Nordic collaboration tracks positive mental health among adolescents

Repeated rounds of the Health Behaviour in School-aged Children (HBSC) study in Sweden during the 1990s highlighted a worrying spike in health complaints among the nation’s young people. This led to the government investing heavily in schools and the coordination of work to protect and promote good mental health.

In 2010, the Royal Swedish Academy of Sciences appointed an expert group to identify, describe and analyse trends in young people’s mental health. HBSC was an important component of that systematic review. The 2014 HBSC study revealed persistent health complaints around low mood and irritation, with a particular emphasis on stress in schools and increasing mental health complaints among 13-year-olds.

A regional research team, the Nordic Collaboration on Positive Mental Health, is tracking changes in positive mental health. Supported by the Nordic Council of Ministers, it is comprised of the HBSC teams in Denmark, Finland, Iceland, Norway and Sweden.

Professor Charli Eriksson is part of Swedens HBSC team and  he coordinates the Nordic research collaboration. “The need for indicators of positive mental health was the background to the Nordic HBSC research collaboration,” he explains. “The aim of the collaboration included analysing changes over time in positive mental health for school-aged children in the 5 Nordic countries. We are also enhancing positive mental health research by piloting additional measures related to the positive dimension of mental health.”

Rather than just tracking negative trends, in 2018 the researchers included questions in the survey that assess positive mental health, including questions on self-efficacy, self-esteem and social integration. Analysing these measures has so far provided promising results for positive mental health.

The importance of this international cooperation is clear. “The 5 Nordic countries offer interesting possibilities for comparative studies of relevance for policy-makers and practitioners,” explains Professor Eriksson. It provided the opportunity for a Nordic conference, held in Stockholm in 2018, of which young people’s health and life conditions were essential themes. It also led to crucial discussions about the persistence of these health problems within states with well-developed welfare policies. Cooperation between the 5 HBSC programmes has helped deepen research into young people’s mental health.

Professor Eriksson lays out the importance of the HBSC: “A common finding in many studies is a lack of actual, continuous, relevant and reliable data on the health and well-being of children. If you don’t have data, you can’t act properly. So the HBSC study can play such a vital role”.

For example, the different HBSC surveys have all pointed at the importance of mental health, and its deterioration, especially among girls. This has resulted in several government reports on mental health and has indirectly influenced local agencies to conduct surveys on young people, which have been used in turn for monitoring, planning and evaluation of public health interventions.

About the HBSC study

HBSC is a WHO collaborative cross-national study of adolescent health and well-being. The survey, administered in schools, is undertaken every 4 years using a questionnaire for 11-, 13- and 15-year-olds. HBSC findings are used at the national, regional and international levels to:

• gain new insight into young people’s health and well-being
• understand the social determinants of health
• inform policy and practice to improve young people’s lives.