What is mental health competence?

Do you know what is mental health competence (MHC)? It sounds like the “mental health” we are talking about every day. But MHC is not about emotional burnout, therapy, or Freud… It is a set of positive psychosocial skills, including 1) being good at interacting with others, 2) being responsible and respectful, 3) being positive towards learning, 4) being open to new experiences, and 5) being kind and helpful to others (Goldfeld et al., 2014). Studies have found that MHC is associated with a range of important outcomes among children: cognitive abilities, academic performance, and physical health (e.g., Hope et al., 2019; O’Connor et al., 2022).

However, MHC is a largely underexplored area. MHC has been considered as the reverse of mental health difficulties for a long time – when children don’t have mental health difficulties, they will have high MHC. This is not the case. Research has revealed that MHC is not the reverse of emotional symptoms (Hope et al., 2019). This previous research tells us MHC is different from subclinical mental health difficulties. We want to further demonstrate that MHC is not the inverse of mental health difficulties when the symptoms meet clinical diagnostic criteria (e.g., depression).

The other potential research topic about MHC is whether MHC is relevant to children’s life at schools. Children spend lots of time at school as students, which makes the school an important place to study. There are positive associations between MHC-similar skills (e.g., motivation to learn) and students’ positive experiences at school (Aldridge & McChesney, 2018; Thapa et al., 2013). But we don’t know whether MHC (itself!) has the same positive relationship with school experiences.

What did this study do?

The current study aims to examine whether children’s MHC and mental health difficulties are separate constructs. By uncovering this relationship, we can provide more solid evidence to say MHC is not just different from sub-clinical emotional symptoms, but also clinical types of mental health difficulties. We also aim to explore whether MHC is relevant to children’s experiences at school. By doing so, we can point out the starting points of potential school-based interventions to improve students’ MHC.

We used a dataset from 485 UK secondary school students (aged 11-13). This dataset contained rich measures of students’ life at schools. We picked the assessments of eating disorder, depression, and anxiety as mental health difficulties measures. We picked the measures of school climate, including 1) students’ efforts in learning, 2) sense of belonging to schools, 3) involvement in school decisions, 4) feeling of safety at school, and 5) their relationships with teachers. We picked measures of students’ relationships with peers, including their 1) friendship at school, 2) whether they have bullied others, and 3) whether they have been bullied. And finally, we picked the measures of MHC!

What did the current study find?

Mental Health Difficulties

The results supported that MHC and mental health difficulties were different from each other. We found that students who had high MHC can also have eating disorder, depression, or anxiety. Similarly, Students with low MHC did not always have these mental health difficulties.

School Experiences

Students’ high MHC was related to a more positive student-reported school climate. Students’ efforts in learning showed the strongest association with MHC, followed by involvement in school decisions, relationship with teachers, feeling safe at schools all the time, and feeling of belonging to schools. We did not find much evidence for the association between MHC and students’ relationships with their peers.

How to understand the results?

Mental Health Difficulties

We now understand that MHC and clinical types of mental health difficulties are not the inverse of each other. Our study improves upon previous research. We show that MHC is not just different from subclinical mental health difficulties (Hope et al., 2019), but also clinical types of difficulties like eating disorder.

School Experiences

We have convincing evidence that MHC is relevant to students’ interactions with school and teachers. In particular, students’ efforts in learning and involvement in school decisions are strongly correlated with MHC. These two areas describe students’ behavioural engagements at school.

Our results suggest that MHC is not related to how well students get along with their peers. However, most students in our sample said they had good relationships with their peers. Our results cannot represent the voice of students who did not get along well with their peers. We should not overstate this result.

Who can learn from this study?

• Everyone: You now understand MHC is relevant to students’ experiences at school (particularly behavioural engagements) and high MHC ≠ low mental health difficulties.
• Policymakers: When designing programmes to promote mental health, MHC and mental health difficulties are both important. MHC cannot be improved by only preventing mental health difficulties.
• Schools and teachers: You should take extra care about how you interact with students.
• Researchers:
  • You can examine the relationship between MHC and mental health difficulties further. One potential topic is: Are there associations between MHC and other clinical types of mental health difficulties (e.g., Obsessive-Compulsive Disorder)?
  • You can explore more about MHC at schools. You might be interested in finding out whether school experiences can predict students’ MHC.

How can this study be improved?

• Missing data: There was a notable number of missing data in our dataset. This issue reduced our sample size.
• Measurements: We only had student self-reported data. It will be interesting to compare students’ self-reported data and data from parents/carers or teachers.

References

Aldridge, J. M., & McChesney, K. (2018). The relationships between school climate and adolescent mental health and wellbeing: A systematic literature review. International Journal of Educational Research, 88, 121–145. https://doi.org/10.1016/j.ijer.2018.01.012

Goldfeld, S., Kvalsvig, A., Incledon, E., O’Connor, M., & Mensah, F. (2014). Predictors of mental health competence in a population cohort of Australian children. Journal of Epidemiology and Community Health, 68(5), 431–437. https://doi.org/10.1136/jech-2013-203007

Hope, S., Rougeaux, E., Deighton, J., Law, C., & Pearce, A. (2019). Associations between mental health competence and indicators of physical health and cognitive development in eleven year olds: Findings from the UK Millennium Cohort Study. BMC Public Health, 19(1), 1461. https://doi.org/10.1186/s12889-019-7789-7

O’Connor, M., Arnup, S. J., Mensah, F., Olsson, C., Goldfeld, S., Viner, R. M., & Hope, S. (2022). Natural history of mental health competence from childhood to adolescence. Journal of Epidemiology and Community Health, 76(2), 133–139. https://doi.org/10.1136/jech-2021-216761

Thapa, A., Cohen, J., Guffey, S., & Higgins-D’Alessandro, A. (2013). A Review of School Climate Research. Review of Educational Research, 83(3), 357–385. https://doi.org/10.3102/0034654313483907