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Research and Projects

Psychiatric disorders and emotional and behavioural disturbance in children excluded from school

Theme: CLAHRC - Mental Health & Dementia
Status: Live

Why did we do this review?

In the UK although the number of school exclusions is reported to be decreasing the proportion of school exclusions which are for children with Special Educational Needs is increasing. This suggests that these children are not receiving the support they need despite initiatives to help schools in this way. The situation also implies that children who have problems but are as yet unidentified will also be more likely to be excluded from school without appropriate assessment or support being explored first.

Being excluded from school can exacerbate a child’s difficulties and may reduce the likelihood that the child will be able to access appropriate mental health support or specialist education services.

We wanted to explore the extent of this problem in order to inform practices in education and encourage greater awareness of the set backs that can result from school exclusion.


How did we do this review?

The research was a systematic review. This brings together all existing research on a particular question. To find studies that might help us to answer the question we searched the relevant academic literature. 

We found five studies from the US, UK, and Spain mostly conducted in the last 20 years. Most of the studies covered the age range 11-16years but some also covered  4-11 years.


What did we find?

  • Children who are excluded from school are more likely to have behavioural or mental health problems e.g. ADHD (attention Deficit Hyperactivity Disorder) or depression than those who are not excluded from school.

  • Children can be excluded from school at an early age (4 years plus).

  • Due to the poor quality and amount of research the full extent of the problem is unknown.

  • There is a  compelling need for mental health and education workers to work together  to understand and support children at risk of exclusion from school.

  • Early intervention to support children with problems in school may reduce the occurrence of school exclusions.


Quality of the research and cautionary notes

The lack of studies in this area means that no conclusions can be drawn about the causality of this relationship. It is possible that the relationship could work differently for different conditions. For example, a child with depression may display attitudes or behaviours that result in an exclusion from school but equally exclusion from school may in itself lead to depression or exacerbate it.  In contrast, exclusion from school is  not likely to be the cause of ADHD but may result from behaviours linked to  it.

More and higher quality research is needed to  fully understand the extent of the problem and what it means in the long term both for schools, pupils and society. This research should detail when or if the child had received a diagnosis or was in contact with support services before  their exclusion from school.


What next?

Much of the responsibility falls on schools to identify and support children through their education yet this is not always possible. Schools could benefit from working more closely with mental health services so that children presenting with problems can be recognised and supported more quickly. For example, through training to identify core features of mental health problems or providing a health needs assessment for children with ongoing behavioural or disciplinary difficulties. However, further research and policy consideration is needed. 


Further information

For further information, read the project paper, read a printable version of this summary here. There is also a related paper which looks at same issue from a different perspective you can read the paper here or a printable version of the summary here.


Others Involved

Ruth Marlow, Claire Parker