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

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

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


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
JournalJournal of Early Adolescence
Issue number4
Publication statusPublished - Apr 2020



  • adolescent mental health
  • HBSC
  • national policies

Cite this