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Children with poor mental health three times as likely not to pass five GCSEs

26 July 2021 | Tags: mental health, education, attainment, COVID-19

Children experiencing poor mental health while at secondary school are three times as likely not to pass five GCSEs including Maths and English, a major new study led by researchers at the National Centre for Social Research (NatCen) has found.

The study analysed responses from 1,100 children aged 11-14 from the Understanding Society study and used the National Pupil Database for England to link this information to their exam results at age 16.

It found young people with mental health difficulties were three times more likely to not achieve five GCSE grades A*-C (or 9-4), including Maths and English, than their peers.

Poor mental health and lower grades at GCSE were more common for pupils from disadvantaged backgrounds, but mental health difficulties affected young people’s GCSE grades regardless of their background.

The research also found that mental health difficulties adversely affected boys’ educational attainment to a greater extent than girls’.

Even when background factors known to affect mental health as well as grades were controlled for, such as poverty, child-parent relationships and parental engagement with schoolwork, children who experienced mental health difficulties were still twice as likely to not reach the benchmark of five GCSE grades A*-C (or 9-4) including Maths and English.

The study argues that improving young people’s mental health can narrow the attainment gap at GCSE level by boosting the performance of pupils from disadvantaged backgrounds, who are more likely to experience mental health difficulties.

“Improving mental health could possibly increase average attainment levels within this group to a greater extent than within the majority population who are not disadvantaged. The potential effect at a population level would be to reduce the average difference in attainment between socioeconomic groups, and narrow educational and consequent social inequalities”, the research says.

Published today in the journal BMJ Open, the study was carried out by Dr Neil Smith, Dr Lydia Marshall and Muslihah Albakri, NatCen, Dr Melanie Smuk, London School of Hygiene & Tropical Medicine, Dr Ann Hagell, Association for Young People's Health and Prof. Stephen Stansfeld, Queen Mary University of London.

Dr Neil Smith, who led the study at NatCen, said: “As the school year comes to an end, young people are facing a double hit to their educational prospects. First, disruption to schooling caused by the pandemic has directly impacted on learning. Second, the pandemic has adversely affected many young peoples’ mental health, and it’s likely those whose mental health was affected the most by the pandemic will face greater difficulties in making up for learning time that’s been lost.”


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Notes to editors

  1. The National Centre for Social Research (NatCen), Britain’s largest independent social research organisation, aims to promote a better-informed society through high quality social research (
  2. Understanding Society (the UK Household Longitudinal Study) is a large, nationally representative household panel study that interviews all members of 40,000 randomly selected households.
  3. This project was funded by the Economic and Social Research Council (ESRC) Secondary Data Analysis Initiative (Grant ES/R005400/1).
  4. Nationally representative data from 1,100 respondents to Understanding Society between 2009 and 2012 were linked to the National Pupil Database for England to investigate longitudinal associations between mental difficulties at ages 11–14 and educational attainment at age 16 (General Certificate of Secondary Education (GCSE)). The primary outcome measure was not gaining five or more GCSE qualifications at age 16, including English and Maths at grade A*–C. This was the benchmark measure of educational attainment at key stage 4 (KS4) at secondary schools in England during the study period.
  5. Mental difficulties were measured using the Strengths and Difficulties (SDQ) questionnaire validated for ages 4–15 years. The SDQ asks questions about four domains of negative behaviours that have varying strengths of association with educational attainment, namely, conduct problems, hyperactivity, emotional symptoms, peer problems. Scores from the four subscales were summed to construct a total difficulty score, where a higher score refers to a greater level of mental difficulties. These scores were used to create three groups of children – those with ‘typical’, ‘borderline’ and ‘atypical’ mental health. An ‘atypical’ level of total difficulties was derived from the top 10% of the population scores.