BackgroundGlobally, adolescents are vulnerable to mental health problems, particularly those from sub-Saharan Africa (SSA) due to impoverished living conditions and a higher prevalence of chronic conditions such as HIV/AIDS in the region. The COVID-19 pandemic has further exacerbated this risk. This calls for an urgent need for evidence-based adolescent mental health interventions to reduce the risk and burden of mental health problems in SSA. The review aims to identify and characterize existing adolescent mental health interventions in SSA, as well as to evaluate their implementation strategies and effectiveness.MethodsWe systematically searched PubMed, African Index Medicus, PsycINFO, Web of Science, and CINAHL databases for relevant articles. Furthermore, we searched gray literature databases, including Think Tank search, open gray, NGO search engine, and IGO search engine for additional relevant articles. The scoping review was conducted to identify original research articles on mental health interventions among adolescents in sub-Saharan Africa published from database inception to 31 December 2021. We carried out a narrative synthesis to report our findings.ResultsOur literature search generated 4,750 studies, of which 1,141 were duplicates, 3,545 were excluded after screening, and 64 articles met the inclusion criteria. The 64 studies describe a total of 57 unique mental health interventions comprising 40,072 adolescents. The nature of these interventions was diverse, encompassing various implementation strategies such as economic-based, family strengthening, psychoeducation, interpersonal psychotherapy, Cognitive Behavioral Therapy, and resilience training, among others. Most of the interventions were selective interventions that targeted adolescents at high risk of developing mental health problems including adolescents living with HIV, war-affected adolescents, orphans, adolescents from poorer backgrounds, and survivors of sexual violence. Half of the interventions were delivered by lay persons. Sixty-two of the eligible studies examined the effectiveness of the mental health interventions, of which 55 of them reported a positive significant impact on various mental health outcomes.ConclusionsThe review findings show that there exist several diverse interventions that promote mental health among adolescents in sub-Saharan Africa. These interventions can be implemented in diverse settings including schools, communities, health facilities, and camps, and can be delivered by lay persons.

IntroductionMental health problems among adolescents have been on the rise particularly among adolescents in sub-Saharan Africa (SSA) due to impoverished living conditions and a high burden of chronic diseases including HIV/AIDs. COVID-19 pandemic has further exacerbated the risk and placed additional stress on adolescents’ mental health. While the burden might be high, there are fewer mental health services in the region.ObjectivesTo evaluate the psychological and mental well-being of adolescents living in and co co-design with civil society organizations (CSOs) interventions aimed at enhancing mental health and psychosocial well-being.MethodsFirstly, we conducted a formative phase to assess the burden of various mental health problems in Kenya. We conducted a cross-sectional survey in which we assessed the mental health status of 1541 adolescents using standardized tools. The participants comprised in and out of school adolescents, adolescents with disability, and those living with HIV/AIDS. Furthermore, we undertook a qualitative study through FGDs and KIIs to identify the factors contributing to mental health problems.Secondly, we aim to adapt interventions that seek to promote mental health. Finally, we aim to implement effective mental health interventions targeting over 2000 adolescents living in Kenya’ informal settlements.ResultsWe found the prevalence of depression to be higher among out-of-school adolescents at 36.0% compared to school-going adolescents at 20.6%. Furthermore, out-of-school adolescents had statistically significantly higher anxiety scores as well at 27.7 % when compared to their school-going counterparts at 19.1%. In-school adolescents had a better quality of life scores, lower pandemic anxiety scores, and lower emotional scores compared to their out-of-school counterparts. Results from regression models indicated that being out of school, having a COVID-19 infection, having poor relationships with parents and peers, loneliness, and living in an unsafe neighborhood were factors associated with poor mental health outcomes. During the qualitative interviews, participants noted that COVID- 19 brought about financial stress, joblessness, led to early pregnancies, involvement in commercial sex work by adolescents, school dropouts, lead to stress, and depression among other issues.Image 3:Conclusions Adolescents, especially those out of school are at a high risk of poor mental health outcomes due to exposure to a host of psychosocial risk factors. We have identified two interventions that we are keen to implement: the Shamiri Wellness Intervention (https://www.shamiri.institute/the-shamiri-intervention) and the Mental Health Literacy Programme (http://mentalhealthliteracy.org/). We hope that by working with CSOs, the study will support the development of their capacity to offer mental health services that are sustainable, and contextually appropriate.Disclosure of InterestNone Declared

Background Despite the high burden of mental health problems during adolescence and its associated negative consequences, it has remained neglected especially in sub-Saharan Africa. The 2019 novel Coronavirus disease (COVID-19) pandemic has placed additional stress on adolescent mental health. However, there are few studies documenting the burden of mental health problems and even fewer mental health services in the region. In relation to the limited body of knowledge, the present study aims to determine the psychological well-being of adolescents and to assess the risks and associated factors of mental health problems among adolescents in the context of COVID-19 pandemic in Kenya. Methods We conducted a cross-sectional survey in 2022 among adolescents aged 13–19 years living in Nairobi, and the Coast region of Kenya. We utilized standardized psychological assessment tools including the Patient Health Questionnaire, Generalized Anxiety Scale, Strengths and Difficulties Questionnaire, The World Health Organization- Five Well-Being Index Scale, and the Pandemic Anxiety Scale, to evaluate the psychological wellbeing of the adolescents. A linear regression model was used to evaluate the correlates associated with quality of life, pandemic anxiety, and emotional and behavioural problems among adolescents. Subsequently, a logistic regression model was used to assess factors associated with depression and general anxiety disorders. Variables with a p-value < 0.25 in the univariate model were included in the multivariable regression model. Results The results are based on 797 participants who met the inclusion criteria. We found the prevalence of depression to be relatively higher among out-of-school adolescents at 36.0% compared to school-going adolescents at 20.6%. Furthermore, out-of-school adolescents had significantly higher anxiety scores when compared to their school-going counterparts (27.7% vs 19.1%) respectively. In-school adolescents had a better quality of life scores, lower pandemic anxiety scores, and lower emotional and behavioral problems scores compared to their out-of-school counterparts. Key risk factors associated with depression include; being out-of-school (OR = 1.96 (95% CI 1.33- 2.88) p-value = 0.001), loneliness (OR = 10.68 (95% CI 4.49–22.86) p-value < 0.001), and living in an unsafe neighborhood (OR = 2.24 (95% CI 1.52–3.29) p-value < 0.001). An older age (OR = 1.16 (95% CI 1.03–1.30) p-value = 0.015), being out-of-school (OR = 1.81 (95% CI 1.19–2.77) p-value = 0.006), and living in an unsafe neighborhood (OR = 2.01 (95% CI 1.33–3.04) p-value = 0.001 were key factors associated with anxiety. Furthermore, key factors positively correlated with quality of life include; high socioeconomic status (ß (Std.Err) = 0.58 (0.14) p-value < 0.001, talking to friends often (ß (Std.Err) = 2.32 (0.53) p-value < 0.001, and being close to parents (ß (Std.Err) = 1.37 (0.62) = 0.026. Conclusion Our findings imply that mental health support services targeting adolescents in the country should be prioritized, especially for those who are out-of-school.