The relationship between mental health and SES

Objective. To examine the relationship between mental health and socioeconomic status from adolescence to adulthood. Examining this relationship in both directions allows me to examine whether low SES leads to poor mental health, and/or whether poor mental health leads to low SES. Additionally, I examine the role of schools and neighborhoods in each of these relationships. Identifying school and neighborhood characteristics associated with improving the relationship between mental health and SES can lead to targeted interventions to improve outcomes.;Study design. This is a prospective, nationally representative study of secondary school students in the United States using the National Longitudinal Survey of Adolescent Health (AddHealth).;Findings. Lower SES in adolescence was associated with higher rates of depressive symptoms and suicidality (not significant) in adulthood. Higher SES in adolescence was associated with higher rates of substance use (defined as alcohol and other illicit drug use) in adulthood. Substance use, delinquency, and suicidality were associated with reduced educational attainment, though the association was mitigated for depressive symptoms once externalizing problems were controlled for. I found that the relationships between mental health in adolescence and educational attainment varied across schools and neighborhoods. The relationship between substance use in adolescence and educational attainment was improved when adolescents had access to counseling in schools and when they lived in neighborhoods where people looked out for one another.;Conclusions and policy implications. Mental health problems in adolescence can result in reduced educational attainment. Additionally, SES in adolescence and its accompanying stresses can have implications for mental health problems into adulthood. Policy implications include recognizing the importance of mental health problems in adolescence, and the importance of geographic variation in outcomes. Additionally, promoting access to counseling in schools and neighborhood collective efficacy may help to improve educational outcomes for adolescents with substance use. More research is needed on particular school and neighborhood programs that would be most beneficial.