School-level effects on mental health: a cross-sectional study using Born In Bradford 'Growing Up'

This is a cross-sectional study into the effect of primary schools on the mental health of pupils. Socioeconomic status, ethnicity, and other individual characteristics are associated with mental health outcomes in children and adolescents.[1] Given that schools serve different communities and pupil characteristics vary across schools, it is likely that the average mental health of pupils also varies by school. A small number of studies have already investigated this relationship, and found that a small proportion of variation in mental health or wellbeing is explained at school-level, after adjustment for pupil characteristics. A cross-sectional study of 23,215 year 4 & 5 pupils in 648 primary schools in England found that 4.3% of variation in "high mental health difficulties" (measured using the "Me and My Feelings" self-report questionnaire) was accounted for by schools.[2] Three longitudinal studies of secondary school pupils in England found that 1.4% of variation in mental and emotional health (measured using the "Strengths and Difficulties Questionnaire" and the "Me and My School" questionnaire) was explained at school level.[3] A cross-sectional study of 26,855 pupils at 85 secondary schools in the UK found that schools accounted for 2.4% of variation in ‘psychopathology’ (measured using the "Strengths and Difficulties Questionnaire"); 1.6% of variation in depression (measuring using "CES-D"), and 1.4% of wellbeing (measured using "WEMWEBS").[4] A small number of studies from other countries also suggest that schools account for a small but significant proportion of variation in mental health outcomes. For example, in a cross-sectional analysis of 87,341 secondary school pupils in Finland, schools accounted for 1% of variation in subjective wellbeing.[5] There are many more studies into other contextual and social determinants of young people's mental health. For example, a systematic review of parental factors associated with depression and anxiety in young people identified 181 studies.[6] This study aims to add to evidence of the contribution of schools to pupil's mental health. It also aims to include analysis of crude variation in mental health across schools (ie. whether mental varies before adjusting for pupil characteristics), which could inform prioritisation of school-level interventions to improve pupils' mental health. References: 1. Reiss F. Socioeconomic inequalities and mental health problems in children and adolescents: A systematic review. Soc Sci Med. 2013;90: 24–31. doi:10.1016/j.socscimed.2013.04.026 2. Patalay P, O’Neill E, Deighton J, Fink E. School characteristics and children's mental health: A linked survey-administrative data study. Preventative Medicine. 2020;141; 106292. doi:10.1016/j.ypmed.2020.106292 3. Hale DR, Patalay P, Fitzgerald-Yau N, Hargreaves DS, Bond L, Görzig A, et al. School-Level Variation in Health Outcomes in Adolescence: Analysis of Three Longitudinal Studies in England. Prev Sci. 2014;15: 600–610. doi:10.1007/s11121-013-0414-6 4. Ford T et al. The Role of Schools in Early Adolescents’ Mental Health: Findings From the MYRIAD Study. 2021. J Am Ac Ch Ad Psychiatry. 60,12. 1467-1478.. Doi: 10.1016/j.jaac.2021.02.016 5. Konu AI, Lintonen TP, Autio VJ. Evaluation of Well-Being in Schools ? A Multilevel Analysis of General Subjective Well-Being. Sch Eff Sch Improv. 2002;13: 187–200. doi:10.1076/sesi.13.2.187.3432 6. Yap, M.B., Pilkington, P.D., Ryan, S.M., Jorm, A.F., 2014. Parental factors associated with depression and anxiety in young people: a systematic review and meta-analysis. J. Affect. Disord. 156, 8–23. https://doi.org/10.1016/j.jad.2013.11.007. T. Fukuzaki and S. Takeda