The associations between educational experiences and mental health from childhood to young adulthood

Mental health problems are on the rise, with over 10.3 million reported cases of mental ill health in the UK each year. Mental illness starts early in life, with most cases emerging by adolescence. The earlier symptoms begin, the worse the outcomes are. Childline, a free counselling service for children in the UK, reported that children's primary concern was stress and anxiety related to school performance. However, studies exploring the association between school environment and young people's mental health remain scarce. Here we aim to clarify the links between educational experiences and mental health, considering both subjective and objective school environmental factors using data from the UK and Sweden. We use data from the Twins Early Development Study (TEDS, N∼ 6500 pairs, ages 7-21) and replicate the findings using the Child and Adolescent Twin Study in Sweden (CATSS, N∼2500 pairs, ages 7-21). Both subjective measures (e.g., self, parent- and teacher-reported classroom environment) and objective measures (e.g., national register data on school quality) are used. We use twin analyses and multivariate Cholesky to assess the aetiology of educational experiences and psychopathology and their covariance. Multiple regression and prediction modelling (elastic net) will estimate the prediction of mental health from school experiences contemporaneously (ages 7-21) and over time, controlling for genetic predisposition (29 adult psychiatric polygenic scores), mental health before school and socioeconomic status. We show that subjective parent-, teacher-, and twin-reported educational experiences are significantly associated with mental health (r∼.25). The strongest predictor of mental health was classroom environment; the prediction from class size was negligible. Educational experiences (subjective measures) are associated additively with psychopathology, explaining up to 50% of the variance in mental health, suggesting that these experiences pose a cumulative risk for mental health. The associations remain significant and substantial even after controlling for 29 adult psychiatric polygenic scores and mental health before school. Twin analyses show that both educational experiences and mental health are substantially heritable (h2∼ 50%), and the associations between educational experiences and mental health are substantially mediated by genetic factors suggesting widespread gene-environment interplay. The analysis plan using the objective school environmental measures and the replication in CATSS was pre-registered in OSF, and the analyses are ongoing. Understanding the role of school experiences as early environmental stressors is crucial for children's current and future mental health. Our study reveals pervasive gene-environment correlations for mental health across childhood and early adulthood, using both polygenic scores and the twin method. Knowing individual-specific genetic predispositions and how certain environmental risk factors may dampen or amplify the effect of educational experiences on mental health outcomes will improve our understanding of complex pathways influencing mental health outcomes over development.