Exploring an Applied Ecological Model of the Effects of Household, School, and Community Environments on Adolescent Mental Health in Japan.

Adolescent mental health is an urgent global public health issue and is affected by household, school, and community environments. However, few studies, and none in Japan, have used applied ecological models to identify environmental factors that affect adolescent mental health. This study aimed to examine an applied ecological model of sequential association between household, school, and community environmental factors and their effects on adolescent mental health in Japan (ECO-AM model). This was a secondary analysis of data from the 2013 Japanese Comprehensive Survey of Living Conditions. Participants were 893 adolescents aged 12-14 years and their household heads living in Japan. Data for 728 adolescents were analyzed after excluding participants with missing values (valid response rate: 81.5%). Screening using the six-item Kessler Psychological Distress Scale demonstrated that 33.8% of adolescents had mood and anxiety disorders. Covariance structure analysis yielded a model with strong goodness-of-fit that described associations between mood and anxiety disorder and vitality, and household, school and community environments. The explanatory variables accounted for 36% of mood and anxiety disorder scores. The study emphasizes the importance of the relationship between different environments and suggests that a better understanding of environmental factors would help support adolescent mental health.