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Updated: Apr 22, 2026

Multimodal Protocol for Assessing Metacognition and Self-Regulation in Adults with Learning Difficulties
Published on: September 27, 2020
Leaving school without qualifications and mental health problems to age 30
David M Fergusson1, Geraldine F H McLeod, L John Horwood
1Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch, PO Box 4345, Christchurch, 8140, New Zealand, dm.fergusson@otago.ac.nz.
Purpose:
To examine the associations between leaving school without qualifications and subsequent mental health to age 30, using data gathered over the course of a 30-year longitudinal study.
Methods:
Data were gathered over the course of a 30-year study (Christchurch Health and Development Study) of a birth cohort of 1265 children, born in Christchurch in 1977. This cohort has been studied on 22 occasions from birth to age 30. As part of this study, information was gathered on: (a) school leaving qualifications, (b) mental health problems from 18 to 30; and (c) prospectively assessed childhood and adolescent factors including: child and family background; family violence and child abuse; and adolescent mental health problems.
Results:
Leaving school without qualifications was associated with increased risks of subsequent: major depression (OR = 1.37 at 95 % CI 1.05-1.78, p = 0.019); anxiety disorder (OR = 1.99 at 95 % CI 1.55-2.57, p < 0.001); suicidal ideation/attempt (OR = 1.60 at 95 % CI 1.15-2.36, p = 0.005); alcohol abuse/dependence (OR = 1.54 at 95 % CI 1.20-1.98, p < 0.001); and illicit substance abuse/dependence (OR = 2.97 at 95 % CI 2.16-4.07, p < 0.001). Adjustment for the covariate factors above (family social background; family violence; child abuse and adolescent mental health problems) reduced these associations substantially and to the point of statistical non-significance.
Conclusions:
The findings of this study suggest that there was no direct causal association between leaving school without qualifications and subsequent mental health problems. Associations were explained by the linkages between leaving school without qualifications and: child and family social background; and mental health around the point of school leaving.
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