Adolescent Mental Health Treatment Research Articles

Digital Mental Health Interventions for Adolescents in Low- and Middle-Income Countries: Scoping Review.

Digital mental health interventions (DMHIs) are increasingly recognized as potential solutions for adolescent mental health, particularly in low- and middle-income countries (LMICs). The United Nations' Sustainable Development Goals and universal health coverage are instrumental tools for achieving mental health for all. Within this context, understanding the design, evaluation, as well as the barriers and facilitators impacting adolescent engagement with mental health care through DMHIs is essential. This scoping review aims to provide insights into the current landscape of DMHIs for adolescents in LMICs. The Joanna Briggs Institute scoping review methodology was used, following the recommendations of the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). Our search strategy incorporated 3 key concepts: population "adolescents," concept "digital mental health interventions," and context "LMICs." We adapted this strategy for various databases, including ACM Digital Library, APA PsycINFO, Cochrane Library, Google Scholar (including gray literature), IEEE Xplore, ProQuest, PubMed (NLM), ScienceDirect, Scopus, and Web of Science. The articles were screened against a specific eligibility criterion from January 2019 to March 2024. We analyzed 20 papers focusing on DMHIs for various mental health conditions among adolescents, such as depression, well-being, anxiety, stigma, self-harm, and suicide ideation. These interventions were delivered in diverse formats, including group delivery and self-guided interventions, with support from mental health professionals or involving lay professionals. The study designs and evaluation encompassed a range of methodologies, including randomized controlled trials, mixed methods studies, and feasibility studies. While there have been notable advancements in DMHIs for adolescents in LMICs, the research base remains limited. Significant knowledge gaps persist regarding the long-term clinical benefits, the maturity and readiness of LMIC digital infrastructure, cultural appropriateness, and cost-effectiveness across the heterogeneous LMIC settings. Addressing these gaps necessitates large-scale, co-designed, and culturally sensitive DMHI trials. Future work should address this.

Teens Work It Out: A Three-part Mindfulness Intervention For Adolescent Mental Health And School Success

Teens Work It Out: A Three-part Mindfulness Intervention For Adolescent Mental Health And School Success

Debate: How much should nonspecialists be involved in mental health care when resources are limited? A perspective from low- and middle-income countries.

Millions of children and young people (CYP) in low- and middle-income countries (LMICs) have no access to mental health care. This huge treatment gap is primarily due to limited availability of trained mental health professionals. We propose task-sharing as a scalable strategy to expand access to child and adolescent mental health (CAMH) interventions in LMICs. Task-sharing involves using the few mental health specialists in LMICs to train and supervise nonspecialists to provided CAMH interventions. There is strong evidence of clinical and cost effectiveness of task-shared mental health interventions for adults in LMICs and promising evidence for CYP. To succeed, task-shared programmes need to be embedded in a balanced system-wide care setting that includes stakeholder involvement. The existing mental health specialists may require additional training in leadership, supervision, mentoring, service design and evaluation in order to meet the additional expectations of managing task-sharing programmes. The nonspecialists to be trained would need assurances about workload, ongoing supervision, clinical back up for cases that exceed their expertise, certification for their training and career progression. CAMH task-sharing offers good promise for increasing CYP's access to mental health interventions in LMICs. However, planners need to be aware of the important practical, ethical and contextual considerations necessary for success and sustainability.

What Emotion Regulation Strategies are Associated with a General Psychopathology Factor (p) in Adolescence? Identifying Possible Transdiagnostic Targets for Intervention.

Mental health problems in adolescence are increasing and there is an urgent call for transdiagnostic interventions, as most adolescents experience problems across multiple domains. Research has identified a general psychopathology factor (p) capturing the shared variance across mental health problems. In parallel, there is empirical support for the transdiagnostic nature of emotion regulation. In the current study, we explore the associations between p and emotion regulation strategies to identify which strategies may be promising targets for intervention. Data from the population-based Youth and Mental Health Study (YAMHS) (N = 2,464, mean age 13.7years, SD 0.6) was used. The fit of different structural models of emotion regulation and psychopathology were compared, and latent factors from the final models were included in multiple regression analyses to explore the associations between p and emotion regulation strategies. A bifactor exploratory structural equation model (B-ESEM) showed best fit for modelling p. For emotion regulation strategies, an ESEM model showed best fit, including Rumination, Reactive Impulsivity, Distraction, Non-Acceptance, Problem Solving, Social Support, and Proactive Behavior. Results showed that a higher score on p was predicted by higher scores on the emotion regulation strategies Rumination (β = .38, p < .001) and Reactive Impulsivity (β = .35, p < .001), and lower scores on Problem Solving (β = -.15, p < .001). The results indicate that Rumination and Reactive Impulsivity have the strongest associations with p and may be promising targets for mental health interventions for adolescents.

Adolescent Mental Health Interventions: A Review of Psychological and an Islamic Approach

Mental health programs among adolescents are conducted with various approaches based on the program's objectives and the target population's needs which impact mental health and well-being. The objective of this review is to examine the implementation of mental health intervention of the psychological and Islamic approaches in maintaining mental health among adolescents. This review's main sources are articles from databases, Scopus, Eric, ProQuest, and Google Scholar. Most psychological approaches emphasize emotional well-being in interventions, while Islamic approach, viewed mental health care holistically. This includes obeying religious teachings which positively impact teenagers' well-being. The exploration of adolescent self-development, including social well-being and emotional, spiritual, and religious values is important to increase the effectiveness of mental health interventions among adolescents. Both Psychological and Islamic approaches can be applied in promoting mental health interventions. Mix-method approaches such as Islamic Cognitive Behavioural Therapy (ICBT) can be explored for modifying negative thoughts while incorporating spiritual and religious practice.

Inconsistency in psychological resilience and social support with mental health in early adolescents: A multilevel response surface analysis approach

BackgroundGiven the high prevalence of adolescent mental health problems, promoting understanding and implementation of protective factors is crucial for prevention and intervention efforts addressing adolescent mental health problems. This study aims to investigate whether consistency and inconsistency in protective factors are associated with adolescent mental health problems and to inform adolescent mental health interventions that target the unique needs of adolescents and promote adolescent mental health. MethodsWe used multistage cluster sampling to conduct psychological resilience, social support, and mental health questionnaires from April to June 2023 among 10,653 Chinese adolescents (52.3 % were boys). Data were analyzed using polynomial regressions with response surface analysis. ResultsThe higher levels of psychological resilience and social support in adolescents were associated with fewer mental health problems (anxiety: a1 = −1.83, P < 0.001; depression: a1 = −2.44, P < 0.001; and perceived stress: a1 = −1.20, P < 0.001). When the level of psychological resilience was greater than social support, the greater the discrepancy the higher the perceived stress among adolescents (a3 = 1.19, P < 0.001). Moreover, the consistency of psychological resilience and social support had a greater impact on girls' mental health (anxiety: a1 = −1.97, P < 0.001; depression: a1 = −2.71, P < 0.001; perceived stress: a1 = −1.23, P < 0.001). LimitationsThe cross-sectional study design limited the inference of causal relationships between variables. ConclusionsThese results emphasize that adolescents need a balanced development of protective factors and targeted intervention programs for different mental health problems.

Anxiety, depression and distress outcomes from the Health4Life intervention for adolescent mental health: a cluster-randomized controlled trial

Mental disorders are a leading cause of disease burden worldwide. As onset typically occurs in adolescence, prevention during this period is critical. The Health4Life-school-based multiple health behavior change (MHBC) intervention targets six lifestyle risk factors: diet, sleep, physical activity, screentime, alcohol use and smoking. Health4Life has been evaluated in a cluster-randomized controlled trial in 71 Australian schools (6,639 grade seven students). This study presents intervention effects on secondary outcomes of depressive, anxiety and psychological distress symptoms. Generalized linear mixed-effect analyses of data from baseline, post-intervention (7 weeks), 12 months and 24 months showed that the Health4Life intervention was no more effective than an active control in reducing depressive, anxiety or psychological distress symptoms at a 24 or 12 month follow-up; however, there were short-term benefits for psychological distress and depressive symptoms immediately post-intervention. This study offers new evidence that multiple health behavior change interventions may improve adolescent mental health, but future research should explore methods to address anxiety and sustain effects over the longer term. A priori ANZCTR trial registration: ACTRN12619000431123.

Mental toughness in adolescents: bridging family relationships and depression across personality traits

BackgroundAdolescence is a pivotal stage vulnerable to mental health issues like anxiety and depression. While family relationships, mental toughness, and personality traits are known to impact adolescent mental health, their interactive and moderating roles are not fully understood.AimThis study aims to investigate the mediating role of mental toughness in the relationship between family relationships and depression among high school students, and to examine the varying impacts of personality traits on this mediation.MethodA cross-sectional study was conducted on a sample of 734 adolescents. Participants completed measures assessing family relationships, mental toughness, personality traits, and mental health outcomes (depression). Latent Profile Analysis, Multiple Regression Analysis, and Structural Equation Modeling, to investigate these relationships.ResultsThe study found that mental toughness significantly mediates the relationship between family relationships and depression. Notably, this mediating effect varied between personality type; it was more pronounced in the moderate-reserved type compared to the proactive-engaged type. LPA identified two distinct personality types of students based on their personality traits, with differential patterns of family relationships, mental toughness, and depression. Multiple regression analysis indicated that character and adaptability, components of mental toughness, were significant negative predictors of depression.ConclusionThe study contributes to understanding the dynamics of adolescent mental health, particularly in the context of Chinese high school students. It underscores the importance of considering family dynamics, personality traits, and mental toughness in developing effective mental health interventions for adolescents.

IMPACT OF SOFT DRINK CONSUMPTION ON ADOLESCENT MENTAL HEALTH: EVIDENCE FROM THE KOREAN YOUTH RISK BEHAVIOR WEB-BASED SURVEY

This study investigates the impact of soft drink consumption on adolescent mental health using data from the Korean Youth Risk Behavior Web-Based Survey. Analyzing responses from a large sample of adolescents, the study explores the association between soft drink consumption and indicators of mental health, including depressive symptoms and suicide attempts. Results reveal a significant correlation between frequent soft drink consumption and adverse mental health outcomes among adolescents. The findings underscore the importance of considering dietary habits in adolescent mental health interventions and highlight the need for targeted public health initiatives aimed at promoting healthier beverage choices among youth.

Adolescent mental health interventions: a narrative review of the positive effects of physical activity and implementation strategies.

The psychological well-being of adolescents is a global concern due to increasing societal pressures and mental health issues. Physical activity is known to enhance physical health and has potential benefits for mental health, including reducing symptoms of anxiety and depression, boosting self-esteem, and improving social skills. This narrative review explores how physical activity can serve as an intervention to help adolescents manage psychological stress and prevent mental health issues. An extensive literature search was conducted using databases such as PubMed, PsycINFO, Web of Science, and Scopus. Keywords included "adolescent mental health," "physical activity," "psychological intervention," "types of exercise," "anxiety," "depression," "self-esteem," "social skills," and "emotional regulation." Studies were included based on relevance, peer-reviewed status, and involvement of adolescent populations. Data were extracted and analyzed qualitatively, focusing on the psychological impacts of different types of physical activity. Sixty one articles were eventually included. The review identified multiple studies highlighting the positive effects of various physical activities on adolescent mental health. Aerobic exercises were found to improve mood and cognitive function, strength training reduced depressive symptoms and increased self-efficacy, team sports enhanced social skills and a sense of community, and mind-body practices like yoga and tai chi improved stress management and emotional regulation. The findings suggest that physical activity can play a significant role in promoting adolescent mental health. Implementation strategies in school and community settings, including integrating physical activity into school curricula, offering diverse activity options, training professional instructors, encouraging family and community involvement, and regular monitoring and evaluation, are recommended. Future research should address limitations such as sample diversity and long-term effects. This narrative review underscores the importance of physical activity in enhancing adolescent mental health. Effective implementation strategies and multi-sector collaboration are essential for maximizing the benefits of physical activity interventions.

Adolescents’ Perceptions of School Nurses’ Role in Functional Seizures at School

Adolescents with functional (psychogenic nonepileptic) seizures experience school-related struggles. School nurses are positioned to address such struggles. However, school nurses report having little education or confidence in their role of managing or responding to this mental health condition. Little is known about adolescents’ perceptions of school nurses’ role in functional seizure care. This qualitative study used semi-structured interviews with 10 adolescents from across the United States with functional seizures to explore adolescents’ perceptions of school nurses’ roles in functional seizure care at school. Results revealed school nurses, when present, play a spectrum of roles according to adolescents’ perceptions, ranging from negative (harmful and uninvolved) to positive (being present, expressing care, and actively doing tasks for the student). These perceived roles shed light upon school nurses’ lack of functional seizure awareness and opportunities to incorporate mental health interventions for adolescents with functional seizures in the school setting.

Promotive and preventive interventions for adolescent mental health in Sub-Saharan Africa: a combined scoping and systematic review

IntroductionPoor mental health in adolescence is associated with mental, physical and social problems in later life. Adolescence is, therefore, a critical time for promoting mental well-being and preventing mental illness,...

The Effect of Psychological Distress on Adolescents' Academic Engagement: The Roles of Social-Emotional Competence and Teachers' Caring Behavior.

The relationship between psychological distress (PD) and academic engagement (AE) in adolescents is widely recognized. However, there is a lack of research on the mechanisms behind this correlation, especially in COVID-19 pandemic policy liberalization. This study proposed a moderated mediation model to determine the mediating role of social-emotional competence (SEC) between PD and AE and the moderating role of teachers' caring behavior (TCB). The moderated mediation model was tested by PROCESS macro developed based on SPSS with Chinese adolescents aged 13-18 years (n = 8625; male 50.5%) as survey respondents. Multiple scales, including the 6-item Kessler PD Scale, SEC Scale, TCB Scale, and AE Scale, were used in this test. Adolescent PD negatively predicted AE. In addition, SEC partially mediated the relationship between adolescent PD and AE. TCB moderated the direct and indirect relationships between PD and AE, which mitigated the negative effect of PD on AE and enhanced the positive effect of SEC on AE. Adolescent SEC and TCB are essential in mediating PD and AE. This study provided instructions for schools and teachers to intervene in adolescents' PD and academic problems, such as improving SEC and engaging in TCB in an adequate and timely manner. In addition, these findings provided vital references for adolescent mental health interventions in future large-scale public health events.

The Development of Self-Identity During Emerging Adulthood and Relevant Factors

This review paper examined the relationship between self-cognition development and related factors during the emerging adulthood phase. Extensive literature, including studies, surveys, and experiments, was analyzed to understand the influence of various factors on self-cognition development. In the research, it was found that self-cognition development has significant connections with daily identity dynamics, family and peer attachment, stress, and psychopathological distress. Two main factors, namely identity confusion and mental health issues, show a positive correlation with the development of self-cognition. As self-identity confusion deepens, individuals may increasingly avoid emotional challenges, potentially increasing the risk of internet addiction and negatively impacting their self-identity development. While emerging adult college students shape their online identities, their choices are not solely influenced by their self-perception but also by their emotional well-being and the social environment in which they exist. Furthermore, unique cultural backgrounds also play a crucial role in the development of self-identity during emerging adulthood. These research findings hold critical implications for the development of adolescent self-cognition and mental health interventions. Future research should delve deeper into the self-cognition development of individuals in emerging adulthood in different regions and the associated factors, as well as the effectiveness of various intervention strategies in diverse contexts.

Exploring the Interplay of Social Anxiety Symptoms and Family Perception among Chinese Adolescents: A Psychosocial Investigation

Anxiety among children and adolescents has received significant attention. Nonetheless, the inquiry into social anxiety and its relationship with family dynamics, particularly within the Chinese culture, remains less explored. This study undertakes the task of bridging this scholarly void through the employment of a comprehensive questionnaire survey. Data from 308 participants aged 13 to 17 were collected through a questionnaire facilitated by the Sojump platform. The survey employed the Interaction Anxiousness Scale (IAS) and the Adolescent Student Family Satisfaction Scale (ASFSS). Results reveal high internal reliability (=0.963) for IAS and ideal reliability (=0.973) for ASFSS. A strong negative correlation (r = -0.548) emerged between family satisfaction and social anxiety symptoms. This study addresses the underexplored relationship between these factors, contributing to the understanding of adolescent mental health dynamics within the familial context. Future research is recommended to incorporate longitudinal designs to enhance the breadth and depth of findings. Additionally, investigating mediating factors and developing family-centered interventions could yield valuable insights for shaping mental health interventions for adolescents.

Research Reviews: Advances in methods for evaluating child and adolescent mental health interventions.

The evidence base for interventions for child mental health and neurodevelopment is weak and the current capacity for rigorous evaluation limited. We describe some of the challenges that make this field particularly difficult and expensive for evaluation studies. We describe and review the use of novel study designs and analysis methodology for their potential to improve this situation. While several novel designs appeared ill-suited to our field, systematic review found others that offered potential but had yet to be widely adopted, some not at all. While funding is inevitably a constraint, we argue that improvements in the evidence base of both current and new treatments will only be achieved by the adoption of a number of these new technologies and study designs, the consistent application of rigorous constructive but demanding standards, and the engagement of the public, patients, clinical and research services to build a design, recruitment, and analysis infrastructure.

68.1 Re-Shaping the Power Differential in Adolescent Mental Health Treatment

68.1 Re-Shaping the Power Differential in Adolescent Mental Health Treatment

Effectiveness of Adolescent School-Based Digital Mental Health Interventions: A Systematic Review

Purpose: This review aimed to investigate the effectiveness of digital school-based mental health interventions for adolescents in Sub-Saharan Africa. Method: The authors conducted a comprehensive search of digital school-based mental health interventions to identify studies conducted in Sub-Saharan Africa targeting adolescents between the ages of (10–19) years. Peer-reviewed studies published in English between 2009 and May 2023 were obtained through electronic bibliographic databases. Result: Only one study met the full inclusion criteria for this review. The included study tested a digital mental health intervention (“Shamiri Digital”) for treating depression, anxiety, and well-being in adolescents. The “Shamiri Digital” intervention demonstrated positive outcomes on depressive symptoms within the full sample. Discussion: The dearth of studies investigating digital mental health solutions for adolescents in low-income countries demonstrates a critical gap in intervention and research for adolescent mental health in resource constrictive settings

Child and adolescent mental health and psychosocial support interventions: An evidence and gap map of low- and middle-income countries.

Mental disorders affect about one in seven children and adolescents worldwide. Investment in effective child and adolescent mental health prevention, promotion and care is essential. To date, however, the evidence from this field is yet to be comprehensively collected and mapped. The objective of this evidence and gap map (EGM) is to provide an overview of the existing evidence on the effectiveness of interventions aimed at promoting mental health and reducing or preventing mental health conditions among children and adolescents in lower-middle-income countries (LMICs). We searched for studies from a wide range of bibliographic databases, libraries and websites. All searches were conducted in December 2021 and covered the period between 2010 and 2021. We included evidence on the effectiveness of any Mental Health and Psychosocial Support (MHPSS) interventions targeting children and adolescents from 0 to 19 years of age in LMICs. The map includes systematic reviews and effectiveness studies in the form of randomised control trials and quasi-experimental studies, and mixed-methods studies with a focus on intervention effectiveness. A total of 63,947 records were identified after the search. A total of 19,578 records were removed using machine learning. A total of 7545 records were screened independently and simultaneously by four reviewers based on title and abstract and 2721 full texts were assessed for eligibility. The EGM includes 697 studies and reviews that covered 78 LMICs. School-based interventions make up 61% of intervention research on child and adolescent mental health and psychosocial support. Most interventions (59%) focusing on treating mental health conditions rather than preventing them or promoting mental health. Depression (40%, N = 282) was the most frequently researched outcome sub-domain analysed by studies and reviews, followed by anxiety disorders (32%, N = 225), well-being (21%, N = 143), and post-traumatic stress disorder (18%, N = 125). Most included studies and reviews investigated the effectiveness of mental health and psychosocial support interventions in early (75%, N = 525) and late adolescence (64%, N = 448). The body of evidence in this area is complex and it is expanding progressively. However, research on child and adolescent MHPSS interventions is more reactive than proactive, with most evidence focusing on addressing mental health conditions that have already arisen rather than preventing them or promoting mental health. Future research should investigate the effectiveness of digital mental health interventions for children and adolescents as well as interventions to address the mental health and psychosocial needs of children in humanitarian settings. Research on early childhood MHPSS interventions is urgently needed. MHPSS research for children and adolescents lacks diversity. Research is also needed to address geographical inequalities at the regional and national level. Important questions also remain on the quality of the available research-is child and adolescent MHPSS intervention research locally relevant, reliable, well-designed and conducted, accessible and innovative? Planning research collaborations with decision-makers and involving experts by experience in research is essential.

The impact of area level mental health interventions on outcomes for secondary school pupils: Evidence from the HeadStart programme in England

In light of the dramatic rise in mental health disorders amongst adolescents seen in the past decade across the world, there is an urgent need for robust evidence on what works to combat this trend. This paper provides the first robust evaluation of the impacts on school outcomes of 6-year funding programme (HeadStart) for area-level mental health interventions for adolescents. Exploiting educational administrative data on ten cohorts of state-educated secondary school students, we use the synthetic control method to construct counterfactual outcomes for areas that received the funding. We show that the funding did not affect students’ absenteeism or academic attainment, but it prevented around 800 students (c. 10% of students typically excluded yearly) from being excluded in its first year. The transient nature of this effect suggests that sustained funding for intervention may be a necessary but not sufficient condition to maintain programme effectiveness over time.