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medRxiv PreprintsInternational9 November 2026

Mental Health-related School Provision and Hospital Contacts among Pupils enrolled in Alternative Provision

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Background. Pupils enrolled in Alternative Provision (AP) represent a highly vulnerable population, with heightened mental health need at risk of long-term educational disengagement. Examining AP enrolment in relation to mental health-related school support and hospital contacts may inform early intervention and prevention approaches to address unmet mental health need. Methods. We analysed population-level linked school and hospital administrative data for 1.7m pupils (born 2000-2002) who attended state schools in England. We examined differences by racial-ethnic group and gender in rates and
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