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Young people with depression need targeted educational support before GCSEs

Children suffering with depression would benefit from targeted educational support on the lead up to their GCSEs, researchers have said.

The King’s College London research found that young people who receive a depression diagnosis during their school career show a substantial decline in attainment in Year 11.

Dr Johnny Downs, senior author, Senior Clinical Lecturer (Honorary Consultant) in Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, said: “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.”

The researchers, funded by the NIHR, carried out a historical, longitudinal cohort study linking data from health and education records. Using 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, researchers identified the primary and secondary educational attainment of young people who received a clinical depression diagnosis under the age of 18.

In the 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.

The results showed that while young people who had received a depression diagnosis in their school career had achieved well at primary school, their attainment declined as they headed towards their GCSEs.

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

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

Alice Wickersham, first author, NIHR Maudsley Biomedical Research Centre PhD Student, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, 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,” she added.

Dr Johnny Downs added: “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,” he concluded.

Educational attainment trajectories among children and adolescents with depression, and the role of sociodemographic characteristics: longitudinal data-linkage study


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