Mental health, education, and work in Canada, the Netherlands, and the United States: a comparative, life course investigation

Many mental health concerns emerge in adolescence, having profound implications for education and work in young adulthood. This dissertation examines how adolescent mental health and its effect on education and work are impacted by institutional differences between Canada, the USA, and the Netherlands. This research is presented in four quantitative studies of population-level prospective cohort data. Growth mixture models were used to identify depressive symptom trajectories between adolescence and young adulthood in Canada and the USA. Multinomial logistic regression was used to examine the relationship between childhood socioeconomic status (SES) and depressive symptom trajectories, and education, and work in Canada and the USA. Causal mediation was used to estimate the indirect effect of adolescent internalizing and externalizing problems on NEET (not in education, employment, or training) through educational attainment in the Netherlands, and two cohorts in the USA. The findings demonstrate that depressive symptom trajectories between adolescence and young adulthood were similar between Canada and the USA, but inequalities by childhood SES were more pronounced in the USA. Elevated symptoms predicted lower standing in education and work in both Canada and the USA. However, Canadians had more favourable education and work outcomes than Americans in general. Educational attainment was an intervenable mechanism linking adolescent mental health problems to labour market exclusion in young adulthood in both the Netherlands and the USA. However, this indirect effect was stronger in the Netherlands than in the USA. While this indirect effect did not vary between cohorts, the direct effect of adolescent mental health did. The findings show that adolescent mental health inequalities are shaped by a dynamic interplay between developmental processes and the institutional environment (the social safety net, and the education and labour market systems). Normative developmental processes drive longitudinal patterns in adolescent mental health problems, and the risks they present for education and work in young adulthood. This dissertation suggests, however, that the contexts in which individuals grow up make a difference for the (un)equal distribution of mental health within a society, and for the potential for mental health problems to negatively impact education and work in young adulthood.