Introduction Mental health problems cause a considerable burden of disease in adolescents, with potential negative consequences on employment later in life. Earlier, five trajectories of internalising and externalising problems (high-stable, moderate-high, decreasing, moderate-low, low-stable) among adolescents from 11 to 19 years were identified and a relationship with employment status at age 19 was found. However, at age 19, many participants were still in education.

Objectives This study aims to examine associations of trajectory membership with having paid work and type of employment contract in young adults at age 26.

Methods Fifteen-year follow-up data of the longitudinal TRacking Adolescents’ Individual Lives Survey (TRAILS) cohort study (N=1711) were used. Logistic regression analyses were applied to examine associations of trajectory membership of internalising and externalising problems with having paid work and type of employment contract at age 26. The analyses were stepwise adjusted for sex, intelligence, parental education, family composition, physical health, negative life events and mental health comorbidity, all measured at age 11.

Results For internalising problems, the high-stable (adjusted OR: 2.19; 95% CI: 1.17–4.11) and moderate-high (adjusted OR: 1.75; 95% CI: 1.14–2.69) trajectories were strongly associated with not having paid work, compared to the low-stable trajectory. No associations were found between the trajectories of externalising problems and having paid work. For both internalising and externalising trajectories, no associations were found between trajectory membership and having a permanent or temporary employment contract.

Conclusion This study expands current knowledge about the impact of internalising problems on employment of young adults. To prevent the effects of mental health problems on work, a life course perspective is needed taking into account the development of mental health problems in childhood and adolescence. In the transition from school to work, integrating youth- and occupational healthcare may be key to prevent negative employment outcomes due to internalising problems.