Improving wellbeing in every area of the UK is the overarching ambition of the Levelling Up White Paper, and government has said it will undertake further work to supplement existing wellbeing data at a subnational level. In Greater Manchester, a community-led, hyper-local project is underway to understand and improve children and young people’s wellbeing, and some of the approaches and early data can provide ideas for levelling up mental health. In this blog Professor Neil Humphrey, academic lead for #BeeWell, reflects on a recent analysis of wellbeing inequalities for young people across Greater Manchester, focusing in particular on disparities experienced by LGBT+ young people, and considers how they should be addressed.

• In autumn 2021, we surveyed nearly 40,000 young people from more than 160 secondary schools across all ten local authorities (LAs) in GM to ask about their wellbeing.
• Only 7% of boys report a high level of emotional difficulties, compared with 22% of girls and 50% of non-binary young people.
• Gay, lesbian, bi and pansexual young people scored, on average, less than 5 out of 10 on our life satisfaction measure, compared to around 7 out of 10 for their heterosexual peers.
• In order to address these inequalities, we must work with young people to identify solutions and take a whole community approach, involving local and regional authorities, charities, researchers and schools, to support their wellbeing.

What is #BeeWell?

#BeeWell is a programme that aims to make the wellbeing of young people everybody’s business. We are assessing their wellbeing on an annual basis via a co-produced survey and aim to use the data generated to bring about positive change in Greater Manchester’s (GM) schools and communities as a result.

In autumn 2021, we surveyed nearly 40,000 young people from more than 160 secondary schools across all ten local authorities (LAs) in GM. Data were analysed using robust statistical methods that quantified wellbeing inequalities across gender identity, sexual orientation, ethnicity, language, age, socio-economic status, caregiving responsibilities, and special educational needs and disabilities (SEND). For this analysis, we focused on the following domains:

• Life satisfaction – overall quality of life as a whole
• Psychological wellbeing – feeling good and functioning well
• Stress – feeling overwhelmed by the demands of daily life
• Negative affect – experience of difficult emotions such as sadness and worry

What did we find?

In our recent evidence briefing, we identified major wellbeing inequalities in relation to gender identity and sexual orientation.

There are gaps in wellbeing scores between males and females. For example, girls’ average life satisfaction score was 6.2 out of 10, whereas boys scored 7.2. Only 7% of boys reported a high level of emotional difficulties compared with 22% of girls. Non-binary young people also report lower levels of wellbeing than boys, with even more pronounced differences. For example, 50% of non-binary young people reported a high level of emotional difficulties, and they score, on average, more than 3 points lower on our psychological wellbeing measure. Meanwhile, transgender young people reported significantly higher stress levels than those who are cisgender.

There are also sizeable wellbeing inequalities for young people when focusing on sexual orientation. For example, gay, lesbian, bi and pansexual young people scored, on average, less than 5 out of 10 on our life satisfaction measure, compared to around 7 out of 10 for their heterosexual peers.

Finally, our analyses identified wellbeing inequalities across ethnicity, SEND, caregiving responsibilities, socio-economic status, caregiving responsibilities, and age. However, these were much smaller in magnitude than disparities relating to gender identity and sexual orientation.

Why do these wellbeing inequalities exist?

#BeeWell survey data shows differences in wellbeing but not the reasons behind them. So we are working with a coalition of partners and young people in GM to explore how to address the findings.

Lisa Harvey-Nebil, Chief Executive Officer from The Proud Trust has noted: “As an LGBT+ youth charity we were not surprised that LGBT+ young people report feeling less satisfied with their lives than their counterparts. These results align with our own research findings conducted with young people attending our provision during the pandemic. Our research highlighted that 21% of LGBT+ young people had experienced more LGBT-phobia during the pandemic, with 76% saying their mental health had worsened during that time.”

Simone, a Proud Trust young person, reflects: “education establishments need to look at themselves, their spaces, the culture they foster, and the training they provide their staff to ensure that it is LGBT+ inclusive, making it a happier and safer environment for LGBT+ young people”. Outside of education, Simone says, “Material change for transgender lives would show young trans and non-binary people that their needs are being met, that their problems are considered to have equal weight to their cisgendered counterparts.”

How can we support the wellbeing of LGBTQ+ young people?

Now we have initial findings from the survey, #BeeWell partners are in early stages of using those findings to support young people’s wellbeing. Some of the approaches we are taking can act as a model for similar initiatives across the country and there are also broader areas for consideration.

Young people must be involved in creating solutions. The voice of young people is critical to the success of any wellbeing programme. An example of how we have done this with #BeeWell is to have young people sitting on our governance boards, holding the programme accountable to its aims and co- creating our survey. Any programme of work to support young people must include young people.  For example, in response to our findings, the Greater Manchester Health and Social Care Partnership have created a youth-led commissioning pot for activities to support LGBT+ young people’s  wellbeing.

A whole community approach is necessary to truly support our young people. The #BeeWell project team consists of a team of experts in wellbeing and education across local government, the University and charities. By working with schools, local authorities, and other organisations in Greater Manchester, we can use this data to direct services in the right places and help schools to identify and support their students. Addressing LGBT+ inequalities in wellbeing is an example of how we are taking this approach. By working with organisations such as The Proud Trust, who are experts in the inequalities our data has highlighted, we can combine our knowledge to provide support for young LGBT+ people. This is something that couldn’t be done without collaboration with people with lived experience and organisations that work with communities whose wellbeing is impacted.

Collect new data as well as analysing existing data. Linking in with the Levelling Up White Paper, the ONS has created the Subnational Indicators Explorer, which breaks down data to regional and local authority (LA) level. While it wouldn’t be feasible for the ONS to break down data to an even more local level, it could provide information on how and where combined authorities, LAs, researchers, schools and voluntary and community organisations can access data that is either gathered or disaggregated at a local level. Data collected in a place, co-designed by the people living there, can add extra layers of information and nuance.

Prioritise addressing gender and sexual orientation wellbeing inequalities in the 10-year mental health plan. Both the call for evidence and discussion paper for the Department of Health and Social Care’s 10-year mental health plan reference gender and sexual orientation disparities, among others like socio-economic disadvantage and ethnicity.  However, our findings indicate gender identity and sexual orientation should be given more prominence as part of a wide-ranging strategy to promote positive mental wellbeing and prevent mental ill-health.  Key to any strategy will be intervening to address the factors that underpin the wellbeing inequalities LGBT+ young people experience, such as higher levels of bullying and discrimination.

Evaluate the impact of the Relationships and Sex Education (RSE) statuary guidance. The RSE guidance should be helping to improve pupils’ wellbeing and should make schools more LGBT+ inclusive, but the initial findings from our survey suggest this may not be the case. The Department for Education should evaluate the impact of guidance so far and on a long-term basis to see how it is affecting young people’s wellbeing, understanding and experiences, and amend guidance if it finds that not all students have the opportunity to learn about LGBT+ relationships.

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