Young people with multiple mental health disorders who have been hospitalised have up to eight times the risk of not completing high school when compared to their peers, according to new research from the Australian Institute of Health Innovation at Macquarie University.
Warning signs: The most common diagnoses for girls of all ages were depression and anxiety disorders.
The study, published in the Australian and New Zealand Journal of Psychiatry, looked at young people hospitalised due to mood, anxiety, eating, substance abuse, conduct disorder or a pattern of antisocial behaviour, and psychotic disorders. The most common diagnoses for girls of all ages were depression and anxiety disorders.
It is the fifth in a series led by Associate Professor Rebecca Mitchell to investigate educational outcomes for children and youths who have been hospitalised at least once for reasons including injury, asthma, epilepsy and Type 1 diabetes.
For all five studies, the research team used linked birth, health and education records in NSW from 2005 to 2018 to analyse NAPLAN assessment tests and high school completion.
Unfortunately, young people with mental health disorders often perform poorly at school.
To create a peer comparison group, each hospitalised young person was matched against a randomly selected peer of the same age and gender who lived in the same postcode, but had not been hospitalised.
Mitchell said the findings around mental health had been the most pronounced of any of the studies.
“Unfortunately, young people with mental health disorders often perform poorly at school,” she said.
“Boys hospitalised for mental health reasons were 1.7 times more likely than their peers to not achieve the national minimum standard (NMS) in both numeracy and literacy. For girls, there was no difference in reading, but they were 1.5 times more likely to not achieve the NMS in numeracy.
“We saw the biggest differences in high school completion rates. Both boys and girls with a single mental health disorder had a three times higher risk of not completing Year 12 when compared to their peers.
“This more than doubled for girls with multiple mental health disorders, who had eight times the risk of not finishing school. Boys with multiple disorders had six times the risk.
“Not completing high school can have an ongoing negative effect for the rest a person’s life, not only by reducing employment opportunities, but because it can be associated with poorer general health and even instability in relationships.”
One in seven have disorder
For boys in the Years 3 to 9 age group, the most common diagnoses were conduct and anxiety disorders. By the time boys reached the Years 10 to 12 age group, the most common disorders were anxiety, conduct and substance abuse.
Help at hand: Early recognition and support for kids’ mental health disorders, and access to services, could improve school performance.
More than 96 per cent of the young people hospitalised for mental health concerns had not been in hospital for other health conditions; 83 per cent came from English-speaking households, similar to that of the general population.
Professor Olav Nielssen, Clinical Professor of Psychiatry at Macquarie University, said about one in seven children and young people in Australia had a mental health disorder, with mood, anxiety, substance abuse and conduct disorders being the most common.
“Mental health disorders can be the cause of poor performance at school, or coincide with other problems, such as poor supervision at home, and conduct disorder, that in turn affect participation at school,” Nielssen said.
Conduct disorders create their own vicious cycle of suspension that further interrupts education.
“Substance abuse can also lead to further mental health issues, for example, cannabis, the usual gateway drug, affects mental function and contributes to the earlier onset of psychosis.
“Conduct disorders, which can include aggressive behaviour and acting out in class, create their own vicious cycle of suspension that further interrupts education.”
Nielssen said there were not many mental health beds for under 18s, and only the most serious cases were hospitalised, which could explain why hospital admission for any disorder was linked to poor educational outcomes.
“We shouldn’t be waiting until kids start dropping out of school, which can be a warning sign that they’re having trouble with their mental health.
“Early recognition and support for kids’ mental health disorders, and access to services, could improve school performance and educational outcomes if it’s provided with the involvement and assistance of the school.
“If the pandemic has shown us anything it’s that remote education is possible, so perhaps that’s something that could be provided while young people with mental health disorders are admitted to hospital.”
Associate Professor Rebecca Mitchell (pictured) is a researcher at the Australian Institute of Health Innovation at Macquarie University.
Professor Olav Nielssen is a Clinical Professor of Psychiatry at Macquarie University.