Mental Health Problems amongst Left-behind Adolescents in China: Serial Mediation Roles of Parent-Adolescent Communication and School Bullying Victimisation

Abstract Background Adolescent mental health is a global public health concern and parental migration has been identified as a risk factor. However, the effect mechanism remained unclear. Methods A total of 2,737 participants (mean = 11.93, SD = 1.23) were recruited from twelve schools in migrant-sending areas in Zhejiang and Anhui provinces. The participants responded to items in Child Depression Inventory, Parent–Adolescent Communication Scale, Olweus Bully or Victim Questionnaire and socio-demographic questions. Serial multiple mediation models were analysed using the bootstrapping method. Results Current and previous left-behind (LB) experience were significantly associated with higher risks of depression, non-suicidal self-injury and suicidal ideation (p < 0.05). Mother–adolescent communication and school bullying victimisation, in serial order, mediated the effect of current LB status on mental health (p < 0.05). In terms of previously LB adolescents, parent–adolescent communication was a standalone mediator (p < 0.01) and the serial mediation effect of parent–adolescent communication and school bullying victimisation was significant. Conclusions Lack of parent–adolescent communication and school bullying victimisation acted as risk factors for the negative effect of LB status or experience on adolescent mental health. The importance of these two interpersonal factors motivates future intervention initiatives to support the mental health of LB adolescents from an integrated perspective. • Current and previous left-behind (LB) experience imposes risks to adolescent mental health. • Mother–adolescent communication mediated the effect of LB experience on mental health. • School bullying victimisation mediated the effect of current LB status on mental health. • Parent–adolescent communication and school bullying victimisation are serial mediators.