Inequalities in mental well-being of 11-15 year old boys and girls in Scotland, 1994-2006

Background: The mental well-being of children and adolescents is a priority area for the Scottish Executive, as is tackling socioeconomic inequalities in health. Previous research has shown that emotional and mental health problems are predictors of externalising behaviour and mental well-being in later life. Promoting young people’s health therefore has long-term benefits to individuals and society as a whole.

Objective: The aim of this study is to describe changes in mental well-being amongst adolescents living in Scotland between 1994 and 2006, to investigate socioeconomic inequalities in mental well-being and changes in inequalities over time.

Methods: Data from the 1994, 1998, 2002 and 2006 Health Behaviour in School-Aged Children survey were modelled using Multilevel Binomial modelling for boys and girls, adjusting for age, year and deprivation using the Family Affluence Scale.

Results: For measures of confidence, happiness, multiple health complaints (MHC), helplessness, feeling left out and perception of looks, positive mental well-being is higher among boys than girls, and among younger than older adolescents. Adjusting for age, the odds of “feeling very happy” in 2006 among boys is 1.70 (95% CI 1.49 to 1.94) and among girls 1.75 (1.50 to 2.03) that of 1994. Similarly, there is a significant increase in confidence among girls, and a significant decrease in MHC, helplessness, and feeling left out. For boys, significant reductions are seen in MHC helplessness and feeling left out. Among boys and girls, socioeconomic inequalities in happiness, MHC and perception of looks are evident. Inequalities in confidence and helplessness also exist among girls. Between 1998 and 2006 socioeconomic inequalities in MHC and happiness increased for boys, and inequalities in happiness, MHC and perception of looks increased for girls so that, for example, the odds of happiness among girls with high FAS relative to low FAS in 2006 are 1.46 (1.11 to 1.91) those of high FAS relative to low in 1998. Inequalities in all other indicators do not change significantly over time.

Conclusions: Indicators of adolescent mental well-being in Scotland appear to be improving over time. However, gender and age differences in mental well-being persist, as do socioeconomic inequalities. Inequalities are seen to widen for some indicators suggesting that a targeted approach is required in addressing the mental health of young people in Scotland.