Adolescent mental health, disability conditions and family socioeconomic status: a cross-national study of 16 countries

ABSTRACT Adolescents with disability conditions and from disadvantaged socioeconomic status (SES) report disproportionately low mental health. Yet, how disability status and inequalities interplay in explaining adolescent mental health across countries is unclear. Using an intersectional micro-macro approach, this study examined how adolescent mental health outcomes (i.e., life satisfaction and psychological complaints) differ by disability condition both within and across countries, and how country-level factors (i.e., public spending, income inequalities) and family-level SES moderate this relationship. We applied a two-step meta-analytic approach to data from 16 countries participating in the 2018 Health Behaviour in School-aged Children study (N = 90,882; age = 13.5). Results showed that adolescents with disabilities reported lower life satisfaction and higher psychological complaints than non-disabled adolescents in all countries. Country-level public spending and income inequalities were weak moderators of the relationship between adolescent disability and mental health. Adolescent mental health gaps by disability status were constant across SES groups in most of the countries that were examined. Yet, mental health gaps by adolescent disability status declined with family SES in some countries (i.e., Denmark, Ireland) and increased with family SES in some other countries (i.e., Austria, Czech Republic, France). The study implications and future research avenues are discussed.