I have been grappling recently with the assertion made on several lists and blogs that the passage of the CSF Bill will result in the death of children who will commit suicide if forced to attend school. It sounded very implausible to me, but I thought it worth looking into the question in a little depth. To begin with, I telephoned an old friend to whom I have not spoken for a couple of years. She is a Community Psychiatric Nurse who works with adolescents. I put to her the thesis that problems at school or the fear of school were major factors in the suicide or attempted suicide of children and young people. I have to report that she laughed unpleasantly at the idea and gave the kind of snort which is usually rendered as, 'Huh!' Her view was that most of the kids who attempt suicide are disturbed and that their parents often blame schools or bullying as a way of diverting attention from problems at home which have actually had more bearing on the matter. She pointed out that an awful lot of bullying actually takes place within families! She then directed me towards a lot of research, which I am bound to say seems to bear out her opinion. I have listed some of this at the bottom of the post for those who wish to check for themselves.
To begin with, over 90% of children and adolescents who attempt suicide are indeed suffering from psychiatric disorders. Chief among these are emotional disorders including anxiety and depression. Mental illness in children is associated with a number of risk factors such as family conflict, living in rented housing, having a parent with mental heath problems and having a low reading age. A very big factor is the child living apart from the father; in other words being part of a fractured family. This increases the risk of mental illness in a child by 40%. Normal, well balanced and healthy adolescents do not tend to attempt suicide in response to stressful life events, whether involving school or anything else.
It seems to me, after looking into this carefully, that the idea that home educated children would kill themselves if sent back to school is pretty unlikely. I suppose that there would be a slight risk with any such child who was already suffering from a mental illness. Since only 4% of children are in this category, I should think that the chances of any child actually dying as a result of the passage of the Children, Schools and Families Bill is remote in the extreme. It must also be borne in mind that suicide in this age group is very rare, with only eleven cases a year being recorded. This means that on average each year only one child without a psychiatric problem commits suicide. Those wishing to look into this matter for themselves, rather than relying upon Internet gossip, could start by reading Ford, Goodman and Meltzer's article; The relative importance of child, family, school and neighbourhood correlates of childhood psychiatric disorder. This may be found in Social Psychiatry and Psychiatric Epidemiology, 39, 487-96 2004. They might also care to read a publication by the Office of National Statistics called, Mental Health of Children and Young People in Great Britain, 2004.
I am sorry to dispel a popular myth, but suicides of this sort do seem, as my friend suggested, to be connected with psychiatric disorders and unfavourable home circumstances rather than schools. I find it interesting that living with a single mother is the greatest risk factor of all in such conditions and I would be curious to know whether the proportion of home educated children living apart from their fathers is higher than in the general population. The fact that having a low reading age is associated with mental health problems in children and adolescents might also prove of interest to some home educating parents. I think that these would be more productive lines of enquiry than looking at the educational setting itself as a precipitating factor for suicide.
Correlation does not always indicate causation. In other words, the association of a number of factors with suicide does not necessarily mean that those factors cause suicide.
ReplyDeleteAlso, group risk does not always indicate individual risk. Growing up in a single-parent household might be associated with higher risks to the group as a whole, but not to any given individual.
Given that you have questioned the diagnosis of ‘alphabetic’ development disorders, Simon, I’d be interested to know what reliance you place on the diagnosis of a ‘psychiatric’ disorder. Given that the same practitioners do the diagnosis for both.
It’s hardly surprising that low reading age is associated with mental health problems, given the failure of the education system to effectively address reading difficulties at the same time as making access to education dependent on the ability to read. It would be interesting to find out if the same mental health problems were experienced by home-educated children who learned to read ‘late’.
And lastly, I would be interested to know how the literature eliminated school as a risk factor; how researchers decided that school couldn’t have been a problem. A commonly reported feature of school bullying, for example, is that the victim doesn’t disclose what’s happening. In addition there is a widespread assumption that the interactions that occur in schools are ‘normal’ for human beings. How did the researchers control for this assumption?
I have been careful Suzyg, not to fall into the fatal error of assuming post hoc, ergo propter hoc! Of course these factors which are associated with psychiatric disturbance and suicide do not necessarily cause either. The best that we can say is that there is a connection. And you are right, I am sceptical about diagnoses made by the medical profession of psychiatric syndromes in children. As for school being a risk factor, this was not eliminated. Experiencing two stressful life events was a risk factor. These could be changing schools, moving home or the death of a parent. there is nothing to implicate schools or bullying in particular. I made the above post because direct cause and effect was being posited between the passage of an act of parliament, my support for this and the subsequent suicide or sterility of adolescents. I was pointing out that there is a little more to it than that.
ReplyDeleteI've had a look at the study you recommend, The relative importance of child, family, school and neighbourhood correlates of childhood psychiatric disorder. Under methodological issues they state:
ReplyDelete"Our measures of schools and neighbourhoods were based on aggregated data, and this may have missed important school and neighbourhood influences that are relatively specific to a given child. For example, the fact that a child is attending an ‘average’ school as far as school-wide indicators are concerned does not mean that the child’s mental health will not be severely affected if he or she is bullied or associates with antisocial peers.Consequently, aggregated measures of a school or a neighbourhood as a whole may well miss important risk factors that would only be evident if children were asked about their individual experience of their school and neighbourhood."
the children bill will not get passed its dead in the water and the consevative party is not interested in home education so its over thank goodness Brown is finshed your watching the fag end of his government limping to defeat
ReplyDelete"Her view was that most of the kids who attempt suicide are disturbed and that their parents often blame schools or bullying as a way of diverting attention from problems at home which have actually had more bearing on the matter. She pointed out that an awful lot of bullying actually takes place within families! "
ReplyDeleteSo is she suggesting that bullying at home increases risk of suicide but bullying at school does not? And how does she differentiate between problems at the home that were caused by the stress of a family member undergoing bullying from other, unrelated problems? A depressed, stressed child within a family is likely to affect the family as a whole, possibly worsening existing but relatively minor issues.
The study, Psychological adjustment in bullies and victims of school violence, found that victims of bullying were more likely to have low self-esteem, depressive symptoms, loneliness, feel stressed and express less satisfaction with life. Plenty of research has found that depression is strongly linked with suicidal thoughts.
This also seems a relevant study.
Bullying, depressive symptoms and suicidal thoughts, Erling Roland, Centre for Behavioural Research, Stavanger University College, N-4091 Stavanger, Norway
"Based on this, it seems reasonable so far to suspect that emotional problems on the part of the victims can be both a consequence of being bullied and a reason why these pupils are victimized. A most interesting question is whether certain kinds of emotional problems make a pupil a convenient target of bullying and whether other kinds of problems mostly may be a consequence of being bullied."
"The present investigation has demonstrated that both bullies and victims are signicantly above neutral pupils on depressive symptoms and suicidal thoughts."
"Research concerning home conditions of bullies and victims is limited. However, the main conclusion from such research is that bullies suffer from more family problems than pupils not involved in bullying, while victims are more similar to pupils neutral to bullying...Since victims probably are not much different to neutral pupils relative to family conditions, it is difficult to believe that home problems are main reasons why victims have high scores on depressive symptoms and on suicidal thoughts. Rather, it is conceivable that being victimized by peers causes much of these problems.Where bullies are concerned, home problems may at least partly explain their high scores on depressive symptoms and on suicidal thoughts. This is because home problems related to bullying, depression and suicidal symptoms have much in common, as discussed above. It seems reasonable to conclude that depressive symptoms and suicidal thoughts mainly have different sources for victims and bullies. For bullies, home problems seem to be an important source, while being bullied is a main reason why victims score high on depressive symptoms and suicidal thoughts."
Your research methods seem a bit dodgy, Simon. Attempting to disprove a link between bullying and suicide with a research study that explicitly states that their results are unsuitable for this purpose and that the design of the study results in bullying as a risk factor being missed completely.
ReplyDeleteI have just seen this about Peter the chess player thought you love to read it Simon!
ReplyDeletehe other notable performer was 13-year-old Peter Williams, whose parents incurred the wrath of Hampshire education authorities five years ago when his primary school refused to allow time off for chess. They opted for home tuition, although his chess advance was slower than hoped. But at Hastings Williams made his breakthrough in style with a splendid 5.5/9 including a win and a draw against IMs, narrowly missing an IM score, Peter won £250pound and a silver chess set.
"The fact that having a low reading age is associated with mental health problems in children and adolescents might also prove of interest to some home educating parents. I think that these would be more productive lines of enquiry than looking at the educational setting itself as a precipitating factor for suicide."
ReplyDeleteI would imagine that being unable to read or reading poorly after 7+ years of instruction at school whilst being set research and written work and having to sit and fail written tests might well affect mental health. I would be surprised if it didn't and the possible cause and effect seems quite obvious.
How do you think this is comparable to say, an autonomously educated child who has not failed to learn to read failed to produce the required homework or failed written tests for years and who generally catches up to and often exceeds their peers in reading skills very rapidly once they decide to learn to read? In my experience the child in this situations feels great satisfaction at a job well done and freely chosen.
If the AE child had felt stress because of lack of reading skills for any length of time before asking to learn to read, why do you think they would not ask to learn to read? In my experience lack of reading skills in situations where they are needed can be the trigger for an AE child to ask to be taught to read and some level of stress may be involved - they cannot communicate with their friends online when they want to, for instance. However, this type of stress is very different to that experienced by a child in school when they have to face getting into trouble for failing to produce homework, written tests and routine failure. I think it's generally accepted that a low level of stress is positive, healthy and useful, stimulating efforts to achieve - competitive edutainment software probably takes advantage of this. This level of stress does not seem at all comparable to the years and years involved with none reading school children and I've seen both.
I was simply pointing out that this is a risk factor in psychiatric disorders in young people. It is at least as plausible that young people living with single mothers and who are not reading well could be at risk of mental health problems and sucide, as it is to suggest that sending them to school will cause these things. Here are the main factors associated with suicide among young people in this country;
ReplyDeleteAlcohol and drug abuse Substance abuse is thought to be a highly significant factor in youth suicide. Alcohol and drugs affect thinking and reasoning ability and can act as depressants. They decrease inhibitions, increasing the likelihood of a depressed young person making a suicide attempt. American research has shown that one in three adolescents is intoxicated at the time of an attempt.
Unemployment There is much debate over the role of unemployment in suicide and causal links have not been established. However the rate of attempted suicide amongst the short-term unemployed has been shown to be 10 times as high as for people in work.
Physical and Sexual Abuse Young people who suffer, or have suffered, abuse in the past are often at increased risk of suicide or deliberate self-harm.
Custody Within the prison population as a whole, young prisoners represent the largest group of at-risk individuals, particularly those under 21 who make up a third of the remand population. In 1995, 20% of prison suicides were by people of 21 or under.
But looking at the entire population of people with suicidal thoughts is not the best way to find the level of risk of suicidal thoughts in a particular sub-population, i.e. children suffering from bullying at school. They form a relatively small proportion of the larger population and any statistics relevant to the issue we are interested in are buried by the mass of statistics from the rest of the population.
ReplyDeleteIf you want to find out if bullying leads to suicidal thoughts or actions you need to compare bullied (and bullying) children with similar but un-bullied children. The control group should be matched for other variables such as single parents, social housing and other known risk factors for suicidal thoughts in an attempt to reduce the chance that other variables are responsible for any differences observed. This was done in Bullying, depressive symptoms and suicidal thoughts, and they concluded:
"It seems reasonable to conclude that depressive symptoms and suicidal thoughts mainly have different sources for victims and bullies. For bullies, home problems seem to be an important source, while being bullied is a main reason why victims score high on depressive symptoms and suicidal thoughts."
To find out if late reading causes depression in HE children you would need a sample of AE late readers and a matched sample early AE readers. The two groups should be matched for other risk factors for depression such as chronic disease and the others mentioned above. You could then compare depression rates between the two groups to see if late reading by itself increases rates of depression.
ReplyDeleteAnd that, as far as it goes, is quite plausible. It does not alter the fact that suicide and attempted suicide are inextricably linked with psychiatric problems. These combine with various events in the life of the young person and then these can act as triggers. I don't doubt for a moment that bullying can be one of these stressful life events, but it is far from being a major one. I have listed those above. The difficulty here is that we are not talking straightforward cause and effect. Children do not kill themselves "because" of a family row, or bullying or alcohol. What happens is that a young person might have a tendency to being anxious and depressed. Then things happen in life which set off the fatal train of events. Sure, bullying could be a part of this, but there is no reason to think this is common. There are, as I have already said, only eleven suicides in total each year in the eleven to seventeen age range. Statistically, only one of these is likely to be a child without any history of anxiety and depression. I dare say that in some cases this is reactive depression involving bullying, but the evidence is pretty weak here.
ReplyDelete"These combine with various events in the life of the young person and then these can act as triggers. I don't doubt for a moment that bullying can be one of these stressful life events, but it is far from being a major one."
ReplyDeleteIf it only saves one child... is a common mantra from those in favour of the Bill. Doesn't the same apply in reverse? Why would it need to be a major cause (major as causing large numbers of suicides)? Surely 1, 2 or 3 would be too many?
"Children do not kill themselves "because" of a family row, or bullying or alcohol. What happens is that a young person might have a tendency to being anxious and depressed."
But suicidal thoughts are linked to depression and anxiety and the research I quoted linked anxiety and depression with being bullied. The family life of these children were comparable to unbullied children who were not anxious and depressed so how can you possibly claim as fact that children do not kill themselves because of bullying? If bullying causes depression and depression leads to suicidal thoughts it isn't much of a step to consider that it might be the main cause in some suicides.
You mention 11 suicides in the 11 to 17 year old age range, can you provide a link? According to the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness; Suicide in juveniles and adolescents in the United Kingdom there were 1722 suicides in the 8 years ending in 2003 for males and females aged from 10 to 19, which averages out at 215 per year, quite a difference from your 11 suicides a year for 11 to 17 year olds, but maybe rates have dropped significantly since 2003 and I know the rate is likely to be higher in the 17 to 19 year olds which may account for the difference.
Maybe we are just lucky that children are not very successful at suicide because more than 4000 under 14s were admitted to hospital after attempting to kill themselves in 2007. http://www.telegraph.co.uk/health/3352972/What-drives-children-to-suicide.html
Simon wrote,
ReplyDelete"I dare say that in some cases this is reactive depression involving bullying, but the evidence is pretty weak here."
Others appear to disagree with your assessment:
Bullying: We need to increase our efforts and broaden our focus.
Michaud, Pierre-André, Journal of Adolescent Health, Lausanne, Switzerland
Journal of Adolescent Health, Vol 45(4), Oct, 2009. pp. 323-325.
"Forty years or so ago, Olweus initiated the world’s first systematic research on bullying. He defines bullying as a situation in which "a person is bullied when he or she is exposed, repeatedly and over time, to negative actions on the part of one or more other persons, and he or she has difficulty defending himself or herself." According to MEDLINE, between 1991 and 1993, only eight articles were devoted to bullying, whereas in 2008 alone, around 80 such articles were published. For many years, research and interventions on bullying were mainly restricted to Europe, especially Scandinavia. It is only recently that this public health issue has aroused worldwide interest because of the fact that educators, physicians, and health scientists have realized the potential negative impact bullying has on the physical and emotional development of pupils. Bullied pupils achieve less in school and have more somatic complaints and functional disorders. Moreover, bullying can lead to depression and represents a risk factor for suicide. This issue of the Journal brings together four articles that shed further light on the phenomenon and raise interesting issues from both conceptual and preventive perspectives.
And this one,
Title: Bullying and suicide. A review.
Authors: Kim, Young Shin, Child Study Center, Yale University School of Medicine, New Haven, CT, US
Leventhal, Bennett, Center for Child Mental Health and Developmental Neuroscience, Institute for Juvenile Research, University of Illinois College of Medicine, Chicago, IL, US
"Being a victim or perpetrator of school bullying, the most common type of school violence, has been frequently associated with a broad spectrum of behavioral, emotional, and social problems. Suicide is third leading cause of mortality in children and adolescent in the United States of America and around the world. This paper provides a systematic review of the previous 37 studies conducted in children and adolescents from communities, as well as in special populations that examined the association between bullying experiences and suicide, with an emphasis on the strengths and limitations of the study designs. Despite methodological and other differences and limitations, it is increasingly clear that any participation in bullying increases the risk of suicidal ideations and/or behaviors in a broad spectrum of youth."
Yes, the only problem here is that we are apt to fall into the classic post hoc, propter hoc fallacy again. The study from Ilinois is not specifically about victims of bullying. it includes the risk of suicide by the bullies themselves. Since we know that many bullies come from dysfunctional homes and are more likely to suffer from mental illness, this is significant. The fact that somebody who is depressed is both involved in bullying and at greater risk of suicide, does not mean that we are justified in positing a cause and effect chain. It is altogether possible that psychiatric disturbance both caused the bullying and the increased risk of suicide. There is an association between bullying and depression. There is also an association between depression and suicide. there is no reason at all to think that this is anywhere near as great a risk factor as the major ones I listed above.
ReplyDeleteSimon Webb admitted:
ReplyDelete"I have not heard of any cases of HE Inspectors killing or abusing children, but that does not mean that it can't happen in the future."
Although the relevance of this to a debate about bullying escapes me.........
ReplyDeleteSimon wrote,
ReplyDelete"there is no reason at all to think that this is anywhere near as great a risk factor as the major ones I listed above."
Again, why does the rank of a risk matter? A risk is a risk. Isn't one death too many, especially when you consider all of the children who aren't driven as far as suicide but who's lives are seriously harmed by bullying, either harm to their mental health, self harm or direct physical harm inflicted by the bullies.
and Simon wrote,
"The study from Ilinois is not specifically about victims of bullying."
It's true that it wasn't just about victims but they concluded that bullying victims were 2 to 9 times more likely to report suicidal thoughts (they looked at 37 studies, hence the range). When they say 'participation' in bullying in the part I highlighted they meant as either bully or victim.
And there are more studies that find the same or similar. They should be easy enough to find by searching the title on PubMed.
Childhood bullying behaviors as a risk for suicide attempts and completed suicides: A population-based birth cohort study.
"frequent victimization among girls is associated with later suicide attempts and completed suicides, even after controlling for conduct and depression symptoms."
Suicide attempt by hanging in preadolescent children: a case series.
"Stressful life events such as family disruption, physical abuse, and bullying at school were factors associated with suicidal behaviour."
Bullying and symptoms of depression in chilean middle school students.
"Bullying is common among middle school children in Chile, and bullying and symptoms of depression are strongly linked. This finding is consistent with studies of bullying and depression in adolescents from other parts of the world."
Bullying increased suicide risk: prospective study of Korean adolescents
"Bullying independently increased suicide risks."
Suicidal ideation among Canadian youth: a multivariate analysis.
"In particular, ability to communicate feelings, negative attachment to parents/guardians, taunting/bullying or abuse, and presence of deviant peers were significant predictors of suicidal ideation."
Qualitative analysis of Coroners' data into the unnatural deaths of children and adolescents.
"Thematic analysis highlighted: bullying, teenage sexualization and pregnancy, alcohol and substance misuse, reconstituted family difficulties and out of control behaviour as being significant factors on the causal pathway."
School bullying and its association with health and lifestyle among schoolchildren
"A significant association between experiencing bullying and adverse health outcomes was found...Perpetrating and/or experiencing bullying increased the risk of high suicidal ideation that had cumulative effect."
Bullying, depression, and suicidality in adolescents.
"OBJECTIVE: To assess the association between bullying behavior and depression, suicidal ideation, and suicide attempts among adolescents.
CONCLUSIONS: Victimization and bullying are potential risk factors for adolescent depression and suicidality. "
Bullying and victimization in adolescence: concurrent and stable roles and psychological health symptoms.
"The authors compared each stable group with its corresponding late group and found that stable victims and stable bully/victims reported higher degrees of anxiety, depression, and withdrawal than did the other groups."
*who's*, I know my spelling and grammar then to be poor, but that's a new one for me! Of course it should be *whose*!
ReplyDelete*then* should be *tend*, I really most go to bed!
ReplyDelete"It must also be borne in mind that suicide in this age group is very rare, with only eleven cases a year being recorded."
ReplyDeleteDid you actually find these statistic on the government statistics web site, or are you just going by the various articles in newspapers that reported these figures in 2006? I would be interesting in seeing the source document to see how these figures were collated, but have been unable to find them on the government site.
Simon Webb admitted:
ReplyDelete"I have not heard of any cases of HE Inspectors killing or abusing children, but that does not mean that it can't happen in the future."
Simon replied:
"Although the relevance of this to a debate about bullying escapes me........."
The title of your posting is:
"Will the Children, Schools and Families Bill kill children?"
I merely pointed-out that you've already admitted the possibility.