Factors affecting children’s mental health and wellbeing: findings

1 Introduction

Understanding the factors that influence mental wellbeing amongst children and young people provides policy makers with an evidence base for targeting initiatives at those who are most at risk. Child circumstances and experiences that can enhance or impair mental wellbeing tend to cluster together: for example, deprivation, family relationships and school experiences are each associated with child mental wellbeing individually, but are also interconnected. This report therefore moves beyond considering associations separately, to examine how a range of factors work together to influence child mental wellbeing when examined together. This approach can help identify the most important factors to target when aiming to maximise the positive impact of child mental wellbeing policies and interventions.

1.1 Policy context

The Realigning Children’s Services (RCS) programme contributes to the Scottish Government’s Getting It Right For Every Child approach. It is a two-stranded programme. The evidence strand gathers data on the experiences of children and young people through school based surveys and maps investment in children and family services. The second strand provides support and facilitation to Community Planning Partnerships (CPPs) to improve their joint strategic decision making in relation to children’s services.

The Scottish Government wants every child to grow up loved, safe and respected so that they can realise their full potential. This is reflected in the National Performance Framework^[1]. The Getting it right for every child (GIRFEC) approach ensures that this is at the heart of all policies and initiatives to help and support children, young people and their families^[2].

GIRFEC has established a common understanding of wellbeing that is shared by children and young people, their parents and the services that support them. It outlines eight wellbeing domains that can be used to assess dimensions of wellbeing: Safe, Healthy, Achieving, Nurtured, Active, Respected, Responsible and Included (known in practice as SHANARRI). This holistic framework of wellbeing is embedded in the Children and Young People (Scotland) Act 2014^[3].

Within the GIRFEC approach, the Realigning Children’s Services (RCS) programme aims to support participating Community Planning Partnerships (CPPs) to make joint strategic decisions using robust and timely evidence. This is achieved by:

• Bringing together organisational stakeholders to share information, build collective understanding, agree priorities and develop joint plans of action.
• Using data and evidence to map current need, services and investment; identify priority outcomes and ways of addressing those; and evaluate subsequent changes to policy and practice.
• Identifying ways to shift investment ‘upstream’ to allow prevention and early intervention and reduce the need for high intensity, high cost services.
• Finding meaningful and effective ways of involving children, families and frontline practitioners in the process of service redesign.
• Using improvement methodology to help CPPs bring about effective, sustainable and scalable change.

This report makes use of data from the RCS Children’s Wellbeing Surveys to examine how a range of potential risk and protective factors combine to influence children and young people’s mental health and wellbeing.

1.2 Understanding the mental wellbeing of children and young people

This report is focused specifically on mental health and mental wellbeing. These are key components of children’s overall wellbeing more broadly, which also encompasses physical health, safety and development.

There are a core set of national mental health indicators for children and young people in Scotland, outlined in a report by NHS Health Scotland^[4]. These indicators cover both mental health problems (using the Strengths and Difficulties Questionnaire; SDQ) and positive mental wellbeing (using the Warwick-Edinburgh Mental Wellbeing Scale; WEMWBS). This report examines mental health problems and positive mental wellbeing, using these measures for secondary school pupils, and age-appropriate equivalent measures for primary school pupils (see Section 2.2 for details on measures).

Mental health problems include symptoms that meet diagnostic criteria for mental illness (most commonly emotional problems and conduct problems) and symptoms below this threshold that still interfere with everyday life. is complex and can be conceptualised in different ways, with ongoing debate around its exact nature. This report follows the working definition of mental wellbeing used in developing the national set of mental health indicators for children and young people^[5]. It is more than an absence of mental health problems, and captures both subjective experiences (e.g. happiness and life satisfaction) and psychological functioning (e.g. confidence, energy and purpose).

Evidence from Scottish secondary school pupils shows that during the last decade, conduct problems have decreased but emotional problems have increased (particularly amongst older girls). In contrast, mental wellbeing has remained relatively stable over time^[6].

1.3 Research questions and report outline

This report presents quantitative analysis of the RCS Children’s Wellbeing Surveys to examine how different factors influence children and young people’s mental health and wellbeing. It uses individual-level survey data to explore the following research questions:

1. How prevalent are emotional and behavioural problems and positive mental wellbeing?

2. How prevalent are potential risk or protective factors?

3. Which of these potential risk or protective factors are most strongly associated with emotional and behavioural problems or positive mental wellbeing?

4. How do different risk or protective factors combine together to influence the likelihood of emotional and behavioural problems or positive mental wellbeing?

Chapter 2 outlines the study methods, with an overview of the surveys, measures and data analysis. Chapters 3 and 4 then present the findings for the secondary and primary school data respectively, addressing each of the research questions above. Finally, Chapter 5 presents the conclusions of the current findings, with recommendations for both future research, policy and practice.