Student- and School-Level Factors Associated With Mental Health and Well-Being in Early Adolescence
Open accessAbstract
OBJECTIVE: Adolescence is a key developmental window that may determine long-term mental health. As schools may influence mental health of students, this study aimed to examine the association of school-level characteristics with students' mental health over time. METHOD: Longitudinal data from a cluster randomized controlled trial comprising 8,376 students (55% female; aged 11-14 years at baseline) across 84 schools in the United Kingdom were analyzed. Data collection started in the academic years 2016/2017 (cohort 1) and 2017/2018 (cohort 2), with follow-up at 1, 1.5, and 2 years. Students' mental health (risk for depression [Center for Epidemiologic Studies Depression Scale], social-emotional-behavioral difficulties [Strength and Difficulties Questionnaire]) and well-being (Warwick-Edinburgh Mental Well-Being Scale) and relationships with student- and school-level characteristics were explored using multilevel regression models. RESULTS: Mental health difficulties and poorer well-being increased over time, particularly in girls. Differences among schools represented a small but statistically significant proportion of variation (95% CI) in students' mental health at each time point: depression, 1.7% (0.9%-2.5%) to 2.5% (1.6%-3.4%); social-emotional-behavioral difficulties, 1.9% (1.1%-2.7%) to 2.8% (2.1%-3.5%); and well-being, 1.8% (0.9%-2.7%) to 2.2% (1.4%-3.0%). Better student-rated school climate analyzed as a time-varying factor at the student and school level was associated with lower risk of depression (regression coefficient [95%CI] student level: -4.25 [-4.48, -4.01]; school level: -4.28 [-5.81, -2.75]), fewer social-emotional-behavioral difficulties (student level: -2.46 [-2.57, -2.35]; school level: -2.36 [-3.08, -1.63]), and higher well-being (student level: 3.88 [3.70, 4.05]; school-level: 4.28 [3.17, 5.38]), which was a stable relationship. CONCLUSION: Student-rated school climate predicted mental health in early adolescence. Policy and system interventions that focus on school climate may promote students' mental health.
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School attendance is a critical foundation for academic success, well-being, mental health, economic stability, and societal participation of young people.
“School attendance is crucial for academic success, well-being, and long-term social participation of young people.”
From “So That You Can Feel Well”: Perspectives of Students with Social, Emotional and Behavioral Difficulties on Factors that Support School Attendance (2025) · cites this paper as Hinze et al., 2023
The Discussion (page unavailable) says positive school climate is associated with better attendance and academic performance, and the paper links school climate to mental health and well-being. It does not say that attendance is a foundation for those outcomes or for long-term social participation. I searched the full-text copy for attendance and its relationship to the claimed outcomes. (LLM, conf=0.76)
Experimental — accuracy not yet measuredThe link between mental health issues and school attendance during adolescence has been documented.
“While the link between mental health issues and school attendance during adolescence has been documented”
From “So That You Can Feel Well”: Perspectives of Students with Social, Emotional and Behavioral Difficulties on Factors that Support School Attendance (2025) · cites this paper as Hinze et al., 2023
The Discussion links school climate to adolescent mental health and, separately, says school climate has been associated with better attendance. It does not document a link between mental health issues and attendance themselves (searched: school attendance, absenteeism, attendance). (LLM, conf=0.73)
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Cites
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Enderle, C., Kreitz-Sandberg, S., Backlund, Å., Isaksson, J., Fredriksson, U., & Ricking, H. (2024) · Frontiers in Education · doi:10.3389/feduc.2024.1405395 · Cited by 14 · see citing works
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“While the link between mental health issues and school attendance during adolescence has been documented (e.g. Gubbels et al., 2019; Hinze et al., 2023), the role of complex systems and processes in adolescents’ educational experience and social-emotional development has not been well represented…”
- Authors
- Hinze, V., Montero-Marin, J., Blakemore, S.-J., Byford, S., Dalgleish, T., Degli Esposti, M., Greenberg, M. T., Jones, B. G., Slaghekke, Y., Ukoumunne, O. C., Viner, R. M., Williams, J. M. G., Ford, T. J., & Kuyken, W.
- Affiliations
- University of Oxford (GB)
- University of Cambridge (GB)
- King's College London (GB)
- Pennsylvania State University (US)
- University of Exeter (GB)
- University College London (GB)
- Corresponding author
- Kuyken, Willem
- ORCID
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2024-02
- Volume
- 63
- Issue
- 2
- Pages
- 266-282
- ISSN
- 0890-8567 (ISSN-L)
- PMC
- PMC10935542
- OpenAlex
- W4387769191
- Cited by
- 65
- References
- 7
- Citations by year
- 2026: 17 · 2025: 40 · 2024: 8
- FWCI
- 23.83
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion, cc-by)
- Apollo (University of Cambridge) (submittedVersion, cc-by)
- Figshare (submittedVersion, cc-by)
- Open Research Exeter (University of Exeter) (submittedVersion, cc-by)
- Funders
- Wellcome Trust (WT104908/Z/14/Z, WT107496/Z/15/Z)
- National Institute for Health and Care Research
- Topics
- Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Sociology and Political Science › Psychosocial Factors Impacting Youth
- Keywords
- adolescent mental health, school climate, depression risk, student well-being, early adolescence, school factors, gender differences
- MeSH terms
- Adolescent, Depression, Female, Humans, Male, Mental Health, Surveys and Questionnaires, Schools, Students
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