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Are children with unrecognised psychiatric disorders being excluded from school? A secondary analysis of the British Child and Adolescent Mental Health Surveys 2004 and 2007

Published online by Cambridge University Press:  20 December 2018

Claire Parker Open the ORCID record for Claire Parker [Opens in a new window] ,
María Tejerina-Arreal ,
William Henley ,
Robert Goodman ,
Stuart Logan  and
Tamsin Ford
Claire Parker*
Affiliation:
College of Medicine and Health, University of Exeter, Exeter, UK
María Tejerina-Arreal
Affiliation:
College of Medicine and Health, University of Exeter, Exeter, UK Personality, Evaluation and Psychological Treatments Department, Faculty of Psychology, University of Murcia, Murcia, Spain
William Henley
Affiliation:
College of Medicine and Health, University of Exeter, Exeter, UK
Robert Goodman
Affiliation:
Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Stuart Logan
Affiliation:
College of Medicine and Health, University of Exeter, Exeter, UK
Tamsin Ford
Affiliation:
College of Medicine and Health, University of Exeter, Exeter, UK
*
Author for correspondence: Claire Parker, E-mail: c.h.parker@exeter.ac.uk
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Abstract

Background

There is limited research that explores the association between exclusion from school and mental health, but it seems intuitively plausible that the recognition of mental difficulties by key teachers and parents would influence the likelihood of exclusion from school.

Methods

A secondary analysis of the British Child and Adolescent Mental Health survey 2004, (n = 7997) and the 2007 follow-up (n = 5326) was conducted. Recognition of difficulty was assessed via a derived variable that combined the first item of the Impact supplement of the Strengths and Difficulties Questionnaire which asked parents and teachers if they thought that the child has difficulties with emotions, behaviour and concentration, and the presence/absence of psychiatric disorder measured by the Development and Well-being Assessment.

Results

Adjusted logistic regression models demonstrated that children with recognised difficulties were more likely to be excluded [adjusted odds ratio (OR) 5.78, confidence interval 3.45–9.64, p < 0.001], but children with unrecognised difficulties [adjusted OR 3.58 (1.46–8.81) p < 0.005] or recognised subclinical difficulties [adjusted OR 3.42 (2.04–5.73) p < 0.001] were also more likely to be excluded than children with no difficulties. Children with conduct disorder and attention deficit hyperactivity disorder were most likely to be excluded compared with other types of disorder.

Conclusion

Exclusion from school may result from a failure to provide timely and effective support rather than a failure to recognise psychopathology.

Keywords

Behaviourchildpsychopathologyrecognitionschool exclusion
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 15 , November 2019 , pp. 2561 - 2572
Copyright
Copyright © Cambridge University Press 2018 

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References

Achenbach, TM, McConaughy, SH and Howell, CT (1987) Child/adolescent behavioral and emotional problems: implications of cross-informant correlations for situational specificity. Psychological Bulletin 101, 213–232.10.1037/0033-2909.101.2.213Google Scholar
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, 4th Edn. (DSM-IV). Washington, DC: American Psychiatric Association.Google Scholar
Association of Teachers and Lecturers (2015) School children's mental health at serious risk. Available at http://www.atl.org.uk (Accessed 28 March 2018).Google Scholar
CACI Information Services (1993) ACORN User Guide, CACI Limited 1994. All Rights Reserved. Source: ONS and GRO (S) © Crown Copyright 1991.Google Scholar
Children's Commissioner (2012) “They never give up on you”, Office of the Children's Commissioner School Exclusions Inquiry, London.Google Scholar
Children's Commissioner (2013) “Always someone else's problem”, Office of the Children's Commissioner School Exclusions Inquiry, London.Google Scholar
Cloth, AH, Evans, SW, Becker, SP and Paternite, CE (2014) Social maladjustment and special education: state regulations and continued controversy. Journal of Emotional and Behavioral Disorders 22, 214–224.10.1177/1063426613487405Google Scholar
Collishaw, S, Goodman, R, Ford, T, Rabe-Hesketh, S and Pickles, A (2009) How far are associations between child, family and community factors and child psychopathology informant-specific and informant-general? Journal of Child Psychology and Psychiatry 50, 571–580.10.1111/j.1469-7610.2008.02026.xGoogle Scholar
Craddock, N and Mynors-Wallis, L (2014) Psychiatric diagnosis: impersonal, imperfect and important. British Journal of Psychiatry 204, 93–95.10.1192/bjp.bp.113.133090Google Scholar
Department for Education (2010) The Importance of Teaching – The Schools White Paper 2010. London: The Stationary Office Limited.Google Scholar
Department for Education (2012) Pupil Behaviour in Schools in England (DFE-RR218). London: The Stationary Office Limited.Google Scholar
Department for Education (2018) Permanent and fixed period exclusions from schools and exclusion appeals in England: 2016/17. Available at https://www.gov.uk/government/statistics/permanent-and-fixed-period-exclusions-in-england-2015-to-2016. (Accessed 20 July 2017).Google Scholar
Department for Education, Department of Health (2014) Special Educational Needs and Disability Code of Practice: 0 to 25 Years. London: The Stationary Office Limited.Google Scholar
Department of Health, NHS England (2014) Future in mind: promoting, protecting and improving our children and young people's mental health and wellbeing. Available at https://www.gov.uk/government/publications/improving-mental-health-services-for-young-people (Accessed 17 March 2015).Google Scholar
Department of Health & Social Care & Department for Education (2018) Government Response to the Consultation on Transforming Children's and Young Peoples Mental health provision: a Green Paper and Next Steps. London.Google Scholar
Ford, T (2004) Services for Children with Mental Health Disorders: Rates and Predictors of Specialist Service Use (PhD thesis). Institute of Psychiatry, Kings College London, University of London.Google Scholar
Ford, T and Parker, C (2016) Emotional and behavioural difficulties and mental (ill) health. Emotional and Behavioural Difficulties 21, 1–7.10.1080/13632752.2016.1139300Google Scholar
Ford, T, Goodman, R and Meltzer, H (2003) The British child and adolescent mental health survey 1999: the prevalence of DSM-IV disorders. Journal of the American Academy of Child and Adolescent Psychiatry 42, 1203–1211.10.1097/00004583-200310000-00011Google Scholar
Ford, T, Hamilton, H, Meltzer, H and Goodman, R (2007) Child mental health is everybody's business; the prevalence of contacts with public sectors services by the types of disorder among British school children in a three year period. Child and Adolescent Mental Health 12, 13–20.10.1111/j.1475-3588.2006.00414.xGoogle Scholar
Ford, T, Hamilton, H, Meltzer, H and Goodman, R (2008) Predictors of service use for mental health problems Among British School children. Child and Adolescent Mental Health 13, 32–40.10.1111/j.1475-3588.2007.00449.xGoogle Scholar
Ford, T, Macdiarmid, F, Russell, AE, Racey, D and Goodman, R (2017) The predictors of persistent DSM-IV disorders in 3-year follow-ups of the British Child and Adolescent Mental Health Surveys 1999 and 2004. Psychological Medicine 47, 1126–1137.10.1017/S0033291716003214Google Scholar
Ford, T, Parker, C, Salim, J, Goodman, R, Logan, S and Henley, W (2018 a) The relationship between exclusion from school and mental health: a secondary analysis of the British Child and Adolescent Mental Health Surveys 2004 and 2007. Psychological Medicine 48, 629–641.10.1017/S003329171700215XGoogle Scholar
Ford, T, Hayes, R, Byford, S, Edwards, V, Fletcher, M, Logan, S, Norwich, B, Pritchard, W, Allen, K, Allwood, M, Ganguli, P, Grimes, K, Hansford, L, Longdon, B, Norman, S, Prices, A and Ukoumunne, O (2018 b) The effectiveness and cost-effectiveness of the incredible years® teacher classroom management programme in primary school children: results of the STARS cluster randomised controlled trial. Psychological Medicine, [online] 1–15. doi: 10.1017/S0033291718001484.Google Scholar
Frith, E (2016) Centre forum commision for children and young´s people mental health. State of the nation report. Available at http://centreforum.org/publications/children-young-peoples-mental-health-state-nation/ (Accessed April 2016).Google Scholar
Gill, K (2017) Making The difference: Breaking the link between school exclusion and social exclusion, IPPR. Available at http://www.ippr.org/publications/making-the-difference (Accessed March 2018).Google Scholar
Goldberg, D and Williams, PA (1988) User's Guide to the General Health Questionnaire. Windsor: NFER-Nelson.Google Scholar
Goodman, R (2001) Psychometric properties of the strengths and difficulties questionnaire. Journal of the American Academy of Child and Adolescent Psychiatry 40, 1337–1345.Google Scholar
Goodman, R, Ford, T, Richards, H, Gatward, R and Meltzer, H (2000) The development and well-being assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology. Journal of Child Psychology and Psychiatry 41, 645–655.10.1111/j.1469-7610.2000.tb02345.xGoogle Scholar
Green, H, McGinnity, A, Meltzer, H, Ford, T and Goodman, R (2005) Mental Health of Children and Young People in Great Britain, 2004. London: Palgrave Macmillan.Google Scholar
Hemphill, SA, Toumbourou, JW, Smith, R, Kendall, GE, Rowland, B, Freiberg, K and Williams, JW (2010) Are rates of school suspension higher in socially disadvantaged neighbourhoods? An Australian study. Health Promotion Journal of Australia 21, 12–18.Google Scholar
Heyman, I, Fombonne, E, Simmons, H, Ford, T, Meltzer, H and Goodman, R (2001) Prevalence of obsessive-compulsive disorder in the British nationwide survey of child mental health. The British Journal of Psychiatry 179, 324–329.Google Scholar
Kim-Cohen, J, Caspi, A, Moffitt, T, Harrington, H, Milne, BJ and Oulton, R (2003) Prior juvenile diagnoses in adults with mental health disorders: a follow-back of a prospective longitudinal cohort. Archives of General Psychiatry 60, 709–717.Google Scholar
Liddle, EB, Batty, MJ and Goodman, R (2009) The social aptitudes scale: an initial validation. Social Psychiatry and Psychiatric Epidemiology 44, 508–513.Google Scholar
Loades, ME and Mastroyannopoulou, K (2010) Teachers recognition of children's mental health problems. Child and Adolescent Mental Health 15, 150–156.10.1111/j.1475-3588.2009.00551.xGoogle Scholar
MECD (Ministerio de Educación, Cultura y Deporte de España) (2016) Facts and figures, 2016/2017 School year. Available at http://www.mecd.gob.es (Accessed 30 December 2016).Google Scholar
Mellin, EA, Ball, A, Iachini, A, Togno, N and Rodriguez, AM (2017) Teachers’ experiences collaborating in expanded school mental health: implications for practice, policy and research. Advances in School Mental Health Promotion 10, 85–98.Google Scholar
Munir, KM (2016) The co-occurrence of mental disorders in children and adolescents with intellectual disability/intellectual developmental disorder. Current Opinion in Psychiatry 29, 95–102.Google Scholar
Newlove-Delgado, T, Ukoumunne, O, Stein, K and Ford, T (2015) Trajectories of psychopathology in relation to mental health related service contacts over three years in the British child and adolescent mental health survey 2004. European Psychiatry 30, 28–31.Google Scholar
NHS England (2016 a) Children and Young People Improving Access to Psychological Therapies Programme. Available at https://www.england.nhs.uk/mentalhealth/cyp/iapt (Accessed March 2016).Google Scholar
NHS England (2016 b) The Five Year Forward View for Mental Health. Available at https://www.england.nhs.uk/2016/02/paul-farmer-3/ (Accessed February 2016).Google Scholar
Nye, E (2017) Classroom Behaviour Management to Support Children's Social, Emotional, and Behavioural Development (PhD). University of Oxford.Google Scholar
Paget, A, Parker, C, Heron, J, Logan, S, Henley, W, Emond, A and Ford, T (2018) Which children and young people are excluded from school? Findings from a large British birth cohort study, the Avon Longitudinal Study of Parents and Children (ALSPAC). Child Care Health and Development 44, 285–296.Google Scholar
Parker, C and Ford, T (2013) School exclusion is a mental health issue. Journal of Child Psychology and Psychiatry 54, 1366–1368.Google Scholar
Parker, C, Whear, R, Ukoumunne, OC, Bethel, A, Thompson-Coon, J, Stein, K and Ford, T (2014) School exclusion in children with psychiatric disorder or impairing psychopathology: a systematic review. Emotional and Behavioural Difficulties 20, 229–251.Google Scholar
Parker, C, Marlow, R, Kastner, M, May, F, Mitrofan, O, Henley, W and Ford, T (2016 a) The “Supporting KIds avoiding Problems (SKIP) study: relationships between school exclusion, psychopathology, development and attainment”. Journal of Children's Services 11, 91–110.Google Scholar
Parker, C, Paget, A, Ford, T and Gwernan-Jones, R (2016 b) '..he was excluded for the kind of behaviour that we thought he needed support with…' A qualitative analysis of the experiences and perspectives of parents whose children have been excluded from school. Emotional and Behavioural Difficulties 21, 133–151.Google Scholar
Parker, C, Paget, A, Ford, T and Gwernan-Jones, R (in submission) ‘It sounds like I'm making excuses doesn't it?’ A qualitative analysis of the experiences and perspectives of teachers making sense of exclusion from school. Emotional and Behavioural Difficulties.Google Scholar
Parry-Langdon, N (ed) (2008) Three Years on: Survey of the Development and Emotionial Well-Being of Children and Young People. London: ONS.Google Scholar
Patalay, P, Giese, L, Stanković, M, Curtin, C, Moltrecht, B and Gondek, D (2016) Mental health provision in schools: priority, facilitators and barriers in 10 European countries. Child and Adolescent Mental Health 21, 139–147.Google Scholar
Rothi, DM, Leavey, G and Best, R (2008) Recognising and managing pupils with mental health difficulties: teachers' views and experiences on working with educational psychologists in schools. Pastoral Care in Education 26, 127–142.Google Scholar
Specht, JA (2013) Mental health in schools: lessons learned from exclusion. Canadian Journal of School Psychology 28, 43–55.Google Scholar
StataCorp. (2015) Stata Statistical Software: Release 14. College Station, TX: StataCorp LP.Google Scholar
Vostanis, P, O'Reily, M, Taylor, H, Day, C, Street, C, Wolpert, C and Edwards, R (2012) What can education teach child mental health services? Practitioners' perceptions of training and joint working. Emotional and Behavioural Difficulties 17, 109–124.Google Scholar
Whear, R, Marlow, R, Boddy, K, Ukoumunne, OC, Parker, C, Ford, T and Stein, K (2013) Psychiatric disorder or impairing psychology in children who have been excluded from school: a systematic review. School Psychology International 35, 530–543.Google Scholar
Winsper, C, Wolke, D, Bryson, A, Thompson, A and Singh, SP (2016) School mobility during childhood predicts psychotic symptoms in late adolescence. Journal of Child Psychology and Psychiatry 57, 957–966.10.1111/jcpp.12572Google Scholar
Wolke, D, Waylen, A, Samara, M, Steer, C, Goodman, R, Ford, T and Lamberts, K (2009) Does selective dropout in longitudinal studies lead to biased prediction of behaviour disorders? British Journal of Psychiatry 195, 249–256.Google Scholar
World Health Organization (1993) The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research. Geneva: Worl Health Organization. Available at http://www.who.int/classifications/icd/en/GRNBOOK.pdf (Accessed March 2017).Google Scholar
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