The effects of individual factors and school environment on mental health and prejudiced attitudes among Norwegian adolescents

INTRODUCTION: The aim was to examine the prevalence of mental health difficulties and prejudices toward mental illness among adolescents, and to analyze possible school and school class effects on these issues. METHODS: The sample comprised 4,046 pupils (16-19 years) in 257 school classes from 45 Norwegian upper secondary schools. The estimated response rate among the pupils was about 96%. Self-reported mental health difficulties were measured with a four-item scale that covered emotional and behavioral difficulties. Prejudiced attitudes toward mental illness were assessed using a nine-item scale. Multilevel regression analysis was used to estimate the contribution of factors at the individual level, and at the school and class levels. RESULTS: Most of the variance in self-reported mental health difficulties and prejudices was accounted for by individual level factors (92-94%). However, there were statistically significant school and class level effects (P