Exploring Shared and Unique Factors Linked to Adolescent Mental Health and Well-Being in a National Survey of 11-16 Year Olds in Wales.

Résumé

PURPOSE: Mental health (MH) and mental well-being (WB) are related but distinct, potentially shaped by shared or unique factors. Understanding how influences like bullying, body image, and peer support affect each can guide more targeted interventions.METHODS: The School Health Research Network includes 176,603 pupils from 196 secondary schools in Wales (94% coverage of all schools). Biannual pupil health survey data were used to explore the relationship between MH (i.e., Strengths and Difficulties Questionnaire Total Difficulties) and WB (i.e., Short Warwick-Edinburgh Mental Wellbeing Scale) using structural equation modeling. Explanatory variables hypothesized to influence MH or WB were grouped into demographic, behavioral, and social domains. Any 11-to 16-year-old pupils with a pair of MH and WB scores in the 2019 or 2021 survey (N = 176,603) were included.RESULTS: Explanatory variables from each domain were adversely associated with MH and WB. Difficulties sleeping had the strongest adverse effect on WB (β = 0.18, 95% confidence interval = 0.13-0.23, p < .001) and MH (β = 0.21, 95% confidence interval = 0.16-0.26, p < .001). The strength of this association did not differ significantly between the two outcomes. There was no evidence of an effect of school on MH or WB indicating that the individual-level effects may not directly be influenced by schools.DISCUSSION: Key modifiable explanatory variables, for example, academic pressure, body image, and lack of support from friends and teachers could serve as targets for interventions for MH and WB. Further development with schools, families, and health and social care services across Wales could support a more coordinated approach to improving adolescent MH and WB.