Understanding the Social Determinants of Adolescent Boys' Mental Health and Wellbeing in Education: an Intersectional-Ecological Approach

Abstract

Social determinants of health are the social and economic circumstances that shape health across the life course and are important to address for health and social equity. This thesis seeks to understand the social determinants of adolescent boys' mental health and wellbeing in education. Adopting an intersectional-ecological approach, this research also contributes to the application of ecological systems and intersectionality to understand the social determinants of adolescent boys' mental health and wellbeing in this context. Gender disparity in prevalence of mental health conditions and uptake to psychological support suggests that adolescent boys are not accessing the support and services that they need to stay well during the transition to adulthood. A review of the literature identified a lack of relevant evidence for ways to support adolescent boys' mental health through school-based interventions and outlined a need to better focus on the ways that social environments shape mental health and wellbeing. This thesis consists of four original research articles: one academic blog and three original research studies presented in journal article format. Research Article One is an academic blog that discusses the disproportionate impact of school exclusions in Britain on Black British boys, in the context of the Black Lives Matter movement. Research Article Two is a scoping literature review which identifies, evaluates and synthesises epidemiological studies of stress in adolescent males. Research Article Three is a qualitative exploration that challenges the individualisation of NEET (Not in Education, Employment, or Training) status and the culture of blame that frames adolescent boys' transition into employment and economic independence. Research Article Four generates 'I-Poems' from interview transcripts to counter popular narratives about adolescent boys as unwilling or unable to talk about their personal health and wellbeing. Each of the four original articles contribute to an understanding of social determinants of health and adolescent boys' mental health and wellbeing. Together, the four Research Articles illustrate how social context shapes how identity and distress are understood, and what role policy and practice play in sustaining social inequalities experienced by adolescent boys in schools. In particular, how adolescent boys are categorised often recreates social inequality, and this inequality is reinforced and sustained by social policy which fails to take into account the ways that socially-defined characteristics shaped lived experience in ways that restrict access to opportunity and resource across education, employment, and health for adolescent boys. Thesis findings build upon several fields and a broad range of existing literature across adolescent mental health, wellbeing in education, intersectional analysis, social policy, feminist methodology, and ecological systems theory. The benefits of drawing on Ecological Systems Theory and Intersectionality to understand the social determinants of health are outlined, with a focus on how overlapping systems of power contribute to practice of discrimination in education. Practical implications for education and health policy, practice, and research concerning adolescent boys and the wider population of young people in schools are presented. In particular, this thesis offers directions for future research and implications for practice that can contribute to better support for adolescent boys during, through, and beyond the transition to adulthood in and outside of school.

Date of Award	1 Aug 2024
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Neil Humphrey (Supervisor) & Ola Demkowicz (Supervisor)