This page includes information about:
- adverse childhood experiences and their impact on mental health
- which groups of children and young people are most at risk
Context
Taking a whole-school or college approach to children and young people’s mental health relies on understanding the systemic issues that affect mental health. This means collecting your own data where possible, noting general trends and identifying risk factors.
Risk factors
Adverse childhood experiences
Research tells us that early childhood experiences, particularly adverse ones – such as poverty, deprivation, physical or sexual abuse, having a parent or carer with a mental health problem, witnessing domestic conflict or violence – have an impact on mental health. The greater the number of adverse childhood experiences (ACEs) a child faces before the age of 18, the greater their chance of poorer outcomes in adulthood. You can find more information about the impact of adverse childhood experiences from the Early Intervention Foundation here.
Systemic issues
Other factors that are associated with increased mental health problems in children and young people include sex, ethnicity, eligibility for free school meals, special education needs, and child-in-need status. The presence of multiple risk factors can make a young person more susceptible to experiencing a mental health problem.
Race and ethnicity
Black Caribbean and mixed White and Black Caribbean pupils are three times more likely to be excluded as White British pupils. Afro-Caribbean boys are far likelier than White boys to have serious mental health problems when they grow up, despite having no higher rate of mental health in their childhood. Racism is known to be a contributing factor to mental health problems.
ONS findings and findings from our HeadStart evaluation show that rates of mental health problems in White Children are higher than any other ethnic group. Headstart findings show that being Asian significantly reduced the odds of experiencing emotional and behavioural difficulties, hyperactivity or inattention difficulties and peer relationship difficulties. Being Black significantly reduced the odds of experiencing emotional difficulties, hyperactivity or inattention difficulties and peer relationship difficulties. Behavioural difficulties experienced by Black children and young people were comparable to White children and young people.
Gender and sexual identity
The most significant increase in the prevalence of mental health problems is in girls and young women aged 16–24. The high rates of self-harm and attempted suicide among those with a mental health disorder – particularly girls – is a reminder, if any were needed, of how serious these issues are.
Further information on prevalence is available from NHS Digital.
Young people who identify as lesbian, gay, bisexual or a sexual identity other than heterosexual are roughly 2.5 times as likely to have a mental disorder than those who identify as heterosexual.

Using information about risk factors
Risk factors cannot be considered in isolation, but are helpful to provide a sense of what the profile of your pupils is so that you can better understand which children or young people could be at risk and may require additional support or monitoring. This information can then be used in conjunction with an in-depth knowledge of pupils and through using surveys. See our Measure pupil wellbeing action for more information about conducting surveys.
Anna Freud and CORC: Using measurement tools to understand need
This short guide for schools and colleges focuses on how to use measurement tools to understand pupils’ wellbeing so that you can provide them with the support they need.
Mentally Healthy Schools: Risks and protective factors
This section of the site helps school staff understand the many risk factors that may challenge and undermine children’s mental health including being vulnerable, having family problems e.g. substance misuse, and poverty.
Young People and Trauma
Bereavement
Mentally Healthy Schools: Bereavement and loss
This page offers information about child bereavement and loss, including spotting the signs of complex grief.
UK Trauma Council: Childhood Trauma and the Brain animation
A general introduction to what happens in the brain after children face traumatic experiences in childhood, like abuse and neglect. You can find additional resources to support your learning in the resources section of the UK Trauma Council website.
Create an account and login to access and update your personalised 5 Steps action plan
More information about the 5 steps and easy to follow instructions
Find out more about our training offer for schools and colleges
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