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The Youngest Children in Each School Cohort Are Overrepresented in Referrals to Mental Health Services

Shipra Berg, MRCPsych, and Erlend Berg, PhD

Published: May 15, 2014

Article Abstract

Objective: To investigate whether the youngest children in each school cohort are overrepresented as users of specialist mental health services.

Method: Dates of birth were obtained for all 9,157 children and adolescents referred to specialist mental health services in 3 London boroughs from 2008 to 2011. The actual frequency of referrals by month of birth is compared to the expected frequency of referrals as determined by birth statistics for the relevant age group.

Results: August-born children, who are the youngest in their cohorts in England, represent 9.38% of referrals but only 8.59% of the population in the relevant age segment. Hence, August-born children are overrepresented in referrals to specialist mental health services (P value = .007). September- and October-born children, who are the oldest in their cohorts, are underrepresented: September-born children represent 8.62% of the population but 7.99% of referrals to mental health services (P value = .032), and October-born children are 8.56% of the population but 7.86% of referrals (P value = .016).

Conclusions: Being among the youngest in a school cohort is associated with a higher risk of referral to mental health services, while being among the oldest is a protective factor.

Volume: 75

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