# The impact of school absence on mental health in children and young people: Analysis of an English national birth cohort

## TL;DR

This study shows that school absence is strongly linked to mental health problems in children and young people, even before the pandemic.

## Contribution

The study provides causal evidence from pre-pandemic data on the mental health impact of school absence.

## Key findings

- High school absence quadruples the odds of later mental health problems in young children.
- Persistent absence (>10% of school year) is associated with doubled odds of mental health issues.
- The association between school absence and mental health problems is consistent across primary and secondary school.

## Abstract

Given concerns the role of school closures in increasing mental health problems after the Covid-19 pandemic, we used pre-pandemic data to undertake a causal epidemiological analysis of the associations of school absence with later mental health problems.

Longitudinal data from the Millennium Cohort Study were collected pre-pandemic at ages 7 (in 2008), 11 (2012) and 14 years (2015), securely linked with English routine educational data on school absence in the 2 years preceding each cohort wave. We constructed marginal structural models for mental health problems (as outcome) and quartiles of absence (exposure), taking account of baseline and time-varying confounding.

Those in the highest quartile of absence had odds ratios (OR) for experiencing later mental health problems of 2.216 (1.629, 3.014) at age 7 (n = 6383), and in lagged models OR of 1.508 (1.072, 2.122) at age 11 (n = 6102) and 1.903 (1.234, 2.934) at 14 years (n = 5616). Persistent absence (>10% of school year) was associated with OR for later mental health problems of 2.00 (1.56, 2.57) at 7 years, and in lagged models OR of 2.26 (1.62, 3.14) at 11 years and 2.00 (1.27, 3.16) at 14 years.

School absence above the second quartile doubled the odds of later mental health problems in both primary and secondary school children in pre-pandemic data. Our findings support there being a strong and potentially causal association between absence from school and later mental health problems, and suggest that absence from school is harmful for CYP’s mental health.