The study, which analysed responses from a national sample of adults in Wales, revealed that individuals who had experienced ACEs (e.g., child maltreatment, parental substance use) or negative school experiences (e.g., being bullied or having a lower sense of school belonging) were more likely to experience poor mental health, including low mental wellbeing and both current and lifetime mental illness. The research also highlighted the cumulative effect of ACEs and negative school experiences in exacerbating health risks.
According to the study, only 6 percent of individuals with no ACEs reported both being bullied and having a lower sense of school belonging, compared to 51 percent of those who had experienced four or more ACEs. This suggests that children who experience adversity at home are also more vulnerable to further adversity in school.
School systems play a vital role in the development of children’s social and emotional skills and can serve as safe and supportive environments for those facing difficulties at home. However, ACEs can be linked to lower school engagement, increased absenteeism, and a greater risk of exclusion due to behavioural challenges. Children affected by ACEs may struggle with foundational academic and social skills, which can impact their ability to learn and form positive relationships with peers and teachers.
Encouragingly, the study also suggested that positive school experiences can help mitigate the negative effects of ACEs. Among adults who reported experiencing four or more ACEs in childhood, the adjusted proportion reporting current mental illness dropped from 44 percent among those who had been bullied and had a low sense of school belonging to 19 percent among those with more positive school experiences. This highlights the protective role that schools can play in fostering resilience among children who experience adversity.
In Wales, efforts to support children with ACEs have included training staff in schools and other educational institutions to better understand and address the impact of childhood adversity. Additionally, initiatives promoting collaboration between schools and other agencies aim to ensure continued support for children and families. The ACE Hub Wales Trauma and ACE-Informed Organisational Toolkit has been implemented across educational institutions in Wales, as well as in a range of public and third-sector services.
Professor Karen Hughes, Policy and International Health, Public Health Wales, said: "This study reinforces the importance of ensuring schools are safe, supportive spaces for children facing adversity. By fostering positive school experiences and equipping staff with the tools to provide appropriate support, we can help improve long-term health outcomes and create lasting benefits for individuals and society."
Dr Joanne Hopkins, Director of ACE Hub Wales, Public Health Wales said: "Children have a right to education, and a right to be safe. This research finds that those who experienced more ACEs at home were also more likely to experience bullying and traumatic experiences at school, and that more positive school experiences can help mitigate the impact of ACEs. The study signals that it is vital we maintain focus on developing a trauma- and ACE-informed education system in Wales."
Public Health Wales continues to advocate for evidence-based policies and practices that support children affected by ACEs, aiming to reduce the lifelong impact of childhood adversity and promote better health and wellbeing for future generations.
Dr Kat Ford, Public Health Collaborating Unit, Bangor University, said: "The experience of childhood trauma is common. Here, around one in ten people reported having experienced four or more ACEs. Our findings add to a growing body of evidence demonstrating the need to ensure safe and secure childhood environments, to provide children with the best opportunities for health throughout their lives."
