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

This is the author accepted manuscript. The final version is available from Cambridge University Press via the DOI in this record.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 (BCAMH) 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 (SDQ) 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 (DAWBA). 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 (CI) 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 to 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.This paper presents independent research funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for the South West Peninsula

Data Resource Profile: The Mental Health of Children and Young People Surveys (MHCYP).

This is the author accepted manuscript. The final version is available from Oxford University Press via the DOI in this record.England’s Department of Health and Social Car

The longitudinal relationship between child emotional disorder and parental mental health in the British Child and Adolescent Mental Health surveys 1999 and 2004

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this recordBackground: Research suggests parental psychopathology has an adverse effect on child mental health. However, due to the interactional nature of parent-child relationships and with a high rate of emotional disorders reported in school-age children, it is important to know whether the effect is reciprocal. Methods: We explored the longitudinal relationship between child and parent mental health in the British Child and Adolescent Mental Health Surveys (N=7,100 child-parent dyads) and their threeyear follow-ups. The Development and Well-Being Assessment with DSM-IV diagnostic criteria was used to measure child psychiatric diagnoses, while parental mental health was assessed using the General Health Questionnaire. Multivariable logistic regression was used to explore the longitudinal association between child emotional disorder and parent mental health. Results: Parents of children who had an emotional disorder at baseline were more likely to have poor mental health three years later compared with parents whose children had no psychiatric diagnosis (33.3% versus 16.7%; crude odds ratio=2.52; adjusted odds ratio=2.19, 95% CI=1.58 to 3.05, p<0.001). Children of parents with poor mental health at baseline were more likely to develop an emotional disorder three years later compared with children whose parents had good mental health (5.2% versus 2.5%; crude odds ratio=2.08; adjusted odds ratio=1.63, 95% CI=1.18 to 2.25, p=0.003). Limitations: The findings of this research are limited by the survey data collected, the measures used and survey dropout. Conclusions: We detected a bi-directional relationship between child and parent mental health, suggesting that effective intervention for one individual may benefit other family members.English Department of HealthWelsh AssemblyScottish GovernmentNational Institute for Health Research (NIHR