The association between mental health problems in childhood and adolescence and educational and labor market outcomes in adulthood: a systematic review and meta-analysis of register data studies

Background
It remains unclear how different mental health problems relate to educational and labor market outcomes, and whether differences between demographic subpopulations exist. To better understand the long-term implications of early-life mental health issues, this systematic review and meta-analysis examined links between child/adolescent internalizing and externalizing mental health problems and different adult educational and labor market outcomes. In addition, differences between age, gender, and parental SES were explored.

Methods
We searched Ovid Medline, APA PsycInfo (Ebsco), ERIC (Ebsco), Web of Science (Core Collection), Scopus and Lens.org from December 12, 2023 up to January 13, 2026. Eligible studies used register data to report associations between children’s/adolescents’ mental health problems and adults’ educational/labor market outcomes. We included 434 odds ratios in the meta-analysis. The narrative synthesis included 713 other effect sizes. Outcomes about education, the labor market, and being Not in Education, Employment or Training (NEET) were analyzed.

Results
Of the 9,003 screened studies, 59 were included mainly from Nordic countries, Canada, and the Netherlands, comprising 1,147 effect sizes. Child/adolescent mental health problems were significantly associated with poorer adult educational outcomes (OR = 1.836; 95% CI = 1.399, 2.408) and labor market outcomes (OR = 1.736; 95% CI = 1.099, 2.744). The few studies on NEET often found that mental health problems were associated with a higher likelihood of being NEET. Externalizing problems were strongly associated with educational and labor market outcomes. For some combinations of mental health problems and outcomes, significant gender differences were found. High study heterogeneity was observed.

Conclusions
Child/adolescent mental health problems are linked to adult educational and labor market outcomes, though specific problems relate differently to distinct outcomes. These findings highlight the need for targeted interventions. The heterogeneous results, a lack of causal studies, the limited generalizability of the results to different countries, and the small number of studies about externalizing problems and NEET warrant further causal research into specific combinations of mental health problems, outcomes, and subgroup populations.

Trial registration
The PROSPERO record for the study is CRD42023495149.