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We investigated associations between adolescent internalizing and externalizing problems and adult human capital in a non-Western setting. Little is known about adolescent mental health problems and adult outcomes in low- and middle-income countries, many of which are characterized by high levels of adversities.

Data came from the Birth to Twenty Plus cohort, started in Soweto, Johannesburg, South Africa, in 1990. We estimated associations of internalizing and externalizing problems at the age of 14 years with self-reported educational, employment, welfare receipt, psychosocial (psychological distress, criminality, substance use), interpersonal (social isolation, intimate partner violence, partnership status), and HIV outcomes at the age of 28 years.

Adolescents with high internalizing problems were less likely to have completed secondary school or be formally employed and more …