To Örebro University

Mental well-being is more than merely the absence of mental illness; it is a multidimensional concept that includes both emotional and functional well-being, which are valuable resources during adolescence. In order to develop relevant interventions and policies to strengthen adolescent mental health, a continuous monitoring of the population well-being becomes important. The aim of the study was to examine the level, distribution, and changes in mental well-being over time in a Swedish adolescent population. Current study is based on four waves (2014-2017-2020-2023) of a cross-sectional student survey (N = 16288, Mage = 16.23). The outcome was measured with the Mental Health Continuum Short Form. Ten explanatory factors were chosen to examine differences in mental well-being in the study population: Grade, Sex, Sexual orientation, Socioeconomic status, Country of birth, Visual, Hearing or Mobility impairment, Specific learning disorder and Neurodevelopmental disorder. Differences in mental well-being between groups as well as temporal trends were examined and evaluated through statistical testing and hierarchical multiple linear regressions modeling. Girls, non-heterosexual adolescents, and adolescents with low socioeconomic status or impairments have lower levels of mental well-being than boys, heterosexual adolescents, and adolescents with higher socioeconomic status or without impairments, respectively. A deterioration in mental well-being is seen over time for several groups; however, results of the multivariable analysis indicates that the deterioration is mainly an effect of sex and the significant decline in mental well-being seen among girls. The most significant factor for explaining the variation in mental well-being in this study is socioeconomic status. This study elucidates temporal changes and differences in levels of mental well-being between social groups in the adolescent population. The overall differences are small, but their potential implications for public health warrant careful consideration since they concern a significant part of the population. The results underscore the imperative of promoting mental well-being in adolescents, particularly among vulnerable groups.

A paucity of studies exists that report on the description and testing of school-based interventions set out to promote mental well-being among adolescents, particularly in a Swedish context. The aim of this paper is to describe a new strength-based intervention designed using the core elements of solution-focused brief therapy for coaching within a normative frame of mental well-being. The Solution-focused Intervention for Mental health (SIM) is a nine-week, classroom-based, group intervention that has been developed to be both feasible and effective in addressing the current public health challenge concerning adolescent mental health. The intervention is described in accordance with guidelines for group-based behaviour change interventions. The results of three subsequent studies are presented and they support the intervention's feasibility. These studies demonstrate improvements in student participation, session attendance and ratings, as well as in a mental well-being outcome. The first two studies show small effect sizes and the third shows a medium effect size, thereby further substantiating the efficacy of implementing SIM in upper secondary schools. The program is now ready to be evaluated in a forthcoming randomized controlled trial.

The latest World mental health report states that mental health is an integral component of health and well-being and is more than the absence of pathology. Indeed, the view of mental health is slowly shifting to an emphasis on positive health indicators as national authorities around the world are increasingly adopting the two continua model of mental health (TCM). Adopting the TCM has several important implications for public health practice. One is that the epidemiological surveillance will have to include measures of both mental illness and mental well-being. The purpose of this presentation is to illuminate the conceptual and practical use of the TCM in the analysis of adolescent mental health. The presentation will be limited to a focus on the theoretical underpinnings and methodological considerations made to operationalize and categorize mental health according to the TCM. It will consider the added value of the TCM to epidemiological surveillance as well as its implications for public health practice when it comes to meeting population needs with appropriate interventions. To construct the model, data from population-based regional public health surveys among adolescents including validated measures of both mental ill health and mental well-being was used. The Kessler 6 scale was used to estimate the proportion of adolescents with or without probable serious mental illness (SMI, >13) and the Mental Health Continuum - Short Form was used to estimate the proportion of adolescents with flourishing (FMH), moderate (MMH) or languishing (LMH) mental health according to the original categorization developed by Keyes. Combining these two dimensions of mental health and their respective categories will yield six mental health status groups: Complete mental health = FMH without SMI, Vulnerable = MMH without SMI, Most vulnerable = LMH without SMI, Symptomatic but content = SMI with FMH, Troubled = SMI with MMH, and Most troubled = SMI with LMH.

Viewing mental health from a two continua perspective, this presentation focuses on results of pooled data from a recurrent cross-sectional survey, carried out in ninth and eleventh grade in lower and upper secondary school of Västmanland county, Sweden, 2020 - weeks prior to the Covid-19 outbreak - and 2023. In total, 7908 students participated of which 50% were girls (2020 N = 3880; 2023 N = 4028; response rate≈72%). A compilation of the results according to the two continua model and the six mental health status groups described in the previous presentation shows that 39.0% are categorized as having Complete Mental Health (CMH), 1.6% as Symptomatic But Content (SBC), 36.7% as Vulnerable (V), and 2.9% as being the Most Vulnerable (MV). Further, 12.8% are categorized as being Troubled (T) and 6.9% as Most Troubled (MT). Statistically significant differences are seen between boys and girls in the categories CMH (boys=47.4%, girls=30.8%), SBC (boys 1.0%, girls 2.1%), T (boys 7.2%, girls 18.3%) and MT (boys 3.7%, girls 10.1%). Significant changes over time, between 2020 and 2023, are seen in SBC (0.9% statistically significant increase) and MV (1.9% statistically significant increase). When divided by sex, significant changes over time are only seen among girls: in CMH (5.3% statistically significant decrease), MV (1.9% statistically significant increase) and SBC (1.3% statistically significant increase). No statistically significant changes are seen over time for boys. The result indicates that only four out of ten adolescents have a CMH. The differences between boys and girls are substantial; almost five out of ten boys and three out of ten girls has CMH. This emphasizes the importance of promoting mental well-being, especially among girls. The result also implies the importance of strengthening well-being in the large group without flourishing mental health since the latter can also provide a buffer against mental illness.