Mental health problems in early adolescents in the Netherlands

Objective A large representative sample of early adolescents in the Netherlands was investigated to assess mental health problems in a school survey. These results were compared to results from former household surveys. In addition, several socio-demographic determinants were analysed. Method A random sample of schools in the Netherlands was approached for participation in the Health Behaviour in School-aged Children Survey study (response rate at school level, 60% in primary education and 45% in secondary education). Within schools, a random selection of classes from the schools participated in the study (response rate within schools >95%). We analysed the percentage of children scoring in the problem range on each of the syndromes of the Youth Self Report and compared these to the percentages found in a former population study. The impact of several socio-demographic background variables was assessed. Results Approximately 20% of the boys and 23% of the girls have total problem scores in the problem range. These percentages are much higher than those found in population studies in the Netherlands so far, particularly in girls. In multivariate analyses, gender, socio-economic status and family composition were found to be of influence. Migrant status does not appear to be of importance once other background variables are taken into account. Conclusions In school surveys on mental health problems, higher problem rates may be found than in population surveys conducted in household settings. This effect has seldom been discussed. It is suggested that this survey context has to be taken into account more explicitly when comparing results of surveys.