Ethnic differences in adolescent mental health trajectories and the influence of racism and context : the Determinants of Adolescent Social well-being and Health (DASH) study

Objective: Using longitudinal data, we investigate mental health trajectories through adolescence, and the interplay between racism and context. Methods: Repeated measures of psychological well-being (Goodman’s Strength and Difficulties Questionnaire), racism and other potential confounding variables were obtained for 4744 adolescents aged 11-17, surveyed at two waves. Neighbourhood and school contextual measures included White-ethnic density and socio-economic position. Results: Ethnic minority adolescents reported better mental health throughout adolescence relative to White-UK peers, particularly Nigerian/Ghanaian boys (coefficient (95% CI)): -2.27 (- 2.97, -1.58) and Indian girls: -1.74 (-2.54, -0.94), adjusted for age, socio-economic position, racism and context. Mental health improved throughout adolescence for boys. The prevalence of racism increased between wave 1 (girls: 18%; boys: 19%) and wave 2 (girls: 29%; boys: 27%). The effects of racism were not ethnic specific, but associated with poorer mental health throughout adolescence among boys: 1.50 (1.21, 1.79) and girls: 1.88 (1.54, 2.22). Context was not associated with mental health either directly, or through effect-modification. Conclusions: Poorer mental health patterns among some minority ethnic adults do not appear to emerge during adolescence. Racism was associated with poorer mental health for all ethnic groups. Adolescence may be a critical period for preventing ethnic differences in adult mental health.