Cross-country differences in the association between socio-economic status and adolescent mental health: The role of mental health policies and services

Abstract

The “social gradient in adolescent mental health” describes the association between higher socioeconomic status (SES) and better mental health in adolescents. This association varies across countries, and little is known about the role of national child and adolescent mental (CAMH) policies in this relationship. This study examined the association between adolescent SES, national-level CAMH policy indicators and three adolescent mental health outcomes using data from eleven- to fifteen-year-olds from 30 European countries (n = 155,375). Multilevel regression models with cross-level interactions examined whether national-level CAMH policy indicators moderated the association between SES and adolescent mental health outcomes. Results showed a social gradient in adolescent in adolescent life satisfaction and psychosomatic complaints. No association was found between CAMH policy indicators and adolescent mental health, only national-level monitoring of CAMH was associated with lower aggressive behaviours. CAMH policies were not associated with mental health inequalities in adolescents. Results of the current study may inform policy processes and guide interventions. Future research should focus on specific national-level CAMH policy indicators to investigate determinants of mental health and mental health inequalities in adolescence.