times	44.8	1830
More than 10 times	41.8	955

3.28 Lower WEMWBS scores, suggesting lower mental wellbeing, were evident among those that truanted more frequently (Table 3.9).

Figure 3.24 Overall SDQ score by sex and by exclusion (2013)

3.29 Pupils who had even been excluded from school were more likely to have a borderline or abnormal overall SDQ score (Figure 3.24).

Figure 3.25 Individual SDQ scores by whether ever excluded (% borderline or abnormal scores) (2013)

3.30 Pupils who had been excluded were more likely to have borderline or abnormal scores on every individual SDQ score. As with truanting, the association was strongest between exclusion and conduct problems (Figure 3.25).

Table 3.10 Average WEMWBS score by exclusion (2013)

Ever excluded	Average WEMWBS score	Bases
Yes	46.1	2490
No	49.1	26000

3.31 Mental wellbeing was associated with exclusion - those that had been excluded had a lower average WEMWBS score than those that had not (Table 3.10).

Figure 3.26 Overall SDQ score by sex and by Free School Meal (FSM) entitlement^[5] (2013)

3.32 Those that reported that they were entitled to receive free school meals^[6] were more likely to have a borderline or abnormal overall SDQ score (Figure 3.26).

Figure 3.27 Individual SDQ scores by Free School Meal (FSM) entitlement (% borderline or abnormal scores) (2013)

3.33 With the exception of the pro-social scale, each of the individual SDQ measures was related to free school meal entitlement. As before, entitlement to free school meals was associated with higher proportions of borderline or abnormal scores (Figure 3.27).

Table 3.11 Average WEMWBS score by Free School Meal (FSM) entitlement (2013)

Free School Meal entitlement	Average WEMWBS score	Bases
Yes	47.2	3229
No	49.1	23172

3.34 Mental wellbeing was lower among those who were in receipt of free school meals (Table 3.11).

Figure 3.28 Overall SDQ score by expectations after school and sex^[7] (% borderline or abnormal score) (2013)

3.35 With regard to post-school expectations, those who thought they would go to university were less likely to have borderline or abnormal scores than all other groups (Figure 3.28).

Figure 3.29 Individual SDQ scores by expectations after school (% borderline or abnormal scores) (2013)

3.36 While expecting to go to university after school was associated with lower levels of borderline or abnormal scores among four of the five individual SDQ scales, it was not closely related to emotional problems (Figure 3.29).

Table 3.12 Average WEMWBS score by expectations after school (2013)

Expectations after school	Average WEMWBS score	Bases
University	49.9	16992
FE college	46.6	4788
Apprenticeship	50.5	1328
Working	47.9	2305
Other	46.4	4406

3.37 Those that thought they would complete an apprenticeship after school had the highest average WEMWBS score, closely followed by those who thought that they would go to university (Table 3.12).

Leisure activities

Existing findings from other sources

• Participation in leisure activities had a significant impact on young people's mental health. However this depended on the type of leisure activity: active leisure was associated with better mental health while sedentary leisure was associated with poorer mental health (10).

Figure 3.30 Regular leisure activities and overall SDQ score (2013)

3.38 Among boys and girls, playing sport and seeing friends at least weekly were associated with lower proportions of borderline or abnormal overall SDQ scores. In contrast, doing nothing, hanging out in the street and going to a concert or gig at least once a week were linked to higher proportions of borderline or abnormal overall SDQ scores (Figure 3.30).

Figure 3.31 Regular leisure activities and emotional problems score (2013)

3.39 As with the overall SDQ score, emotional problems were related to doing nothing (in boys and girls), hanging out in the street (in girls) and going to a concert or gig (in boys) at least weekly. However, among girls they were also associated with social networking and listening to music on a weekly basis. Playing sport and seeing friends were related to lower levels of emotional problems (Figure 3.31).

Figure 3.32 Regular leisure activities and conduct problems score (2013)

3.40 Reading books at least weekly was associated with lower levels of conduct problems in boys and girls, whereas higher levels were associated with hanging out in the street, going to a concert or gig and doing nothing at least weekly (Figure 3.32).

Figure 3.33 Regular leisure activities and hyperactivity problems score (2013)

3.41 Going to church, temple or mosque and reading books on a weekly basis were associated with lower levels of hyperactivity among boys and girls. In contrast, hanging out in the street, doing nothing and using social networking were linked to higher levels of hyperactivity in both sexes (Figure 3.33).

Figure 3.34 Regular leisure activities and peer problems score (2013)

3.42 Seeing friends, playing sport and going to a friend's house at least weekly were all associated with lower proportions reporting borderline or abnormal peer problems scores. Unlike a number of the other individual SDQ scales, social networking was also linked to lower levels of peer problems. As with the other individual SDQ scales, doing nothing and going to a gig or concert at least weekly were related to higher levels of peer problems (Figure 3.34).

Figure 3.35 Regular leisure activities and pro-social score (2013)

3.43 Playing sport, doing a hobby, and reading books at least weekly were associated with pro-social behaviours among both sexes. Doing nothing and going to a gig or concert at least weekly were associated with lower levels of pro-social behaviour (Figure 3.35).

Table 3.13 Average WEMWBS scores by frequency of leisure activities (2013)

Leisure activities	At least once a week	Less often
Do nothing	44.9	50.0
Go to concerts/gigs	47.3	49.0
Hanging out in the street	47.8	49.4
Do a hobby	47.9	49.5
Social networking	48.6	50.0
Listen to music	48.9	49.3
Watch DVDs	48.9	48.4
Go to shops	49.1	48.3
Go to cinema	49.1	48.7
Go to friends house	49.1	48.2
Read magazines	49.2	48.7
See friends	49.4	46.5
Play computer games	49.5	47.7
Volunteer	49.5	48.7
Read books	49.6	48.2
Go to church	50.1	48.6
Play sports	50.5	45.8
Watch sports	50.6	48.1

3.44 Watching and playing sport at least weekly were most strongly related to higher levels of mental health and wellbeing, while doing nothing, going to concerts and gigs and hanging out in the street at least weekly were the strongest negatively associated activity (Table 3.13).

Figure 3.36 Group/club membership by overall SDQ score and sex (2013)

3.45 Those who had attended a group or club (e.g. youth groups, drama clubs, sports clubs or computer clubs etc.) were less likely to have a borderline or abnormal overall SDQ score (Figure 3.36).

Figure 3.37 Individual SDQ scores by group/club membership (% borderline or abnormal score) (2013)

3.46 As with overall SDQ score, the individual scales all showed a relationship with group/club membership. For each scale, group membership was associated with a lower proportion of pupils reporting borderline or abnormal scores (Figure 3.37).

Table 3.14 Average WEMWBS score by club membership (2013)

Member of a club or group?	Average WEMWBS score	Bases
Yes	49.6	23474
No	45.5	5348

3.47 In line with the correlation between group membership and difficulties scores, group membership was also associated with higher levels of mental health and wellbeing (Table 3.14).