Social inequalities in adolescent mental health in the Netherlands

International comparative research shows that Dutch adolescents report high levels of mental health and belong to the “happiest kids in the world”. This does not mean that all adolescents in the Netherlands have such good mental health. In this thesis, we investigated inequalities in adolescent mental health based on country of residence, family affluence, immigration background, adolescent educational level, and gender. Using an adapted and validated instrument, our results showed that adolescents in the Netherlands report relatively low levels of mental health problems compared to their European agemates. Hyperactivity-inattention problems are an exception to this: Dutch adolescents report relatively high levels of hyperactivity-inattention problems. These problem levels were relatively stable across 2003-2013. However, small but rather persistent differences in mental health problems between social groups were found. To illustrate, adolescents with a non-western immigration background and a lower educational level reported highly similar levels of emotional problems, but higher levels of conduct problems and peer relationship problems compared to native Dutch adolescents or adolescents in higher educational levels. Our results also showed that not family affluence, but perceived discrimination seems to play an important role in this relatively high risk of non-western immigrant adolescents. Both in the Netherlands as in Europe, we found little evidence for intersectionality: the idea that adolescents’ belonging to particular combinations of social groups are at a higher risk for poor mental health. The findings highlight the need for selective intervention and prevention efforts targeting at-risk groups of adolescents.