Children whose families struggle to get on are more likely to have mental disorders

Children living in families that struggle to function well are more likely to have a mental disorder¹ than those from healthy functioning families, new analysis has shown.

Research on children aged 2 to 16 years, living in England, found higher rates of mental disorders across all ages in those who lived in families that struggled to function well (unhealthy functioning).²

It showed that parental mental health was also a key factor in understanding the mental health of children, even when taking other factors such as household income and ethnicity into account.

Children aged 11 - 16 from unhealthy functioning families more likely to have a mental disorder

Percent of children with a mental disorder by family functioning and age group, England, 2017

The Office for National Statistics (ONS) analysis of survey³ results published by NHS Digital in November sought to establish which factors (such as marital status and family type), were most closely associated with mental disorders in children (emotional, behavioural, hyperactivity or other less common disorders). Though it should be noted, that these factors are not necessarily the cause of the mental disorders.

In measuring family functioning, researchers looked at issues such as whether family members show affection for one another, whether they communicate openly or whether emotional upsets were resolved.

In its report, Family Breakdown, the Centre for Social Justice describes the family environment as the place where “an individual’s physical, emotional and psychological development occurs.”

Parental mental health

Aside from how well a family functions, this research revealed that the mental health of parents was also associated with mental disorders in children.

Children of parents who had difficulties with their own mental health were more likely to have a mental disorder, when compared with children of parents who did not show signs of a common mental disorder⁵.

Children whose parents had poor mental health more likely to have a mental disorder

Percent of children with a mental disorder by parental mental health and age group, England, 2017

Research by NHS Digital has shown that 3.9 per cent of new or expectant mothers in 2017 were in contact with secondary mental health services.

However, a study from University College London has also suggested a link between depressive symptoms in fathers and similar symptoms in children.

While problems with family functioning or poor parental mental health may contribute to the onset of a mental disorder in children, the presence of a mental disorder in children could also lead to problems with family functioning and a deterioration in parental mental health.

Welfare benefits

The research also found that children of all ages whose parents were in receipt of welfare benefits (which are related to low income or disability) were more likely to have a mental disorder than those whose parents were not in receipt of these benefits.

Children whose parents receive welfare benefits more likely to experience a mental disorder

Percent of children with a mental disorder, by receipt of welfare benefits and age group, England, 2017

The Mental Health Foundation has said that risk factors such as living in poverty can make some children and young people more likely to experience problems than other children.

In a recent report, the Children's Society said: “Reductions in family income, including benefit cuts, are likely to have wide-ranging negative effects on children’s mental health.”

Family type, marital status and parental qualifications

This new analysis has also taken a first look at some additional factors which are linked with higher rates of mental disorder in children.

It found that children aged 2 to 10 years old living with step-siblings showed around double the rates of mental disorder, than those who did not live with step-siblings. But this higher rate could be associated with problems that may be related to family break-ups, such as divorce, moving house or changing schools.

This might explain why school aged children (aged 5 to 16 years) from lone parent families experience greater rates of mental disorder, compared with those who live with married parents. This was most noticeable in secondary school aged children (11 to 16 years) of single lone parents (who have never been married).

Secondary school aged children from single lone parent families experience higher rates of mental disorders

Percent of children with a mental disorder by marital status and age group, England, 2017

Another newly-examined factor looked at the association between the qualification level of parents and their children’s mental health. It found primary school aged children of parents without qualifications were twice as likely to have a mental disorder as those with qualifications (16.8% and 8.4% respectively).

5 to 10 year olds whose parents have no qualifications more likely to have a mental disorder

Percent of children with a mental disorder by parental qualification and age group, England, 2017

Explore different factors around mental health and childhood by using our interactive tool

Where to go for help:

• charity YoungMinds offers advice and information about children and young people’s mental health.
• call the Parents' Helpline for advice for parents: 0808 802 5544.
• if you are experiencing difficulties with your mental health and need support, contact YoungMinds Crisis Messenger by texting YM to 85258 or calling Samaritans on 116123

Notes:

1. The four categories of mental disorder: The term mental disorder is generally used in this report. This is because the survey did not screen for general mental health ‘problems’ or ‘issues’, but applied diagnostic criteria for specific disorders. We are also sensitive, however, to the negative connotations of the word disorder.

   Emotional disorders (such as depression)

   They include a range of different types of anxiety disorders (characterised by fear and worry), depressive disorders (characterised by sadness, loss of interest and energy, and low self-esteem) and a small number of cases of mania and bipolar affective disorder.

   Behavioural disorders (including oppositional defiant disorder)

   A group of disorders characterised by repetitive and persistent patterns of disruptive and violent behaviour in which the rights of others, and social norms or rules, are violated. The umbrella term used in ICD-10 is conduct disorders, in this report we have used the term ‘behavioural disorders’ to avoid confusion with the sub-types of disorder included in the survey.

   Hyperactivity disorders

   They are characterised by developmentally inappropriate levels of inattention, impulsivity and hyperactivity. These symptoms lead to impairments in in several settings such as school/work, home life and leisure activities.

   Other (less common disorders)

   They include autism spectrum disorder (ASD), eating disorders such as anorexia nervosa, and other types of disorders, including tics.

2. Family functioning:Family functioning was measured using the general functioning scale of the McMaster Family Activity Device (FAD). The scale comprises 12 statements which are a self-reported measure of perceived family functioning. They include measures of problem solving, communication, roles, affective responsiveness, affective involvement, behaviour control and general functioning in families.

3. The Survey of the Mental Health of Children and Young People:The Survey of the Mental Health of Children and Young People 2017 (MHCYP) collected information on about mental health and wellbeing of 9,117 children aged 2 to 19 in England. The survey was conducted by NatCen Social Research, the Office for National Statistics and YouthInMind on behalf of NHS Digital.

4. The data for preschool children (aged 2 to 4 years) are experimental

5. Common mental disorder: The mental health of the interviewed parent or guardian (usually the mother), was assessed using the General Health Questionnaire (GHQ-12). This is a screening device for identifying minor psychiatric disorders.

Scores range from 0 (no psychological distress) to 12 (severe psychological distress). A score of 4 or more generally suggests the presence of a common mental disorder.