Research concerning adolescents has become an international priority in recent years as the global community works towards achieving the ambitious UN Sustainable Development Goal of promoting “well-being for all, at all ages".
Adolescence is a key phase of development that holds far-reaching consequences for human capital development into adulthood. However, many adolescents are growing up in unstable environments where they are exposed to poverty, abuse and a lack of support systems. This places them at risk of developing mental disorders and of engaging in risky behaviour such as substance abuse and violence.
Despite adolescents' increased risk of poor mental health outcomes, there is limited evidence of what constitutes the best methods of promoting positive mental health and preventing disorders in this segment of the population. The Institute of Life Course Health Research (ILCHR) in SU's Department of Global Health is addressing this research gap by generating evidence on the state of adolescent mental health and identifying effective interventions to support adolescent well-being.
How the ILCHR is supporting at-risk adolescents
In collaboration with the World Health Organization (WHO), the ILCHR team recently completed eight systematic reviews of existing evidence to identify those interventions that proved effective in improving adolescent mental health. These reviews served as foundation in drafting the WHO Guidelines on Mental Health Promotive and Preventive Interventions for Adolescents. The ILCHR team is also working with the WHO in applying the review findings to the design of their Helping Adolescents Thrive (HAT) intervention package for adolescents.
The ILCHR team is furthermore developing a school-based health improvement intervention for young at-risk adolescents: the Health Action in Schools for a Thriving Adolescent Generation (HASHTAG) project. This project will be based on two strategies: school climate improvement and a group-based psychosocial intervention. Preparation is being done for feasibility trials in the Eastern Cape and in Nepal.
Closer to home in Khayelitsha, Cape Town, the ILCHR recently performed two interventions that sought to mitigate the effects of violence exposure and poverty on adolescent development. The Zifune (“Find Yourself") intervention is a solution-based life skills programme for adolescents, with a specific focus on reducing interpersonal violence. This intervention, developed in consultation with an adolescent advisory board drawn from the Khayelitsha community (#nothingforuswithoutus), uses creative activities to help adolescents reflect on their actions and their relationships, and to explore and plan for their future.
In another Khayelitsha-based project, the Teaching Recovery Techniques (TRT) intervention, more than 300 adolescents between the ages of 13 and 17 were screened for traumarelated distress. Those identified as struggling to cope were invited to participate in a feasibility trial of the TRT intervention, which used groupbased sessions to support adolescents and their caregivers in processing their traumatic stress.
Gearing up with the right research tools
Generating larger-scale mental health evidence requires the right tools. There is a massive gap in population-based data on adolescent mental health conditions in low- and middle-income countries like South Africa. In addition, there are few validated, culturally appropriate measures available for use among adolescents in such countries. In response, UNICEF is funding the ILCHR team to adapt and conduct gold-standard validation of an adolescent mental health measure in South Africa – the Measurement of Mental Health among Adolescents at the Population Level (MMAP) tool. In this project, the team will validate ways to assess and address adolescent mental health, and gather evidence that can inform the development of tools and treatments for adolescents at a population level.
The above initiatives all contribute to identifying relevant, novel ways to support adolescent mental health in South Africa and other low- and middle-income countries, to building evidence, and to creating opportunities for engagement with future generations of adults so that they may thrive.
* This article featured in the latest edition of Stellenbosch University (SU)'s multi-award winning publication Research at Stellenbosch University . Produced annually by SU's Division for Research Development (DRD), this flagship publication offers the national and international research community as well as other interested parties a comprehensive, yet accessible overview of innovative and interesting research being done at the institution.The theme of the edition is Research for Impact which is one of SU's core strategic themes from its Vision 2040 and Strategic Framework 2019–2024.
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