REDUCING MENTAL HEALTH INEQUALITY: Dutch evidence of effective interventions in support of disadvantaged students

16 Apr 2019

School policies that provide additional budget for special needs students can be highly effective in reducing inequalities in mental health, and thereby equalising these young people’s life opportunities with those of their classmates. But girls and students from an ethnic minority and other disadvantaged backgrounds benefit to a lesser extent from the policy.

These are among the findings of an evaluation by Roel Freriks and Jochen Mierau of a policy aimed at reducing mental health inequalities in children, implemented by the Dutch Ministry of Education, Culture and Science in 2003. Their study, to be presented at the Royal Economic Society's annual conference at the University of Warwick in April 2019, analyses data on a randomly sampled cohort of more than 1,000 students in the Northern Netherlands, who were followed from the ages of 10-12 until the ages of 26-28.

It is widely accepted that the mental health of children is strongly related to various later lifetime outcomes as adults, including labour market performance, marital status and overall happiness. For policy-makers, it is therefore crucial to understand the origins of inequalities in mental health.

Determinants of inequalities range from genetic differences to environmental circumstances during birth. Research by Nobel laureate Jim Heckman and colleagues has shown that it is not only important to invest in disadvantaged children during childhood, but to follow these children during adolescence to keep track on inequalities at the start of their adulthood.

The focus of this study is on the mental health state and school performance of more than 1,000 students followed from the end of primary education to their entry into the labour market.

The researchers evaluate a Dutch school policy targeted at reducing mental health inequalities in children, implemented by the Ministry of Education, Culture and Science in August 2003.

The school policy consisted of a ‘backpack’ containing additional budget for students with a mental health state below the average level needed for progression in regular education. These special needs students were in special education (or in the process of switching to special education) at the start of the policy.

For the evaluation, the researchers use data on a randomly sampled Dutch cohort in the Northern Netherlands consisting of 16 follow-up measures of more than 1,000 students. These children were followed from the ages of 10-12 at the start until the ages of 26-28 at the last data entry.

The evaluation makes sure that: (1) there is a distinction between special needs students (eligible for a backpack) and regular students (not eligible for a backpack); (2) the observed differences before and after the policy can be related to the policy instead of other characteristics; and (3) it is possible to find out which groups were actually reached – that is, who benefited the most?


The researchers demonstrate that the school policy reduced the difference in mental health, according to scores on the Child Behaviour Checklist, between special needs students and regular students by 26%. Moreover, the difference in school performance on language and mathematics test scores reduced in the same time period by 65%.

As a result, both groups did not differ in their educational attainment (they both obtained a school degree) at labour market entry. This means that to a certain extent the policy equalised the opportunities throughout life of special needs students with those of their classmates.

Looking closer at the results reveals additional findings:

 

  • First, the policy effect is the largest for special needs students with the worst mental health state before the introduction of the policy, and vice versa.

 

  • Second, the policy is more effective for student with mood disorders than for their classmates with conduct disorders.

 

  • Third, girls and students from an ethnic minority or a lower socio-economic environment benefited less from the policy.

 

The researchers follow previous authors on this last finding and argue that children from more privileged backgrounds have easier access to such additional budget policies. Foreign-born parents from lower socio-economic environments often have more difficulty with the literacy level of corresponding admission procedures.

Further, preferably qualitative, research is needed to understand the story behind the observed differences.

From the study, the researchers conclude that school policies containing additional budget for special needs students are effective in reducing inequalities and thus equalising opportunities with those of their classmates. They also present a cautionary note, as the most disadvantaged classes in society capitalised to a lesser extent on the policy.

 

Additional Funding for Special Needs Students: Quasi-experimental Results from the Netherlands by Roel Freriks and Jochen Mierau, University of Groningen

Roel Freriks

University of Groningen

Jochen Mierau

University of Groningen