National adolescent study reveals insights into child mental health in Scotland

Published: 30 January 2020

A national report, carried out every four years, has provided insights into child mental health in Scotland

A national report, carried out every four years, has provided insights into child mental health in Scotland.

The 2018 Health Behaviour in School-aged Children (HBSC) study in Scotland, led by researchers at the MRC/CSO Social and Public Health Sciences Unit, University of Glasgow and funded by NHS Health Scotland, provides data on the health and wellbeing of the nation’s young people.

Key findings include the majority (85%) of young people reported high life satisfaction in 2018, while almost one in five adolescents rated their health as excellent. However, the report also revealed the lowest levels of adolescent confidence seen in 24 years, with only 51% of adolescents in Scotland reporting often or always feeling confident in themselves.

Beyond mental health and wellbeing, the HBSC study covers areas such as sleep habits, time spent online, physical activity as well as school and home life. The report presents data collected from surveys with a representable sample of 11, 13 and 15-year-olds in Scotland in 2018. The surveys were conducted in schools, with all pupils in the selected classes asked to fill in the confidential questionnaire anonymously.

This is the 8th 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 over the last 28 years. A wider pan global report on the health of young people across the world is due to be published later this year.

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 substance use and eating behaviours. But at the same time, new challenges such as social media are increasingly impacting on how young people live their lives and these can have a significant impact on their wellbeing. This report helps us to better understand the challenges young people face and the areas where more support and investment is needed.”

Dr Rory Mitchell, Public Health Intelligence Principal, NHS Health Scotland said: “This report highlights some positive trends as well as ongoing challenges. The data shows that children from wealthier families tend to report better health and wellbeing than those from poorer families. This highlights the need for a continued focus on tackling health inequalities in Scotland.

“The information provided by this long-running study has enormous value in helping to improve health and wellbeing. Using such information to make a real difference requires a collaborative effort that co-ordinates local and national action. The formation of Public Health Scotland in April this year will contribute to this.​”


Findings of the report include:

Mental health and wellbeing

  • 22% adolescents rated their health as ‘excellent’ but 15–year-old girls were the least likely to report ‘excellent’ health (12%).
  • The prevalence of multiple health complaints is at its highest for both boys and girls since 1994. Overall 35% of young people experienced multiple health complaints every week. The most common health complaints were sleep difficulties, feeling nervous and feeling irritable.
  • 37% adolescents were classified as having low mood (33% boys, 41% girls) and 14% were at risk of depression (11% boys, 17% girls). Both low mood and risk of depression increased with age.
  • All the mental health and wellbeing indicators were significantly associated with family affluence, with poorer outcomes for those from families with lower affluence.


  • The average sleep duration on weekdays was 8.3 hours for 13-year-olds and 7.8 hours for 15 year olds – the recommended sleep for teenagers is 8 to 10 hours each night.
  • The proportion of young people reporting sleep difficulties more than once a week has increased from 23% in 2014 to 30% in 2018.
  • Among 13 and 15-year-olds, sleep difficulties were more common among girls than boys and young people from lower affluence families were more likely to report difficulties in getting to sleep than those from higher affluence families (25% versus 35%).

Social media and online communication

  • Nearly all (95%) young people said they owned a smartphone with connection to the internet.
  • The vast majority (92%) of 15-year-olds kept their smartphones in their bedroom at night.
  • Preference for online (versus face-to-face) communication was higher amongst 15-year-olds than 11 and 13-year-olds.
  • Nearly one in ten (9%) adolescents were categorised as having problematic social media use.

At home and school life

  • Overall 38% of young people reported high teacher support
  • The proportion of girls who find it easy to talk to their father has increased from 48% in 1990 to 67% in 2018.
  • 36% of young people reported eating a meal with their family every day.
  • Vigorous physical activity was higher among boys than girls. 47%) of boys and 41% of girls reported taking part in leisure time vigorous exercise at least four times a week. The gender difference was greatest at age 15 (40% vs 29%)

Jo Inchley added: “Many young people report high life satisfaction and have good support from their families and friends. However, the declines in mental health and increase in sleep difficulties are concerning. There’s been a small but steady increase in the proportion of girls taking part in physical activity in their free time but overall levels are still very low and screen time has been increasing at a much faster rate. It’s important that young people have opportunities to be active and spend time outdoors as these can have substantial benefits for both their physical and mental wellbeing.”

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First published: 30 January 2020

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