Risk factors for severe mental health outcomes among young people: a national cohort study

“Prevention of severe mental health difficulties could transform outcomes for younger people.”
— Dr Lucy Goldsmith, Research Fellow

This study is being led by Lucy Goldsmith (UCL) at the NIHR Policy Research Unit in Mental Health and was funded by the Department of Health and Social Care. The study started in 2024 and aims to finish in 2026.

‍This project was reviewed and approved through ECHILD's data access process. Learn how ECHILD data is kept safe.‍

  • This study aims to examine whether social and educational risk factors recorded before the end of year 11 (when pupils are typically aged 16) can predict severe mental health difficulties in the following years.

  • Current policy aims for rapid access to effective early intervention. Developing strategies to achieve this would be helped by identifying priority groups. This research will inform the evidence base to help services identify who is at the greatest risk of severe mental health difficulties.

  • We will do this by addressing the following research questions. In English state secondary school pupils, which educational and social factors are associated with:

    ·         Psychiatric related attendance to A&E after year 11?

    ·         Unplanned psychiatric related inpatient admissions after year 11?

Find out more

  • Background and aims

    Prevention of severe mental health difficulties could transform outcomes for younger people. This study aims to examine whether social and educational risk factors recorded before the end of year 11 (when pupils are typically aged 16) can predict severe mental health difficulties in the following years. Current policy aims for rapid access to effective early intervention. Developing strategies to achieve this would be helped by identifying priority groups.

    Methods and analysis

    We investigate school-specific and demographic risk factors for young people who have severe mental health outcomes. We aim to identify potential priority groups of young people who could benefit from early intervention.

    We focus on English state secondary school pupils and ask which educational and social factors are associated with:

    • Psychiatric related attendance to A&E after year 11?

    • Unplanned psychiatric related inpatient admissions after year 11?

    ECHILD data used

    • HES: Admitted Patient Care, MHSDS, A&E and ECDS (2019-2023)

    • NPD: Spring Census, Absences, Exclusions, Children in Need Census, Key Stages 2 and 4 (2014-2021)

  • Stakeholder and lived experience involvement

    People with related lived experience of both childhood disadvantage and mental health problems were involved in the design, implementation, analysis, interpretation, and writing of the manuscript as part of a project working group. Experts in linked data analysis, children and young people’s mental health, and experts in policy research were included in the Project Working Group. The lead researcher has relevant lived experience.