Exam stress experienced at age 15 may have lasting consequences for mental health, increasing the risk of depression and self-harm well into early adulthood, according to new research published in The Lancet Child & Adolescent Health.
The study, which examined data from nearly 5,000 individuals born in the UK between 1991 and 1992, adds to a growing body of evidence highlighting the detrimental impact of academic pressure on young people’s wellbeing. While the negative effects of stress on mood are well-known, this research specifically focuses on the long-term implications for mental health.
Researchers assessed academic pressure at age 15 through questionnaires focusing on school experiences. They then tracked participants’ mental health regularly from ages 16 to 22, and monitored self-harm incidents up to age 24. The findings revealed a significant correlation between perceived academic pressure during adolescence and the subsequent development of mental health challenges.
Specifically, the study found that 15-year-olds who reported higher levels of worry about schoolwork or felt significant pressure from their families to succeed academically were more likely to experience depression or engage in self-harm as young adults. For each additional point of academic pressure reported at age 15, the likelihood of experiencing depression by age 16 increased by 25%, and the likelihood of self-harm rose by 8%. These effects persisted into their early twenties.
The researchers calculated that for every one-point increase in reported school stress, 24-year-olds were 16% more likely to report having attempted suicide compared to those who experienced less academic pressure at 15. This underscores the potentially severe and enduring consequences of early academic stress.
“Young people report that academic pressure is one of their biggest sources of stress,” said Professor Gemma Lewis, a psychiatric epidemiologist at University College London and senior author of the study. “A certain amount of pressure to succeed in school can be motivating, but too much pressure can be overwhelming and may be detrimental to mental health.”
The study’s findings align with recent reports from organizations like Young Minds, which found that nearly two-thirds of 15- to 18-year-olds struggle to cope in the lead-up to major exams like GCSEs and A-levels. Their research indicated that a quarter of these students experienced panic attacks, two-fifths reported a worsening of their mental health, and one in eight engaged in self-harm or had suicidal thoughts.
Paul Noblet, Head of External Affairs and Research at Young Minds, emphasized the need for a shift in focus. “The evidence could not be clearer: academic pressures harm young people’s mental health,” he stated. “The focus needs to shift from end-of-year exams and include a mix of assessment methods. How much longer must young people say they are struggling before truly meaningful changes are made?”
Experts suggest that rather than focusing solely on teaching young people coping mechanisms, schools should implement comprehensive, whole-school initiatives to reduce exam stress. These interventions could include enhancing social and emotional learning skills and incorporating relaxation techniques into the curriculum.
Reducing the number of high-stakes tests is also proposed as a potential strategy. Families, too, can play a role by reducing academic pressure and encouraging activities that promote overall wellbeing, such as physical activity, social interaction, and sufficient sleep.
Dr. Sam Jones, a mental health officer at the Royal College of Paediatrics and Child Health, noted that these findings are indicative of broader pressures on children’s wellbeing. “We are seeing a sharp rise in mental health problems among children and young people,” he said. “More younger children are struggling and there has been an increase in self-harm and eating disorders in recent years.”
Dr. Jones advocates for national action to ensure equitable access to both physical and mental health support for children and young people. He also highlighted the importance of addressing underlying social determinants of health, such as child poverty, housing insecurity, access to safe green spaces, and reducing digital harms.
The Children’s Commissioner, Rachel de Souza, echoed these concerns, noting that her research shows one-third of children do not enjoy school despite valuing their teachers and schools. She called for a new system of support that rebuilds trust with families, intervenes earlier, and integrates specialist services into schools, rather than waiting for children to reach a crisis point.
A government spokesperson acknowledged the importance of both academic achievement and student wellbeing, stating that the government is committed to helping pupils manage stress and build resilience. They highlighted the expansion of mental health support teams in schools, with an additional 900,000 pupils set to benefit this year, and a curriculum review aimed at reducing exam time and fostering a greater sense of belonging.
If you are struggling with mental health challenges, resources are available. In the UK, the charity Mind is available on 0300 123 3393 and Childline on 0800 1111. In the US, call or text Mental Health America at 988 or chat 988lifeline.org. In Australia, support is available at Beyond Blue on 1300 22 4636, Lifeline on 13 11 14, and at MensLine on 1300 789 978.
