Associations of adolescent mental health and parental education with healthcare use: a cohort study based on data from the Young-HUNT study, Norway.

Abstract

BACKGROUND Adolescent mental health problems and mental health help-seeking have increased in the later decades. We aimed to assess to which extent adolescents with high mental health symptom loads received help in general practice or specialist mental health services, and whether parental education influenced the association. METHODS This cohort study included 7554 Norwegian adolescents who participated in the population-based Young-HUNT4 Survey (2017-2019). They reported their mental health by the Strengths and Difficulties Questionnaire (SDQ), measuring both internalising and externalising symptoms, summed up to a Total Difficulties score. During 1 year after participation, data on contacts with and diagnoses from general practice and specialist mental health services were collected from national registries. We used generalised linear models to analyse the probability of contact with general practice and specialist mental health services by low, moderate and high SDQ scores. We evaluated effect measure modification using interaction terms. RESULTS Among adolescents with high total, internalising or externalising SDQ scores, 29-31% of females and 19-21% of males consulted a general practitioner for mental health problems, compared with 9-10% and 6-7% among those with low scores. Males and females with high internalising scores had a nine times increased risk of specialist mental health service contacts with internalising diagnoses, and similar associations were found for externalising scores and contacts/diagnoses. The associations were largely independent of parental education level. CONCLUSION Adolescents' mental health symptom loads were positively associated with health service use in general practice and specialist mental health services and largely independent of parental education.