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

Children in the highest quartile of school absence had significantly increased odds of later mental health problems at age 7.

• Odds ratio of 2.216 (95% CI: 1.629, 3.014) for mental health problems at age 7
• Sample size at age 7 was n=6383
• Data collected in 2008 from the Millennium Cohort Study
• Analysis used marginal structural models accounting for baseline and time-varying confounding

Children in the highest quartile of school absence had significantly increased odds of later mental health problems at age 11 in lagged models.

• Odds ratio of 1.508 (95% CI: 1.072, 2.122) at age 11
• Sample size at age 11 was n=6102
• Data collected in 2012
• Lagged models were used, meaning absence preceded the mental health outcome measurement

Children in the highest quartile of school absence had significantly increased odds of later mental health problems at age 14 in lagged models.

• Odds ratio of 1.903 (95% CI: 1.234, 2.934) at age 14
• Sample size at age 14 was n=5616
• Data collected in 2015
• Absence was measured in the 2 years preceding each cohort wave

Persistent absence (greater than 10% of school year) was associated with approximately doubled odds of later mental health problems across all age groups.

• OR of 2.00 (95% CI: 1.56, 2.57) at 7 years
• OR of 2.26 (95% CI: 1.62, 3.14) at 11 years in lagged models
• OR of 2.00 (95% CI: 1.27, 3.16) at 14 years in lagged models
• Persistent absence was defined as more than 10% of the school year

The study used pre-pandemic longitudinal data from the Millennium Cohort Study linked with English routine educational data to perform a causal epidemiological analysis.

• Data collected at ages 7 (2008), 11 (2012), and 14 years (2015)
• Educational data on school absence in the 2 years preceding each cohort wave were securely linked
• Marginal structural models were constructed for mental health problems as outcome and quartiles of absence as exposure
• Models accounted for baseline and time-varying confounding
• Analysis was explicitly framed as pre-pandemic to address concerns about school closures and mental health following Covid-19

School absence above the second quartile doubled the odds of later mental health problems in both primary and secondary school children.

• The doubling of odds was observed across both primary school age (7 years) and secondary school age (11 and 14 years)
• The authors conclude findings 'support there being a strong and potentially causal association between absence from school and later mental health problems'
• The authors state 'absence from school is harmful for CYP's mental health'