OBJECTIVE: The dual-factor model of mental health postulates a role for positive mental health, alongside mental illness, in determining mental health care needs. Informed by this model, the present study delineated profiles of social-emotional competencies and difficulties during middle childhood in a population-based sample of girls and boys and determined their association with adolescent mental disorder diagnoses. METHOD: Latent profile analyses were conducted across five indices of social-emotional competency and four indices of psychopathology that were measured by questionnaire self-report among 13,349 girls and 13,488 boys at age ~11 years. The association of the profiles with adolescent presentations to hospital or ambulatory services (ages ~12-17 years) were determined using logistic regression. RESULTS: Analyses yielded five profiles in each sex: complete mental health (44% girls; 42% boys), average mental health (30%; 33%), internalising symptoms with poor relationship skills (9%; 7%), externalising symptoms with poor self-management (12%; 9%) and low mental health (5%; 10%). Profiles associated differentially with adolescent presentations with any mental disorder, externalising disorders, internalising disorders and self-harm/suicidal ideation, identified in linked health records. Greater odds of any and specific mental disorder diagnoses were characteristic of all profiles relative to average mental health (adjusted odds ratios [aOR]: 1.7-3.3) except complete mental health (aOR: 0.7-0.9), with different strengths of association according to profile. CONCLUSION: Combining information on social-emotional competencies and psychopathology in middle childhood may help refine the provision of mental health promotion and early intervention to alleviate adolescent mental disorder.