School milestones impact child mental health in Taiwan

Abstract

We examine child mental health treatment surrounding three school milestones in Taiwan: Middle school entry, high stakes testing for high school entrance, and college entrance exams. Using age cutoffs for school entry, we compare August-born to September-born children since the August-born reach each milestone one year earlier. Comparing adjacent cohorts of children born in the same month yields similar estimates. We find that entry into middle school increases mental health prescribing of antidepressant, anti-anxiety, and antipsychotic medications. Use of psychiatric medications falls sharply following high-stakes tests. Effects are stronger in counties where parents and children have higher educational aspirations.