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A national report, carried out every four years in collaboration with the World Health Organisation (WHO), presenting data on adolescent health and wellbeing has provided a special focus insight into young people’s mental health in Scotland. The latest report also enables comparison of adolescent health and wellbeing before and after the COVID-19 pandemic.

The 2022 Health Behaviour in School-aged Children (HBSC) study in Scotland provides data on the health and wellbeing of the nation’s young people and was led by researchers at the MRC/CSO Social and Public Health Sciences Unit, University of Glasgow and the School of Medicine, University of St Andrews. The report was commissioned by Public Health Scotland (PHS).

Key findings include the majority (80%) of young people reported high life satisfaction in 2022, and around a fifth (23%) of adolescents rated their health as excellent, with the proportion of boys reporting excellent health increasing since 2018 from 22% to 27%. However, nearly half (49%) of young people experienced multiple health complaints every week (the most common being feeling nervous, sleep difficulties and feeling irritable), and prevalence was higher among girls than boys at ages 13 and 15.

Pandemic impacts were another key finding, with the most positively affected aspects of life reported during the pandemic being family relations (54%) and friendships (50%). While 43% also reported a positive impact on their physical activity, 29% said that their physical activity had been negatively affected. The main negative impacts overall were on mental health (38%) and school performance (34%).

The report also revealed the lowest levels of adolescent confidence seen in 28 years, with only 42% of adolescents in Scotland reporting often or always feeling confident in themselves. Notably, around a fifth (19%) of young people reported feeling lonely all or most of the time in the past year, and feelings of loneliness were highest among 15-year-old girls (31%). The report also found that around a third of young people reported anxiety, with higher levels among girls than boys; and over a third (35%) were classified as having either low mood or risk of depression.

Beyond mental health and wellbeing, the HBSC study covers areas such as sleep habits, screen time, physical activity, sexual health and eating behaviours, as well as school and home life. The report presents data collected from a representative sample of 4,388 eleven, thirteen and fifteen-year-olds in Scotland in 2022. The survey was conducted in schools, with all pupils in the selected classes asked to fill in the confidential questionnaire anonymously.

This is the 9th consecutive World Health Organisation (WHO) cross-national HBSC survey in which Scotland has participated, providing data on the health of the nation’s young people since 1990.

Lead author of the study Dr Jo Inchley, from the MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, said: “These latest findings from HBSC provide a comprehensive picture of young people’s health across Scotland. We’ve seen significant improvements in recent years in areas such as alcohol use and lifetime cigarette smoking.

“But at the same time, new challenges such as vaping and social media are increasingly impacting on how young people live their lives, and there are also significant mental health challenges which are likely to have been exacerbated by the COVID-19 pandemic. This report helps us to better understand the challenges young people face, recognise the broader impact of the pandemic on their lives, and look at areas where more support and investment is needed.”

Dr Richmond Davies, Head of Public Mental Health and Child Public Health at Public Health Scotland, said: “The insight the HBSC study provides into trends in young people’s health, wellbeing and socioeconomic circumstances is invaluable and highlights the need to prevent poor mental health before it emerges.

“We have good evidence of what the drivers of mental health are, so we must not ignore opportunities to increase young people’s exposure to protective factors and reduce their exposure to, and the impact of, the factors that harm their mental health.

“Key drivers of poor mental health in young people include: poverty and economic deprivation; the availability and quality of opportunities post-school; and supportive relationships with peers, family and trusted adults in the community.”

Dorothy Currie, from the School of Medicine at St Andrews University, said: “This most recent HBSC report highlights continuing challenges around gender and socio-economic inequalities in health among young people in Scotland, across areas such as mental health, physical activity, eating behaviour and including the impact of the COVID-19 pandemic. While many Scottish adolescents reported positive impacts of the pandemic across several aspects of their lives, this was less true for those from less affluent families and initiatives aimed at reducing health inequalities among this age group must remain a priority.”

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Enquiries: ali.howard@glasgow.ac.uk or elizabeth.mcmeekin@glasgow.ac.uk / 0141 330 6557 or 0141 330 4831

First published: 21 June 2023