National examinations, children's well-being and academic achievement

High-stakes national examinations are an important part of England's education system. The key stage 2 and GCSE examinations at the end of primary and secondary school are not only used to measure the academic competencies of pupils, but also play a fundamental role in school accountability. Yet there is growing concern amongst parents, teachers and education policymakers about the examination stress that young people suffer, and how this is potentially linked to the development of serious mental health issues. This concern has only increased in recent years, particularly amongst secondary school pupils, with the recent reforms made to GCSE examinations (with much more emphasis now placed upon the end-of-Year 11 tests). For instance, a series of media articles have highlighted how England's examinations are leading to "panic-attacks and crying" (https://www.theguardian.com/education/2018/jun/22/how-new-gcses-affected-pupils-panic-attacks-crying-exams), that they are causing "serious stress and anxiety" (https://www.theguardian.com/education/2018/may/17/stress-and-serious-anxiety-how-the-new-gcse-is-affecting-mental-health), with Lucy Powell MP (former shadow Secretary of State for Education) reportedly describing this as a "mental health ticking time bomb" (https://inews.co.uk/news/education/lucy-powell-mental-health-time-bomb-gcses/).

The aim of this project is to provide new insight into the link between high-stakes examinations and young people's mental health within two research strands. In strand A we will investigate how indicators of pupils' mental health and well-being vary over the academic year and if "spikes" in mental health problems can be observed at key timepoints (e.g. during the examination season, during GCSE results week). For primary school pupils, the analysis will focus upon self-reported questionnaire data designed to measure children's mental well-being, collected as part of the Millennium Cohort Study (MCS). For secondary pupils, administrative data on GP appointments and hospital admissions will be used to explore the emergence of particularly serious mental health issues (e.g. incidence of self-harm). Together this will provide important new evidence about young people's well-being and mental health, whether such problems coincide with the approach of high-stakes national examinations and if it is possible to identify key mental health "flash-points" at certain points during the academic year.

Of course, poor mental health in the lead-up to examinations (e.g. high levels of anxiety) can also affect young people's performance upon these tests. For instance, high levels of test anxiety or generally low-levels of well-being may affect young people's motivation at school, their capacity to revise and their ability to function adequately in an examination setting. We will explore this issue within strand B of the project by investigating the link between pupil's mental health/well-being and their achievement in high-stakes tests. Specifically, the project will analyse Millennium Cohort Study (MCS) and Programme for International Student Assessment (PISA) data linked to the National Pupil Database to provide new insights into this issue. In doing so, we will generate important new evidence on the importance of well-being for young people's academic attainment.

The aim of the project is to investigate the link between high-stakes national examinations and young people's mental health. The following groups will be the major beneficiaries of this work.

1. Teachers and school support staff. This group will benefit by the project providing new information on the characteristics of young people who are most likely to need support with their mental health and, critically, when during the academic year. For instance, if we find there to be a spike in severe mental health issues for children with specific characteristics in the lead-up to Key Stage 2 / GCSE examinations, then extra preventative measures may be put in place at this timepoint in order to effectively support this group. Results from strand B will also help teachers and educators to better understand the links between pupil well-being and national examination outcomes, and hence the extent that effectively tackling such problems (e.g. reducing stress and anxiety around high-stakes tests) may lead to improvements in their grades. Teacher unions are also likely to be engaged in this work, given that they have recently conducted a poll amongst their members about the issue of high-stakes examinations and pupils' mental health. This has since been used to suggest that the recent reforms made to GCSEs is harming children's mental health (https://neu.org.uk/latest/changes-gcses-and-levels-are-damaging-students-mental-health-and-increasing-teachers).

2. Young people and families. The evidence generated will help young people and their families better understand the mental health risks around the time of high-stakes exams. This is likely to be particularly relevant to those young people who have previously suffered from mental health issues and for whom problems may re-emerge. It may, for instance, highlight particular points where young people (and their families) may need to be particularly vigilant about their mental health.

3. Mental health charities. A number of mental health charities have shown interest in the link between high-stakes exams and mental health, such as Mind (e.g. https://www.mind.org.uk/information-support/your-stories/14-ways-to-beat-exam-stress/#.XDxxb83LfIU) and Young Minds (e.g. https://youngminds.org.uk/blog/exam-results-stress-advice-for-young-people/). These charities will benefit from the project by it further raising the profile of one of the key issues that they are interested in, while also providing new large-scale quantitative evidence that can help support their work. For instance, if we were to find spikes in negative mental health outcomes at particular points in the year (e.g. GCSE results week) then this may help inform the timing of interventions and campaigns that such charities run.

4. Policymakers. Mental health is currently a key priority at the Department for Education and Department of Health, with more than £300 million recently being committed to support the mental health of young people through schools (https://schoolsweek.co.uk/government-names-first-25-areas-to-get-school-mental-health-support-teams/). This project will help inform these government departments increasing policy interest and investment in this area by highlighting the groups (and hence schools) where interventions are most needed and the point(s) when serious mental health problems emerge.

5. Public health services. As the organisation responsible for young people's mental health, the Child and Adolescent Mental Health Service (CAMHS) will be a key stakeholder in this work. This organisation is likely to benefit from this research providing new evidence on the epidemiology of young people's mental health which may feed new information into their service provision and planning. For instance, it may help to identify areas or schools where there is a concentration of young people with a high-risk of developing mental health issues and the time during their education when these problems are most severe.