To develop a school-based screening for adolescent risk behaviour and psychopathology and to investigate the predictive value of different adolescent risk behaviours in terms of suffering from psychopathology that requires mental health care.

A two-stage professional screening was developed and constituted in the randomized-controlled prevention trial “Saving and Empowering Young Lives in Europe (SEYLE). A school-based screening consisting of a self-report screening questionnaire and a semi-structured professional interview in case of being identified as at-risk were performed in a representative sample of almost 2,000 adolescents within the SEYLE sample of about 8,000 students from 7 European countries and Israel.

A very high percentage of students were detected to be at-risk by either showing risk behaviour or psychopathology or both in the first stage of the screening. From these students, only about one third came to the study center and took part in the interview. About half of of the interviewed students reached were referred to mental health care.

Risk behaviours are very common among European adolescents and may also have increased during the last years. Nevertheless, most risk behaviours are weak predictors for suffering from psychopathology that requires mental health care compared to psychopathology or suicidal behaviour theirselves. Although they are certainly unhealthy and badly influencing adolescent development risk behaviours seem to be an ubiquitous phenomenon during adolescence and cannot simply be regarded as signs for severe psychopathology.