Nearly a quarter of young people in Wales report very high levels of mental health symptoms following the pandemic

Nearly a quarter of secondary school learners in Wales reported having very high levels of mental health symptoms in the years following COVID-19, according to the latest report from the School Health Research Network (SHRN) at Cardiff University.

The report presents the findings of a large, school-based survey of young people in Wales, which is delivered by Cardiff University in partnership with Public Health Wales and Welsh Government and provides the first detailed overview of young people's health and well-being since the pandemic began. For the first time, a selection of the data can also be compared across local authority areas in Wales, thanks to a SHRN partnership with analysts at Public Health Wales, who have developed an online interactive dashboard to provide the survey results in more detail.

SHRN's Student Health and Well-being (SHW) survey is the largest of its kind in the UK, with more than 123,000 students in years 7 to 11 from 202 schools in Wales taking part in 2021/22. The wide-ranging survey, which is undertaken biennially, asks students about aspects of their physical and mental health and social relationships, with anonymized data shared with schools to inform localized practice.

Findings from the latest report show that 24% of young people in Wales have experienced very high levels of mental health symptoms, based on responses to the Strengths and Difficulties Questionnaire—a standard research tool used to assess children's mental health. Girls (28%) were almost twice as likely as boys (16%) to have reported very high levels of mental health symptoms.

Other measures showed one in two (53%) of young people also reported feeling at least some pressure from their schoolwork, with one in four (27%) feeling a lot of pressure.

Most of those surveyed felt there was support available to them; Two thirds (66%) agreed that there was a member of staff at school they could confide in and most said that they felt accepted by their teachers (70%). More than half (65%) of those surveyed agreed that they get the help and emotional support they need from their family, while almost two thirds (63%) agreed that they can count on their friends when things go wrong, with 29% agreeing "very strongly."

Professor Simon Murphy, Director of the Center for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), based at Cardiff University, and Chief Investigator of SHRN said, "Our research began just 18 months after the first COVID lockdown. It's therefore perhaps of little surprise that so many young people were experiencing mental health challenges and schoolwork pressures at this time."

"But what is also clear and encouraging from the findings is that most young people felt they had someone they could turn to for support, either in school or through their families and friendship groups. These findings provide an understanding of the public health challenges facing young people but also point to areas that can be developed to address them," says Murphy.

Dr. Nicholas Page, Research Associate at DECIPHer and lead author of the report said, "This data, which explores a wide range of issues affecting students in Wales, will be of interest to anyone working in the health and education sectors as well as providing robust evidence which can inform and shape policy. We are grateful to all the schools and students who have participated."

As well as mental health and well-being and school life, the survey explored a number of different topics, including family and social life, physical activity and diet, relationships, substance use and gambling, as well as children's rights.

Other findings include:

• Young caregivers: 17% of young people reported having to care for a family member.
• E-cigarettes and smoking: One in five (20%) young people reported having ever tried an e-cigarette. Current (at least weekly) e-cigarette use was reported by 5% of young people with fewer boys (4%) reporting current use compared to girls (7%). Overall, 3% of young people reported current tobacco smoking.
• Alcohol consumption: Almost three in five (58%) young people reported that they never drink alcohol, with 7% reporting current (at least weekly) consumption.
• Smoke-free environments: Young people's views on banning smoking in environments not currently covered by existing smoke-free laws were obtained for the survey. Around one in two agreed that smoking should be banned in homes when children are present (54%) and outside school gates (49%), while two in five agreed it should be banned outside pubs, cafes and restaurants (37%), and in public parks (40%).
• Physical activity: 16% of young people met the recommended physical activity guidelines of at least 60 minutes per day.
• Fruit and vegetable intake: At least daily consumption of fruits was reported by 33% of students, compared to 35% who ate vegetables at least daily

Zoe Strawbridge, analyst at Public Health Wales said, "This data is so valuable as it gives us the first detailed insight into how young people in Wales were feeling and behaving in the years before and during the acute phase of the pandemic. For the first time we have been able to report localized data, which helps us to understand regional differences in health and well-being of young people in Wales."

In an effort to improve young people's emotional well-being, experts at Public Health Wales are encouraging schools to adopt the Welsh Government's Whole School Approach to Emotional and Mental Well-being. The approach recognizes that every aspect of school life can impact on health and well-being and provides guidance to help everyone work together to improve it. SHRN data plays a critical role in identifying the issues that need to be addressed and a way to evaluate progress.

Emily Van de Venter, a Consultant in Health Improvement at Public Health Wales said, "Public Health Wales are helping schools to use the Welsh Government Framework on a Whole School Approach to Mental Health and Emotional Well-being to support their pupils in this post pandemic era. This recognizes that every aspect of school life can impact on pupil's mental health and well-being and that learners, parents and caregivers, teachers and governors should all work together to improve health and well-being in the school community."

"The environment and ethos of a school should be just as important as their curriculum and policies. We are actively encouraging schools to sign up to this approach and supporting them to make improvements," says Van de Venter.

One of the schools who piloted the approach was King Henry VIII School in Abergavenny. Assistant headteacher Jake Parkinson says it has proved beneficial.

He said, "Being a pilot school for the whole-school approach to emotional and mental well-being has been a really positive learning experience for the school. This framework has helped us celebrate all the great things that we already do, but has also aided the school to specify areas of further development, helping us to prioritize needs through evidence-based self-evaluation."

Speaking about findings gathered from SHRN, Ian Gerrard, Headteacher at Ysgol Aberconwy said, "This data is really important to us as a school as it gives us a detailed insight into how the pandemic has impacted young people in Wales. As a result, our pastoral team is well placed to provide support both to individuals and to groups of children who are expressing concerns about their mental health, and we are able to plan strategically to provide activities that will help them."