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Poor mental health “both cause and effect” of school exclusion

Press release issued: 22 January 2020

News release re-published from University of Exeter.

Children with mental health needs require urgent support from primary school onwards to avoid exclusion, which can be both cause and effect of poor mental health, new research concludes [22 January].

The research, led by the University of Exeter, concluded that a swift response is needed, finding that young people with mental health difficulties were more likely to be excluded and also suffer ill-effects from exclusion. The research, which was initially funded by a doctoral studentship from the NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula, found gender differences in the relationship between mental health and exclusion.

Boys who entered school with poor mental health are at high risk of exclusion in primary school, which prompt assessment and intervention may prevent.  There were too few girls excluded at this early stage in their school career to be sure if they also had poor mental health prior to school entry.

Girls who were excluded in their final year of school experienced deteriorating mental health difficulties afterwards. Teenage boys excluded at this time demonstrated worse mental health than their peers, but did not seem to struggle more afterwards. Both boys and girls who were excluded between the ages of 15 and 16 years may have poor, and in the case of girls, deteriorating, mental health.

Professor of Child and Adolescent Psychiatry, Tamsin Ford said: “This research provides further evidence that poor mental health may be both cause and effect of exclusion from school.  These children are often facing a wide range of challenges, and need both education and mental health practitioners to act quickly and effectively to prevent exclusion and improve both educational and health outcomes in later life.”

The 2017 Mental Health of Children and Young People in England survey reported that one in eight children between five and 19 years old had at least one mental disorder. Latest government statistics also suggested that exclusions had hit an all-time high during the 2017-18 school year with 7,900 pupils excluded, equivalent to 42 per day.

Children in the current study who were excluded from school often had poor mental health and faced early family adversity, signalling the need for support for vulnerable children throughout their schooling. Researchers found gender differences in how exclusion impacted the mental health of children.  

The study used data from the Chidren of the 90s study, which included assessing children’s mental health at a set range of ages from three to 16 years old. Data collection for this cohort, which has run since the early 1990’s, was funded by the Wellcome and Medical Research Council.  More than 8,000 parents responded to a survey asking whether their child had been excluded from school up to the age of eight, and more than 4,000 replied to a second question whether their child had been excluded between 15 and 16 years old.

The full paper entitled: ‘Child and adolescent mental health trajectories in relation to exclusion from school from the Avon Longitudinal Study of Parents and Children (ALSPAC)’ is available at:

Further information

The National Institute for Health Research (NIHR) is the nation's largest funder of health and care research. The NIHR:

•  Funds, supports and delivers high quality research that benefits the NHS, public health and social care

•  Engages and involves patients, carers and the public in order to improve the reach, quality and impact of research

•  Attracts, trains and supports the best researchers to tackle the complex health and care challenges of the future

•  Invests in world-class infrastructure and a skilled delivery workforce to translate discoveries into improved treatments and services

•  Partners with other public funders, charities and industry to maximise the value of research to patients and the economy

The NIHR was established in 2006 to improve the health and wealth of the nation through research, and is funded by the Department of Health and Social Care. In addition to its national role, the NIHR supports applied health research for the direct and primary benefit of people in low- and middle-income countries, using UK aid from the UK government.

This work uses data provided by patients and collected by the NHS as part of their care and support and would not have been possible without access to this data. The NIHR recognises and values the role of patient data, securely accessed and stored, both in underpinning and leading to improvements in research and care.

About the University of Exeter Medical School

The University of Exeter Medical School is part of the University of Exeter’s College of Medicine and Health. Our mission is to improve the health of the South West and beyond, through the development of high quality graduates and world-leading research that has international impact.

As part of a Russell Group university, we combine this world-class research with very high levels of student satisfaction. Exeter has over 19,000 students and is ranked 12th in The Times and Sunday Times Good University Guide 2019.

The University of Exeter Medical School’s Medicine course is in the top 10 in the Complete University Guide 2020, and The Times 2019 guide.

The College’s Medical Imaging programme is ranked in the top 5 in the Guardian Guide 2020, the Complete University Guide 2020, and The Times 2019 guide.

The University of Exeter entered the world top 20 for Biomedical and Health Sciences in the CWTS Leiden Ranking 2019, based on the percentage of publications ranked in the top 10 per cent most cited.

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