Social disadvantage, family support and young people's mental health in the UK

University of Liverpool

About the project

Improving adolescent mental health is a major challenge for public policy. Those exposed to social adversity are more likely to experience lifelong mental health issues, which not only impacts the young people themselves, but can also incur significant costs to society and care systems.

This project investigated how social factors and adversities (eg poverty) interact to impact young people’s family relationships (eg parental involvement, parenting skills), the emotional family support they receive (eg care, safety) and their subsequent mental health. 

Research undertaken

Innovative statistical approaches were applied to understand these complex relationships over time, building on analyses of a large representative sample of children born between 2000 and 2002 (the UK Millennium Cohort Study) and the ongoing OveRcoming Adverse ChiLdhood Experiences project (ORACLE).

Researchers engaged with young people aged 12 years and above, parents and other stakeholders (eg policymakers, practitioners, voluntary organisations, local authorities and the general public) through a series of online workshops and face-to-face meetings.

Key findings

The key findings from the research include:

• At age 14, the overall prevalence of low perceived emotional support was 13 per cent.
• Children of mothers with lower socioeconomic status were more likely to report low emotional support, with a clear social gradient (education: 10.3 per cent for those qualified to at least degree level vs 15.4 per cent for those with no qualifications).
• Children and young people exposed to persistent poverty and family adversity experienced higher odds (57 per cent) of low emotional support and low-quality parent-adolescent relationships compared with those exposed to low levels of poverty and adversity (43 per cent).
• Children exposed to childhood adversity were almost three times more likely to experience poor mental health compared with those in low adversity and poverty.

When looking at how to translate these findings into policy and practice, the project team found that policies to support family functioning may be particularly beneficial for children who have experienced adversity.

The research found that when young people experience feelings of isolation and sadness, they often seek someone to confide in. This source of support doesn't always have to be a parent; sometimes they turn to friends or other trusted adults. The choice of who they went to was often based upon how well they felt this person could relate to their concerns, and not because they perceived the parent to be emotionally unavailable. 

Furthermore, they tend to avoid discussing their concerns with parents who are dealing with financial challenges, due to fears that sharing their problems may add to their parents’ stress. Financial difficulties and parental exhaustion from work can result in household conflicts that weaken the family’s capacity to provide emotional support.

Outputs and future plans

In collaboration with the Young People’s Advisory Group in Liverpool, three online workshops were held. These provided a platform for young people to share their perspectives, experiences and insights. 

There were also sessions held with policymakers, with the aim of bridging the gap between the research findings and policy implementation.

Dr Nicholas Kofi Adjei, project lead, explained the importance of these sessions: “These workshops and discussions were designed to ensure that the voices of those most affected by the project's outcomes – young people – were heard, while also fostering collaboration with policymakers to influence future practices and policies.”

One peer-reviewed paper and a peer-reviewed abstract have been published in European Child & Adolescent Psychiatry and The European Journal of Public Health, respectively, with a forthcoming paper in Scientific Reports.

There has also been a significant amount of policy and practice discussions and engagements, including Professor David Taylor-Robinson, Professor of Public Health and Policy in the Institute of Population Health at the University of Liverpool, presenting a report and evidence to the independent public inquiry into the COVID pandemic. The findings of the studies have also featured in reports from Health Equity North.

Dr Adjei participated in four national and international conferences, which served as key platforms for sharing the project’s findings, engaging with academic peers and practitioners, and generating broader awareness of the issues.  

A blog, Unlocking adolescent potential: The power of family support amidst childhood adversities and poverty, provides an accessible summary of the key insights from the project.

A video animation that explains the key findings and implications of the research in an engaging and accessible way has also been produced.

Key reflections and learnings

The evidence generated from this project will inform the development of more effective policies and interventions to improve family support and reduce inequalities in adolescent mental health in deprived cities across the UK, such as Liverpool.

Through engaging with policymakers and stakeholders, the project has directly informed discussions about how to address mental health inequalities among young people from disadvantaged backgrounds. Engagement with young people and policymakers has fostered collaborations with government departments, helping to advocate for policy changes that prioritise emotional support in addressing mental health challenges. 

Advice for others

It is important to ensure the dissemination strategy for projects such as this involves reaching key stakeholders in a way that is accessible for them. 

The creation of the video animation was designed to make the research accessible to a non-academic audience, including practitioners, policymakers and the public; and a blog allowed the broader public and practitioners to engage with the insights generated.

Contact details

For more information about this project, please contact Dr Nicholas Kofi Adjei, Senior Research Associate, Public Health, Policy and Systems, University of Liverpool.