A new study has revealed that bright children from more economically disadvantaged backgrounds are twice as likely to receive hospital mental health treatment than high-achievers with more affluent upbringings 

Findings of a new nationwide study of tens of thousands of secondary school children in England have been released. The study, published in the Oxford Review of Education, revealed that bright children from poorer backgrounds are twice as likely to be admitted to hospital for mental health-related problems than their high-achieving peers from more affluent backgrounds. Pupils from less advantaged backgrounds were also found to be more likely to be treated for alcohol and drug use, to receive care for self-harm, and to become pregnant.

Professor John Jerrim from the University College London (UCL), study author and renowned expert in the study of mental health and wellbeing within education, said that findings could help explain why high-achieving young people from disadvantaged backgrounds fall behind more than advantaged peers as they get older.

“The findings show high-achieving children from disadvantaged backgrounds are hospitalised due to mental health and behaviour-related issues at a rate of around 80 per 1,000 children between the ages of 11 and 20. This is significantly above the rate of around 40 per 1,000 children for their equally able but more socio-economically advantaged peers.”

The analysis looked at children and young people with a variety of mental health issues and conditions, including anxiety, depression, eating disorders, alcohol or drug misuse, self-harm, and personality disorders. Students who achieved grades in the top 25% of their SATs exams at the end of primary school were classified as academic high achievers, while socio-economic status was based on the area in which children lived and their eligibility for free school meals. Data from over 42,000 high achievers were analysed.

Pupils from the most disadvantaged backgrounds were found to be twice as likely to be admitted to hospital for the majority of the conditions studied (8.6% between ages 11 and 20, compared with 4.2% of their economically advantaged peers) with the exception of eating disorders, which saw similar rates of admission, and the treatment of alcohol and drug use (3.1% vs 1.3%). 

Based on these new findings, Professor Jerrim is calling for education, healthcare, and social services to work together to provide the support and inclusive environments needed for young people of all backgrounds to meet their full potential and get the help they need. More support is needed in schools and at home to help students.

“The results point to a need for services to develop their responses to the complex needs of young people,” Professor Jerrim says. “This includes ensuring the right environment for early intervention. By fostering supportive and inclusive environments, these services can better cater to the unique needs of individuals, promoting equitable opportunities for success.”

Wider implications and further findings of the long-term outcomes of the high-achieving disadvantaged children study 

This latest research, funded by the Nuffield Foundation, is part of the wider Long-term outcomes of high-achieving disadvantaged children study, set to run between April 2024 to March 2026. Investigating the long-term social, health, and labour market outcomes of disadvantaged children who were high achievers at the end of their time in primary school, the study aims to uncover why many children from disadvantaged backgrounds who have the potential to become upwardly socially mobile do not fulfil their early potential. 

Researchers hope that findings from the study will prompt greater policy focus on young people from disadvantaged backgrounds, helping influence national initiatives, informing policymakers, researchers, and the public. 

Earlier findings from this wider study have highlighted the higher rates of absence amongst high-achieving disadvantaged pupils compared to their peers and a sharp increase in high-achieving children receiving school exclusions or police cautions, particularly amongst disadvantaged boys from Black and Mixed ethnic backgrounds. Findings released in November 2024 revealed the socio-economic gap in teenage motherhood, which indicated that high-achieving girls from disadvantaged backgrounds were 10 times more likely to receive pregnancy care than their more advantaged peers (3.5% compared to 0.3%), while low-achieving young women from disadvantaged backgrounds were far more likely to receive pregnancy care by the age of 20 (12.9%). 

Findings into the socio-economic differences in self-harm resulting in hospital admission amongst high-achieving children were released in October 2024. The most disadvantaged 10% of pupils were found to be far more likely to be admitted to hospital following self-harm between Year 7 and Year 10 (1.5 to 10.2 students per 1,000 children from disadvantaged social backgrounds, compared to 0.3 to 4 students per 1,000 children from the most advantaged socio-economic backgrounds). Results indicated that students from disadvantaged socio-economic backgrounds were more likely to self-harm than their more advantaged peers, no matter how high or low achieving they were academically. 

Young people and mental health in the UK 

An estimated one in five children and young people aged eight to 25 has a probable mental disorder in England, according to the Mental Health and Young People in England report. Mental Health Support Teams have begun being rolled out in schools and colleges, with an estimated 60% of pupils in schools and in further education expected to be supported by April 2026. As of April 2025, 52% of pupils currently have access to support from Mental Health Support Teams, with over 5 million young people having access to specialist mental health support through their school or college. 

Research suggests that 50% of all mental health problems start by the age of 14. Ensuring that systems are in place to offer support as well as education and awareness of common mental health concerns is vital in helping young people to access the help that they need to thrive. Young people are calling for better mental health support. 

Young people who took part in Young Mind’s report into deconstructing the system: Young people’s voices on mental health, society, and inequality highlighted the need for shorter wait times, a wider range of treatment options, longer appointments, and more funding to help support young people’s mental health services. 59% of young people seeking support for mental health report worsening mental health while waiting to be seen. 

Accessing help and support for mental health in England 

If you are worried about a child or young person’s mental health and wellbeing, knowing where and how to access support can feel daunting. Different support is available in different areas. Mental health support teams (MHSTs) are available in many schools and colleges across the country, with more being rolled out. 

NHS services, or child and adolescent mental health services (CAMHS), can help with a broad variety of issues. Speaking with your GP, a teacher, school nurse, or social worker can help you to get in touch with your local CAMHS services, or you can self-refer for some services. Check out the NHS guide to getting mental health support for children and young people to find out how to access support in your area.  

Some mental health charities for children and young people can provide someone for children or young people to talk to about how they are feeling, as well as somewhere they can contact in crisis, and the space to get in touch with other young people experiencing similar mental health struggles. 

Working with a counsellor or therapist can help provide a safe space for children and young people to work through issues they may be struggling with, as well as the space to talk about what is worrying them without fear of judgement. Find out more about counselling for children and young people. 

While the study underlines significant challenges, it also offers a chance to spark positive change. By recognising the challenges bright children from disadvantaged backgrounds face and investing in early intervention, schools, families, and health services can help ensure these young people are supported and have the opportunity to thrive, both academically and personally.