Mental health problems in the 10th grade and non-completion of upper secondary school: the mediating role of grades in a population-based longitudinal study.

Åse Sagatun,Tore Wentzel-Larsen,Lars Lien,Sonja Heyerdahl,Ase Sagatun

doi:10.1186/1471-2458-14-16

Abstract

BackgroundSchool drop-out is a problem all over the world with adverse life-course consequences. The aim of this paper is to study how internalising and externalising problems in the 10th grade are associated with non-completion of upper secondary school, and to examine the mediating role of grade points in the 10th grade across general academic and vocational tracks in upper secondary school. We also study the impact of health behaviour.MethodsPopulation-based health surveys were linked with Norwegian registries on education and sociodemographic factors (n = 10 931). Mental health was assessed by the self-report Strengths and Difficulties Questionnaire. Logistic regression was used to analyse the relations between mental health and health behaviour in 10th grade and non-completion of upper secondary school. The mediating effect of grade points was studied by causal mediation analysis.ResultsAdolescents not completing upper secondary school reported more externalising problems and girls more internalising problems in the 10th grade, after adjustments. Smoking and physical inactivity increased the odds of non-completion of upper secondary school. Causal mediation analyses showed that a reduction in externalising problems of 10 percentage points led to lower rates of non-completion of 4–5 percentage points, and about three-quarters of this total effect was mediated by grades. For internalising problems the total effect was significant only for girls (1 percentage point), and the mediated effect of grades was about 30%. The effect of mental health problems on school dropout was mainly the same in both vocational and general tracks.ConclusionsAssuming a causal relationship from mental health problems to school performance, this study suggests that externalising problems impair educational attainment. A reduction of such problems may improve school performance, reduce school drop-out and reduce the adverse life-course consequences.

Highlights

School drop-out is a problem all over the world with adverse life-course consequences
We study the mediating role of grade points when analysing the effect of mental health problems in the 10th grade on non-completion of upper secondary school in a causal modelling framework
The mediating role of grade points when analysing the effect of mental health in 10th grade on non-completion of upper secondary school, and the impact of health behaviour In the causal mediation analysis, we found that a 2point decrease in externalising problems in the proposed model would result in a 6.9 percentage point reduction in the probability of non-completion of upper secondary school in boys, after adjustment for internalising problems, family background and sociodemographic factors (Table 6, Model 2)

Summary

Introduction

School drop-out is a problem all over the world with adverse life-course consequences. Studies’ elaborating on possible mechanisms for the associations between various mental health problems and educational outcome are hard to find. Different educational tracks such as general/academic or vocational education and training may require unique skills, and mental health problems may have different consequences for educational attainment in academic and non-academic tracks. To our knowledge, this has not previously been studied. The risk literature for externalising and internalising problems and academic attainment provides clues about potential common causes, such as sociodemographic factors and health behaviour including physical activity, smoking and alcohol habits [13,15,16]

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