Adolescent Health Series: The status of adolescent mental health research, practice and policy in sub‐Saharan Africa: A narrative review

Abstract

Sub-Saharan Africa (SSA) has the fastest growing adolescent population in the world. In addition to developmental changes, adolescents in SSA face health and socioeconomic challenges that increase their vulnerability to mental illhealth. This paper is a narrative review of adolescent mental health (AMH) in SSA with a focus on past achievements, current developments, and future directions in the areas of research, practice and policy in the region. We describe the status of AMH in the region, critical factors that negatively impact AMH, and the ways in which research, practice and policy have responded to this need. Depression, anxiety and post-traumatic stress disorders are the most common mental health problems among adolescents in SSA. Intervention development has largely been focused on HIV/AIDS service delivery in school or community programs by non-specialist health workers. There is a severe shortage of specialised AMH services, poor integration of services into primary health care, lack of a coordinated intersectoral collaboration, and the absence of clear referral pathways. Policies for the promotion of AMH have been given less attention by policymakers, due to stigma attached to mental health problems, and an insufficient understanding of the link between mental health and social determinants, such as poverty. Given these gaps, traditional healers are the most accessible care available to help-seeking adolescents. Sustained AMH research with a focus on the socioeconomic benefits of implementing evidence-based, contextually adapted psychosocial interventions might prove useful in advocating for much needed policies to improve AMH in SSA.

Can mindfulness training in primary schools promote mental wellbeing in Sub-Saharan Africa?

“…Statistical data on the prevalence of mental health challenges in CAs is limited, but pre-pandemic, it was estimated that 1 in 7 CAs had a mental health challenge (Cortina et al, 2012). There is a severe shortage of specialist 2/3 mental health services for CAs (Sequeira et al, 2022). For example, our scoping study in Rwanda and Ethiopia found that although both countries have developed CA mental health policies, specialists by adequately training the teachers and making mindfulness practice part of the school routine rather than relying on CAs practising independently after the initial mindfulness training.…”

A Review of Mental Health Burden and Social Determinants of Mental Health Among Adolescent Girls and Young Women in Sub-Saharan Africa

“…Research indicates that the relationship between socioeconomic determinants of health, including poverty, and mental health is not well understood in the context of SSA's young people's mental health strategy. [24]. Considerably more investment will need to go into funding support for initiatives working to build African countries' research capacity.…”

“…This coincides with studies conducted in African settings indicating the correlation between the risk of increased mental health problems and issues unique to or more associated with AGYW such as pregnancy, HIV/AIDS, and gender-based violence (GBV) [15] [16] Despite the slowly growing existing body of evidence of youth mental health in SSA, research on AGYW mental health outcomes and determinants remains few. This could be a result of several factors, including cited issues such as few data surveillance systems and the lack of priority for youth mental health in African countries [24] [25]. However, attempts have been made to nd gaps in youth and AGYW mental health research in SSA.…”

The association between family adversity and youth mental health outcomes

“…In sub‐Saharan Africa, about 14% of adolescents experience significant psychological challenges, and one in 10 qualify for a psychiatric diagnosis (Jörns‐Presentati et al, 2021). Even though adolescent mental health is cause for concern in sub‐Saharan Africa, it is a neglected priority in the region (Sequeira et al, 2022). In South Africa, which is the geographic focus of this article, the mental health of adolescents is also neglected, as interest from the national government and policy makers remains low (Mokitimi et al, 2018).…”