National Child and Adolescent Health Policies as Indicators of Adolescent Mental Health: A Multilevel Analysis of 30 European Countries

Anne M. Hendriks, Meike Bartels, Gonneke W.J.M. Stevens, Sophie D. Walsh, Torbjørn Torsheim, Frank J. Elgar, Catrin Finkenauer

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


There is little evidence on the association between child and adolescent mental health (CAMH) policies and adolescent mental health. This study examined this association using data on indicators of adolescent mental health—aggressive behavior, life satisfaction, and psychosomatic symptoms—in 172,829 eleven- to fifteen-year-olds from 30 European countries in the 2013-2014 Health Behaviour in School-Aged Children (HBSC) study. Individual records were linked to national-level policies for CAMH, controlling for national-level adult violence, adult well-being, and income inequality. Multilevel analyses revealed lower adolescent aggressive behavior in countries with more CAMH policies, even after controlling for other national-level indicators. Adolescent life satisfaction and psychosomatic symptoms were not associated with CAMH policies. Results may inform policy recommendations regarding investments in adolescent mental health.

Original languageEnglish
Pages (from-to)537-565
Number of pages29
JournalJournal of Early Adolescence
Issue number4
StatePublished - 1 Apr 2020

Bibliographical note

Publisher Copyright:
© The Author(s) 2019.


This study used survey data collected in the 2013-2014 cycle of the Health Behaviour in School-Aged Children (HBSC) study. The HBSC study is a World Health Organization collaborative study and is supported by each member country. The HBSC study is coordinated internationally by J. Inchley, University of St. Andrews, Scotland, with international data coordination performed by O. Samdal, University of Bergen, Norway. The countries involved in this analysis (including current responsible PI) were Austria (R. Felder-Puig), Belgium (C. Vereecken, A. Hublet, D. Piette), Bulgaria (L. Vasileva), Croatia (M. Kuzman, I. Pavic Simetin), Czech Republic (M. Kalman), Denmark (P. Due, M. Rasmussen), Estonia (K. Aasvee), Finland (J. Tynjälä), France (E. Godeau), Germany (P. Kolip, M. Richter), Greece (A. Kokkevi), Hungary (Á. Németh), Iceland (A. Arnarsson), Ireland (S. Nic Gabhainn, M. Molcho), Italy (F. Cavallo), Latvia (I. Pudule), Lithuania (A. Zaborskis), Luxembourg (Y. Wagener), Malta (C. Gauci), the Netherlands (W. Vollebergh, T. ter Bogt), Norway (O. Samdal), Poland (J. Mazur), Portugal (M. Gaspar de Matos), Romania (A. Baban), Slovakia (A. Madarasová Gecková), Slovenia (H. Jericek), Spain (C. Moreno Rodriguez), Sweden (L. Augustine, P. Lofstedt), Switzerland (E. Kuntsche), and the United Kingdom (A. Morgan, F. Brooks, C. Currie, J. Inchley, C. Roberts). The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the “Aggression in Children: Unraveling gene-environment interplay to inform Treatment and Intervention strategies” project (ACTION). ACTION receives funding from the European Union Seventh Framework Program (FP7/2007-2013) under grant agreement no. 602768. Meike Bartels is supported by an ERC consolidator grant (WELL-BEING 771057 principal investigator [PI] Bartels). The funding sources were not involved in the preparation of the article.

FundersFunder number
Seventh Framework Programme602768, 771057
European Research Council
Seventh Framework Programme
Universitetet i Bergen


    • HBSC
    • adolescent mental health
    • national policies


    Dive into the research topics of 'National Child and Adolescent Health Policies as Indicators of Adolescent Mental Health: A Multilevel Analysis of 30 European Countries'. Together they form a unique fingerprint.

    Cite this