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Loss of potential: teens diagnosed with depression show reduction in educational achievement from primary school to GCSE

Thursday, October 08, 2020

Teenagers who are diagnosed with depression during school show a substantial decline in attainment in Year 11, new research using South London and Maudsley NHS Foundation Trust data has found.

The King’s College London researchers suggest that targeted educational support for children struggling with depression might particularly benefit boys and those from deprived backgrounds, who were especially vulnerable subgroups in this study, although all children with depression might benefit from such support.

The researchers, funded by the NIHR, carried out a historical, longitudinal cohort study linking data from health and education records.

Using an innovative data resource held at South London and Maudsley NHS Foundation Trust, which links together child mental healthcare records and the Department for Education school records, they identified the primary and secondary educational attainment of young people who received a clinical depression diagnosis under the age of 18.

In their sample of 1,492 children and adolescents the median age at depression diagnosis was 15 years. The researchers compared attainment in this sample against a local group of pupils in Year 2, Year 6 and Year 11.

Study findings – results decline between school Years 6 and 11

Among the group who received a depression diagnosis, 83 percent met the expected attainment threshold of level 2 or above in Year 2, and 77 percent met the expected attainment threshold of level 4 or above in Year 6. This was similar to local levels.

However, only 45 per cent met the expected threshold of five A*–C GCSE or equivalent grades (including English and maths) in Year 11, much lower than the proportion meeting this threshold in the local reference population (53 per cent), and also in national estimates (53 per cent).

Mental health and educational support needed 

Dr Johnny Downs, Senior Clinical Lecturer (Honorary Consultant) in Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, one of the Senior authors adds, “The majority of young people with emotional disorders, such as depression, do not receive treatment from mental health professionals, and so this study has two important policy implications: it demonstrates just how powerful depression can be in reducing young people’s chances at fulfilling their potential, and provides a strong justification for how mental health and educational services need to work to detect and support young people prior to critical academic milestones.”

“It also highlights the importance of secure data-sharing partnerships between health and educational organisations, without which we would not be able conduct these important studies and also conduct future work testing whether changes in health and education policies improve young people’s lives.”

Alice Wickersham, NIHR Maudsley Biomedical Research Centre PhD Student, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, first author said, “Previous research has found that, in general, depression in childhood is linked to lower school performance. But what we’ve observed is that a group of children and adolescents who developed depression at secondary school had performed quite well when they were in primary school. It is only when they sat their GCSEs that they tended to show a drop in their school performance, which also happened to be around the time that many of them were diagnosed. This pattern appears to be quite consistent across different genders, ethnicities, and socioeconomic groups.”

“While it’s important to emphasise that this won’t be the case for all teenagers with depression , it does mean that many  may find themselves at a disadvantage for this pivotal educational milestone. It highlights the need  to pay close attention to teenagers who are showing early signs of depression. For example, by offering them extra educational support in the lead up to their GCSEs, and working with them to develop a plan for completing their compulsory education.”

 The findings have been published today in The British Journal of Psychiatry (BJPsych).

 



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