Investigating the link between depression and school performance

PhD Impact Story

Depression is thought to be associated with various school problems during childhood and adolescence. Existing literature on this subject shows that depression symptoms are associated with lower subsequent school performance. But less is known and understood about whether depression is associated with specific changes in school performance over time and its full impact. This topic was investigated by Alice Wickersham, a PhD student funded by NIHR Maudsley BRC.

Alice and her collaborators used a large, existing linkage between data from the Department for Education and the Clinical Record Interactive Search (CRIS). CRIS provides authorised researchers with regulated, secure access to anonymised electronic health information from South London and Maudsley NHS Foundation Trust (SLaM), including Child and Adolescent Mental Health Services.

Findings show the impact of depression on pupils at GCSE level

Their findings suggest that children and adolescents who receive a depression diagnosis before age 18 perform at average, or even above average levels in School Years 2 and 6, however, they showed a substantial decline in their performance in School Year 11. Pupils diagnosed with depression before age 15 were 40% less likely to achieve expected GCSE attainment thresholds (achieve five or more A* to C GCSEs including English and Maths), as compared to those who did not receive a depression diagnosis.

These findings illustrate that many pupils with depression may not fulfil their academic potential. This should encourage educators to offer extra educational support to pupils showing early signs of depression, and to help those pupils develop a plan for completing their compulsory education, a pivotal educational milestone.

Raising awareness among the public, policymakers, charities and teachers

So far, the findings have been published in the Journal of the American Academy of Child & Adolescent Psychiatry and The British Journal of Psychiatry. The research has also been publicised by major media outlets like BBC News Online. As well as raising public awareness, the findings received further comment from spokespeople at the Department for Education, Association of School and College Leaders, and Young Minds. They drew further attention to funding pressures being faced by schools, the need for pupils to receive mental health support, and the potential for these issues to increase in the wake of the Covid-19 pandemic.

In response to the work, Times Educational Supplement also published an outline of eight ways that teachers can support pupils with depression, from spotting early signs of depression to collaborating with pupils’ therapists.

Collaboration and social research

As a result of this work, Alice was awarded a Short Placement Award for Research Collaboration by NIHR to analyse similar data held by the Cambridge Biomedical Research Centre. This placement benefited Alice and her colleagues by developing new collaborations with researchers at the University of Cambridge, understanding how the mental health service pathway for children and adolescents with depression compare between different regions of England, and informing the transferability of methods developed using SLaM data to another NHS Trust’s infrastructure.

This work has also led to Alice being awarded a research fellowship funded by Administrative Data Research UK, an Economic and Social Research Council investment (part of UK Research and Innovation). Building on the methods she developed to investigate school performance trajectories, she is exploring the association between school performance trajectories and offending outcomes using data from the Department for Education and Ministry of Justice. This is another step towards understanding how risk factors span across domains of mental health, education and crime, with the potential to inform policy and crime prevention measures.

Read more about Alice’s research in our news story Diagnosis of depression in adolescents can negatively impact educational performance, study shows’.



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