Adolescent mental health and high school dropout: increasing relative risks across birth cohorts in Norway

Amid growing concern about adolescent mental health, we examine how the association between internalizing (depression and anxiety) and externalizing (ADHD) disorders and high school dropout has changed across recent birth cohorts. Using Norwegian population-based register data on 494,837 adolescents from the 1993–2002 birth cohorts, we estimated Poisson models to calculate relative risks (RR) of dropout for those diagnosed at age 17. RRs for dropout increased from 1.6 (95% CI: 1.5–1.6) to 2.1 (95% CI: 2.0–2.1) for ADHD and from 1.8 (95% CI: 1.7–1.9) to 2.4 (95% CI: 2.3–2.5) for internalizing disorders, approximately a 30% rise. Subgroup analyses indicate similar trends across gender and family income, though RRs were higher for girls and high-income adolescents. These widening gaps indicate that system-level declines in dropout have not translated into equitable gains for youth with mental health problems, pointing to growing educational inequalities as these adolescents transition into adulthood.