How Mental Health Affects School Performance

Many parents, teachers, and clinicians would agree that mental health can affect learning – and the research reflects this. When a student is struggling with anxiety, depression, behavioural difficulties, or other mental health challenges, concentrating in class, completing assignments, and staying engaged at school can become much more difficult.^1–4

But are all mental health conditions associated with poorer school achievement? And are some young people more vulnerable than others? These were two of the questions we explored in our recent study using nationwide Finnish register data from more than 837,000 young people.

We examined mental disorder diagnoses recorded between childhood and adolescence and their association with school achievement at the end of comprehensive school, when students are typically 16 years old.

Within this blog, we will discuss our research, including:

• How mental health affects school performance
• The role of gender in mental health and academic achievement
• How age of onset of mental ill-health impacts school performance
• Why understanding this research matters

How does mental health affect school performance?

Children with mental disorders also exhibit significantly reduced school attendance rates (Lawrence et al., 2019), have a heightened risk for school expulsion (Perry et al., 2008) and suspension (Kang-Yi et al., 2018), are more likely to drop out of high school (Askeland et al., 2022; Breslau, Lane, Sampson, & Kessler, 2008), and often experience delayed educational progression (Tempelaar et al., 2014).

Within our research, we saw a similar pattern. We found that students diagnosed with a mental health disorder had lower school achievement at the end of comprehensive school than their peers without a diagnosis. This pattern was seen across almost all mental disorder categories we examined.

The largest differences were observed among adolescents diagnosed with substance use disorders. At the same time, one interesting exception emerged: girls with eating disorders tended to perform slightly better academically than their peers. Previous research suggests that characteristics such as perfectionism may partly explain this pattern.¹²

Taken together, the findings reinforce what many teachers and clinicians observe in practice: mental health difficulties can have important consequences for educational outcomes already at a young age.

Does gender affect the impact of mental health on academic achievement?

Research repeatedly shows us that female students typically report higher levels of depression, anxiety, and psychological distress, compared to male students.¹³ It’s believed that these differences may be due to social and cultural factors.^14-18

For example, it tends to be more socially acceptable for girls to discuss their mental health difficulties. Whereas boys are often encouraged to suppress or minimise their emotions.

But do mental health problems impact girls’ and boys’ educational attainment differently? Within our research, we found that when girls receive a mental disorder diagnosis, the impact on their academic achievements tends to be greater than for boys.

These findings were present across all mental disorder categories we examined, and it was especially pronounced in those with developmental disorders. Several explanations may contribute to this pattern. Girls are more sensitive to academic pressure,¹⁹ and their difficulties may be less visible to teachers and professionals.²⁰

Importantly, these findings suggest that schools and mental health services need to pay particularly close attention to how mental health difficulties affect learning among girls.

Onset of mental health conditions and school performance

We know that mental health affects school performance, and that this appears to be more intense in girls. But is educational attainment impacted by the time of onset of mental health conditions?

In short: yes. Past research shows us the following:²¹

• Externalising behaviours at age 3 are associated with poorer academic performance at 12 years old, and increased risk of incomplete grades at school.
• Conduct problems at age 12 are linked to incomplete grades in school.
• Mental health difficulties – particularly internalising problems – at preschool are associated with academic performance.

So, mental health and school performance are related, regardless of the age of onset. But is there more of an impact if mental health conditions develop in early childhood or in adolescence?

Childhood vs adolescent onset

Our findings showed that students whose disorders emerged later, particularly during adolescence, showed poorer school achievement than those whose difficulties emerged earlier in childhood.

At first glance, this may seem surprising. We often think of early-onset mental health problems as especially harmful. However, adolescence is also a period of major educational demands and transitions. Mental health difficulties occurring during these years may disrupt learning at a particularly important stage, just as young people are preparing for future educational pathways.

It is also possible that children who identified difficulties earlier received support sooner, helping to reduce some of the long-term impact on learning.

Mental health support for children and adolescents

School achievement is more than a report card. Educational success influences later opportunities, employment, income, health, and wellbeing throughout adulthood.

Our findings highlight the importance of recognising mental health difficulties early and ensuring that appropriate support is available both in healthcare settings and in schools. They also remind us that adolescence remains a critical period for intervention and that girls experiencing mental health difficulties may require particular attention.

Supporting young people’s mental health is not only about reducing symptoms. It is also about helping them stay engaged in learning and achieve their educational potential.

Final word on how mental health affects school performance

Mental health and education are closely connected. Our findings, and those of previous research, suggest that mental disorders can have important consequences for school achievement, particularly for girls and for young people whose difficulties emerge during adolescence.

Schools can play a crucial role in identifying struggling students and providing timely support. By strengthening collaboration between educators, families, and mental health services, we may be able to reduce the educational impact of mental health difficulties and help more young people reach their full potential.

If you’re an educator, school leader, or clinician and want to learn new ways to support students’ mental health, check out our upcoming webinar: How to Support Distressed Pupils: School-Based Resilience Training.

References

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2. Perry, D. F., Dunne, M. C., McFadden, L., & Campbell, D. (2007). Reducing the Risk for Preschool Expulsion: Mental Health Consultation for Young Children with Challenging Behaviors. Journal of Child and Family Studies, 17(1), 44–54. https://doi.org/10.1007/s10826-007-9140-7
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