School characteristics and children’s mental health: A linked survey-administrative data study

Background. Mental health difficulties are childhood-onset with lifelong consequences. Children spend a large proportion of their daily life in schools, making the school setting an important context for mental health prevention and support. Methods. Data from a large-scale mental health survey were linked to the national pupil and school census databases. Data from 23,215 children from 648 primary schools were analysed to examine the associations of school composition (school size, gender, socioeconomic and ethnicity composition) and school climate with emotional and behavioural symptoms, as well as high mental health difficulties (scores above clinical cut-off). The proportion of school-level variation explained by composition and climate and whether the association of school factors with mental health were moderated by child-level socio-demographic characteristics were also investigated. Results. After controlling for child-level characteristics, 3 to 4.5% of the variation in children’s mental health outcomes could be attributed to schools. Of this, small proportions were explained by school composition (1.4 to 3.8%) and larger proportions were explained by differences in school climate (29.5 to 48.8%). In terms of composition, lower school socio-economic status (SES) was associated with higher mean behavioural symptoms and slightly raised odds of high mental health difficulties (OR = 1.05, 95% CI: 1.01,1.09). More positive school climate was associated with lower mean emotional and behavioural symptoms and lower odds of mental health difficulties (OR = 0.78, 95% CI: 0.74, 0.81). Some of the associations between school factors and mental health were moderated by child sex and SES.Conclusion. School composition was for the most part not associated with children’s mental health and explained only a small proportion of the between school variation in mental health. School deprivation was the only compositional variable to be associated with poor mental health and its association was moderated by the child’s socio-economic status. School climate explained a large amount of the between-school variation in mental health and appears a good target for universal prevention of mental health difficulties in children.