Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article


Doctor of Philosophy




Dr. Shannon L Stewart


School disengagement is a significant problem experienced by many students and may be an indicator of or resultant from underlying difficulties. Indeed, the first onset of mental health difficulties typically occurs during childhood and adolescence. Utilizing large clinically referred samples of elementary and secondary school students at intake into community and inpatient mental health service agencies across the Province of Ontario, Canada, school disengagement was explored as associated with physical and mental health as well as peer and familial relationships, other and self-directed harm, and service intensity need. Age and sex differences were explored across studies to inform the development and implementation of targetted prevention and intervention programs for promoting school engagement and circumventing life-long consequences across the lifespan.

Findings from the first paper indicated that physical and mental health distress were associated with school disengagement, while individual and relational strengths were associated with school engagement among clinically referred elementary and secondary students. Distinct predictive profiles of school disengagement were revealed for school-age children (ages 4 to 11 years) and youth (ages 12 to 18 years). Results from the second paper indicated that school disengagement was strongly associated with other- and self-directed harm among clinically referred elementary and secondary students. Notably, male youth were more likely to be at risk for harm to others, while female youth were more likely to be at risk for harm to self. Findings from the third paper indicated that students who are disengaged in school are two to four times more likely in odds to require high-intensity as compared to low-intensity services at intake into clinical services. Although service intensity need tended to decrease across development, this relationship was more stable for male students as compared to female students.

Taken together, findings across the three papers highlight the necessity for early identification of student distress and provision of timely access to intervention. Further, the requirement of service integration across sectors working directly with students and their families is underlined. When school engagement problems are identified early, both immediate and long-term consequences, such as the manifestation of acute distress requiring crisis supports, can be prevented.

Summary for Lay Audience

The emergence of mental health challenges among children and adolescents is well-known. Notably, young people faced with ongoing mental health distress often experience difficulties across many domains of their lives including poor self-care, interpersonal difficulties, and negative school outcomes such as poor achievement, disengagement in school, and school dropout. Specifically, school disengagement, which has been associated with many unfavourable outcomes, may be representative of underlying emotional or behavioural problems. Utilizing large samples of clinically referred elementary and secondary school students, school disengagement was explored as associated with: 1) physical and mental health concerns as well as relational and individual strengths, 2) other-directed and self-directed harm, and 3) service intensity needs and reason for referral. As expected, students who faced health adversity were found to be at a greater risk for school engagement problems as compared to healthy students. Notably, students who pose the greatest risk to themselves (i.e., risk for self-harm) and those around them (i.e., risk for other-direct harm) were found to be experiencing significant problems with engaging in their learning. In contrast, strong relationships with peers and family members were found to be associated with school engagement for all students. Further, 1 in 4 students were found to be at heighted risk for school disengagement and to require high-intensity services at intake into clinical services. Findings confirm the need for early identification of student distress to reduce the likelihood of consequential life-course detriments. Further, findings highlight the demand for providing timely access to intervention for students in an accessible and applicable manner. Given that the education system has been identified as the main point of entry into mental health services for students, school staff are uniquely positioned to identify and support struggling students. Implications of the findings are explored within the context of the school setting as well as across service sectors working directly with students and their families.