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Volume 1

A focus on adolescent mental health & well-being


Health Behaviour in School-aged Children (‎HBSC)‎, a WHO collaborative cross-national study, has provided information about the health, well-being, social environment and health behaviour of 11-, 13- and 15-year-old boys and girls for over 30 years. The 2017/2018 survey report presents data from over 220 000 young people in 45 countries and regions in Europe and Canada. The data focus on social context (‎relations with family, peers, school and online communication)‎, health outcomes (‎subjective health, mental health, overweight and obesity, and injuries)‎, health behaviours (‎patterns of eating, physical activity and toothbrushing)‎ and risk behaviours (‎use of tobacco, alcohol and cannabis, sexual behaviour, fighting and bullying)‎ relevant to young people’s health and well-being. New items on electronic media communication and cyberbullying and a revised measure on family meals were introduced to the HBSC survey in 2017/2018 and measures of individual health complaints and underweight are also included for the first time in the international report. Volume 1 of the international report presents key findings from the 2017/2018 survey, and Volume 2 provides key data disaggregated by country/ region, age, gender and family affluence.

Report details

  • Topics: mental health and well-being
  • HBSC Data: 2021/22, 2017/18 and 2013/14 international surveys
  • Copyright: CC BY-NC-SA 3.0 IGO
  • ISBN: 978-92-890-6035-6
  • Languages: English
Cover of volume 1. HBSC study first international report volume on mental health and well-being.

Key Findings

Girls reported worse outcomes for mental health and well-being than boys across all outcomes included in the 2021/2022 Health Behaviour in School-aged Children (HBSC) survey. An increasing gender difference with age was observed for all the indicators examined. The proportion of adolescents who reported excellent health decreased with age. More boys than girls reported excellent health at ages 13 and 15 in nearly all countries and regions. Life satisfaction and mental well-being were higher among boys than girls across all three age groups in most countries and regions. Adolescents from more affluent families reported higher levels of life satisfaction and mental well-being across almost all countries and regions. Life satisfaction and self-rated health declined between the HBSC surveys in 2017/2018 and 2021/2022. This trend was more pronounced among girls. Girls consistently reported higher levels of loneliness than boys, except at age 11, where gender differences were found in six countries. Almost twice as many 15-year-olds (13% for boys and 28% for girls) than 11-year-olds (8% for boys and 14% for girls) reported feeling lonely in the last year. Girls reported more frequent health complaints than boys across all age groups. The prevalence of multiple health complaints increased with age, particularly among girls. At age 15, two thirds of girls reported experiencing multiple health complaints compared with just over a third of boys. This gender gap is the largest since 2013/2014. One third of adolescents (33%) experienced feeling nervous or irritable more than once a week in the last six months. One in four reported sleep difficulties (29%) and/or feeling low (25%). One in five (20%) reported having headaches more than once a week. The prevalence of 13- and 15-year-olds feeling low, having headaches and experiencing dizziness was twice as high for girls than for boys in most countries and regions.

Cite this data

Cosma A, Abdrakhmanova S, Taut D, Schrijvers K, Catunda C, Schnohr C. Focus on adolescent mental health and well-being in Europe, central Asia and Canada. Health Behaviour in School-aged Children (HBSC) International Report from the 2021/22 survey. Volume 1. Copenhagen: WHO Regional Office for Europe; 2023. Licence: CC BY-NC-SA 3.0 IGO.

Youth Commentary

“I think there’s a lot of girls who put themselves down because they’re like ‘am I good enough? Am I strong enough? Am I capable of doing things?’ And they put themselves down and beat themselves up for nothing. They don’t appreciate themselves for who they are.”

Girl, Scotland


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