Students diagnosed with depression should be given “extra educational support” to prevent them dropping GCSE grades, new research from King’s College London suggests.

Researchers found that one to two students in every class of 30 at secondary school are likely to be suffering from depression, and that those students are likely to see a dip in achievement at GCSE level.

Fewer than half of Year 11 students with a depression diagnosis achieved five A* to C grades, including in English and maths, which is lower than average, the research, published in the British Journal of Psychiatry, shows.

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But when these students were in primary school, they were just as likely to meet the expected attainment threshold as their peers, researchers found.

The study’s authors suggest that targeted educational support for students struggling with depression may particularly benefit boys and those from poorer backgrounds.

Supporting GCSE students with depression

Johnny Downs, senior clinical lecturer (honorary consultant) in child and adolescent psychiatry at the Institute of Psychiatry, Psychology and Neuroscience, King’s College London, told Tes: “If you are looking after a group 30 students at secondary level (11-17), statistically between one or two students are likely to be currently suffering from clinical-level depression.”

The study compared the attainment of 1,492 children and adolescents with a depression diagnosis received at around 15 years of age.

It found that, while in Year 2 and in Year 6 their attainment was similar to that of their peers at national and local level, only 45 per cent of the sample met the expected threshold of five A*-C GCSE or equivalent grades (including English and maths) in Year 11, much lower than the proportion meeting this threshold in the local reference population (53 per cent), and also in national estimates (53 per cent).

Alice Wickersham, first author of the study, said: “While it’s important to emphasise that this won’t be the case for all teenagers with depression, it does mean that many may find themselves at a disadvantage for this pivotal educational milestone.

“It highlights the need to pay close attention to teenagers who are showing early signs of depression. For example, by offering them extra educational support in the lead-up to their GCSEs, and working with them to develop a plan for completing their compulsory education.”

Dr Downs said: “This study has two important policy implications: it demonstrates just how powerful depression can be in reducing young people’s chances at fulfilling their potential, and provides a strong justification for how mental health and educational services need to work to detect and support young people prior to critical academic milestones.

“It also highlights the importance of secure data-sharing partnerships between health and educational organisations, without which we would not be able conduct these important studies and also conduct future work testing whether changes in health and education policies improve young people’s lives.”

Here are Dr Downs’ suggestions on how teachers can help their students with depression: 

Spot the signs

“If possible, be aware of students who have past depression histories: stressful life events like exams are potential triggers for relapse,” Dr Downs said.

Being sensitive to early attention/behavioural/attendance changes may help your student get help early and prevent relapse.  

It’s not only exam day

Dr Downs said: “If you do know which students within your form are depressed, try and get to know your pupil’s individual needs and how exam preparation is being impacted as well as ‘on the day’ exam performance - the impact on academic attainment is likely to be significant. It may also not be obvious in day-to-day interactions.”

He explained that many young people may seem fine within the classroom, smiling and responsive, but they may have significant functional impairment - both cognitively and emotionally. Also, it’s important to bear in mind that even if symptoms have improved, exam preparation and coursework may still have been affected.

If possible, collaborate with the therapist

During the exam preparation phase, if a student is being supported by a therapist, a shared work planning session between the form tutor, pupil and therapist would be beneficial, Dr Downs said. 

He added: “It is likely that cognitive and behavioural targets for depression treatment will already be part of the therapy they are receiving.

“If students are preparing for exams and they provide permission, having a form teacher to join a joint session with the therapist to support positive reinforcement and feedback, and more concrete scheduling of individual revision sessions, peer support groups, activities that bolster the student’s wellbeing within school, are likely to be really helpful.”

Get the paperwork ready

A piece of advice for practical support: become aware of the exam board’s exceptional circumstances policy and how it applies to the student, and then support the student with the application.

Plan ahead

Dr Downs said: “Be aware, and ask the therapist and young person directly if you can, what their plans are around exams and results day.”

Details to take into consideration for contingency planning, he explained, are, for example, what the student will do and who will be available to support them around exam days if they need help.  

The whole-school perspective

Some initiatives need to be undertaken across the whole school. Dr Downs had some recommendations: 

• Run universal programmes for anxiety management, and exam preparation workshops for all years in secondary school.
• Have a clear, well advertised, accessible policy for young people who are currently receiving mental health support, or are concerned they are having difficulties with their mental health, to make themselves aware to a member of staff with whom they have a close relationship. Then have a clear, confidential process for internal referral to the school’s mental health support team.
• Have a parallel process for peers and family members to also report concerns to school.