A Comparative Study of the Associations Between Social Determinants and Adolescent Mental Health Across Nine Countries

Duhita Mahatmya; Wei-Lin Chen; Asih Asikin-Garmager

doi:10.1007/s10566-026-09930-7

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A Comparative Study of the Associations Between Social Determinants and Adolescent Mental Health Across Nine Countries

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A Comparative Study of the Associations Between Social Determinants and Adolescent Mental Health Across Nine Countries

Duhita Mahatmya, Wei-Lin Chen and Asih Asikin-Garmager

Child & Youth Care Forum

02/20/2026

DOI: 10.1007/s10566-026-09930-7

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Published (Version of record)Child Youth Care Forum (2026)CC BY-NC-ND V4.0, Open Access

Abstract

Background Globally, 14% of all 10–19-year-olds experience a mental health disorder. More research is needed to identify and compare risk and protective factors associated with adolescent mental health in an international context. Objective This study aimed to explore the association between social determinants and mental health among adolescents across nine countries. Methods Using PISA 2018 cross-sectional data and multilevel modeling, this study investigated how individual, family, and school characteristics were associated with adoles-cents' mental health symptoms in Bulgaria (n = 3,988), Georgia (n = 4,452), Hong Kong (n = 5,212), Ireland (n = 5,344), Mexico (n = 6,196), Panama (n = 4,873), Serbia (n = 4,992), Spain (n = 28,160), and the United Arab Emirates (n = 17,228). Results Individual and school characteristics were significantly associated with adolescent mental health across all countries, highlighting that positive school experiences and proso-cial interactions are related with fewer mental health symptoms. The study also identified variations in the association between family characteristics and mental health, suggesting nuanced differences across cultural and national contexts. Conclusions This study affirmed the associations between individual and school characteristics and adolescent mental health globally, highlighting the important relationship between supportive educational environments and youth well-being. These results could help researchers and practitioners design school-based mental health interventions that incorporate both universally applicable factors and context-specific considerations.

Child or Adolescent Mental Health

Mental Health

social determinants

PISA

Adolescent development

Details

Title: Subtitle: A Comparative Study of the Associations Between Social Determinants and Adolescent Mental Health Across Nine Countries
Creators: Duhita Mahatmya (Author) - University of Iowa, Center for Social Science Innovation
Wei-Lin Chen (Corresponding Author) - National Sun Yat-sen University, Kaohsiung, Taiwan
Asih Asikin-Garmager (Author) - University of Iowa, Center for Evaluation and Assessment
Resource Type: Accepted manuscript
Publication Details: Child & Youth Care Forum
DOI: 10.1007/s10566-026-09930-7
ISSN: 1053-1890
Language: English
Electronic publication date: 02/20/2026
Academic Unit: Center for Evaluation and Assessment
Record Identifier: 9985137740602771

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