NHS Digital Mental Health of Children and Young People in England: Predictors of mental health problems

NHS Digital has published new analysis to complement their 2018 publication on the mental health of children and young people in England.

The original statistics looked at the prevalence of mental health problems in English children broken down by age, ethnicity, and social and economic influences. However, the relationships between these factors are complex. They may be associated with each other as well as with mental health problems.

To help untangle these relationships, NHS Digital conducted new analysis to look at the association between each of these factors and mental health problems, while accounting for the influence of a range of other potentially related things. This is often referred to as “controlling for” or “adjusting for” these factors.  This can help us understand the unique influence of a factor on the likelihood of mental health problems, when other variables (like gender or ethnicity) are held constant.

The analysis looked at the influence of factors in the following categories on the likelihood of having a mental health problem:

  • Income
  • Location
  • Family
  • Demographics

Several factors were consistently associated with a much higher likelihood of any mental health problem across all age groups. These included:

Parental Mental Health

Children whose parents reported poor mental health were much more likely to have a mental health problem than children whose parents reported good mental health.

Across age groups, the odds of children whose parents reported poor mental health having a mental health problem themselves were two and a half to nearly three times greater than children whose parents reported good mental health[1].

Being the child of a parent who has a mental health problem is a unique and complex experience. In one review of the research children described knowing something was wrong, even if adults felt they were too young to understand or wanted to protect them from too much responsibility. Both parents and children spoke of potential benefits of learning more about mental health as a way to provide the vocabulary and knowledge to speak about it openly in the home or with friends and peers[2].

Programmes that aim to support children whose parents struggle with their mental health often focus on this educational component alongside other forms of support (e.g. cognitive or behavioural support, peer support, family support)[3], and there is some evidence to suggest that these approaches can help to lower the risk of developing mental health problems in these children[4].

Receipt of Benefits

Children whose parents received income and/or disability benefits were much more likely to have a mental health problem than children whose parents did not receive benefits.

Across age groups, the odds of children whose parents received benefits having a mental health problem were over two times greater than children whose parents did not receive benefits[5].

This matches a previous review of the research which found that socioeconomically disadvantaged children are two to three times more likely to develop mental health problems, particularly if this disadvantage is sustained over long periods of time[6].

Other Factors

There were a range of other factors such as family functioning that were associated with the likelihood of mental health problems in different ways depending on the age of the young people, and the type of mental health problem. More information on these relationships can be found in the NHS Digital report.

Limitations

It is important to note that these things were all measured at the same time. This means this analysis cannot tell us if parental mental health problems or receipt of benefits necessarily cause mental health problems in children. While this could be the case, it could also be the case that for example, child mental health problems contribute to poorer parental mental health, or that something else that wasn’t measured can influence parental mental health, child mental health, and receipt of welfare benefits. However, this adds to what we already know about the impact that social and economic factors have on mental health and helps us to build a better picture of what these often complicated relationships look like for children and young people in England.

What’s Next

Understanding more about the factors that are strongly associated with mental health problems in children and young people can provide avenues for policy and practice intervention. Therefore, providing support to children of parents with mental health problems and to families in receipt of benefits may be important routes to improving the mental health of children and young people in England.​

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References

  1. Davis, J., Vizard, T., Forbes, N., Pearce, N., Nafilyan, V., Merad, S., Ford, T., McManus, S., Sadler, K., Goodman, R., & Goodman, A. (2019). Mental health of children and young people in England 2017: Predictors of mental disorders (pages 17, 22, 28). NHS Digital. London. Retrieved from: https://files.digital.nhs.uk/85/7FFC57/MHCYP%202017%20Predictors.pdf
  2. Gladston, B.M., Boydell, K.M., Seeman, M.V., & McKeever, P.D. (2011). Children’s experiences of parental mental illness: a literature review. Early Intervention in Psychiatry, 5: 271-289. doi:10.1111/j.1751-7893.2011.00287.x
  3. Reupert, A.E., Cuff, R., Foster, K., van Doesum, K.T.M., & van Santvoort, F. (2012). MJA Open, 1: 18-22. doi: 10.5694/mjao11.11145
  4. Siegenthaler, E., Munder, T., & Egger, M. (2012). Effect of preventative interventions in mentally ill parents on the mental health of the offspring: systematic review and meta-analysis. J Am Acad Child Adolesc Psychiatry, 51(1): 8-17. doi: 10.1016/j.jaac.2011.10.018
  5. Davis, J., Vizard, T., Forbes, N., Pearce, N., Nafilyan, V., Merad, S., Ford, T., McManus, S., Sadler, K., Goodman, R., & Goodman, A. (2019). Mental health of children and young people in England 2017: Predictors of mental disorders (pages 19, 24, 29). NHS Digital. London. Retrieved from: https://files.digital.nhs.uk/85/7FFC57/MHCYP%202017%20Predictors.pdf
  6. Reiss, R. (2013). Socioeconomic inequalities and mental health problems in children and adolescents: a systematic review. Social Science & Medicine, 90: 24-31. https://doi.org/10.1016/j.socscimed.2013.04.026