Association of School Engagement, Academic Difficulties and School Avoidance with Psychological Difficulties Among Adolescents Admitted to a Psychiatric Inpatient Unit

Mental illness is a pressing public health concern, particularly when the onset is during childhood or adolescence. Many youth admitted to hospital-based psychiatric care experience school-related difficulties. The purpose of this report was to explore the associations of academic difficulties, school avoidance and school engagement to total psychological difficulties and emotional problems. Youth completed surveys that included standardized measures of school-related factors and the Strengths and Difficulties Questionnaire while in hospital. Psychiatrists provided the primary diagnosis and diagnosis most responsible for the current admission. In total, 161 patients participated in this study (mean age 15 years, SD 1.4; 75% female). All three school-related variables were significantly associated with emotional problems; however, only school avoidance and academic difficulties were associated with total difficulties. School-related concerns were significantly associated with the severity of mental health symptoms. Patients may benefit from attention to school-related difficulties before discharge from psychiatric care that continues beyond school reintegration.