Mental health interventions for adolescents in sub-Saharan Africa: A scoping review

Abstract

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.

Association between childhood trauma and mental health disorders in adolescents during the second pandemic wave of COVID-19, Chiclayo-Peru

“…This could be due to the stigma and negative beliefs that may exist toward mental health services and professionals ( 84 ). Therefore, it is essential to adopt effective intervention strategies to address adolescent mental health, such as self-directed cognitive-behavioral interventions that can be implemented in various settings, including schools, communities, health centers, and camps ( 85 , 86 ).…”

Risk and protective factors for mental health and wellbeing among adolescent orphans

“…A recent review of mental health interventions for adolescents in sub-Saharan Africa assessed 57 unique interventions, 17 of which specifically targeted orphan populations, and intervention approaches included economic-based, family strengthening, psychoeducation, cognitive behavioral therapy and interpersonal psychotherapy (Mabrouk et al, 2022 ). Additional reviews of adolescent mental health interventions recommend the implementation of programs by non-specialists within community settings such as schools and community-based organizations (Mabrouk et al, 2022 ; Sequeira et al, 2022 ). For such interventions to be effective, additional research with diverse adolescent populations is needed to understand levels of risk or protective factors and associations with psychological symptoms and wellbeing.…”

Mental health and psychological well-being of Kenyan adolescents from Nairobi and the Coast regions in the context of COVID-19

“…Despite the high burden of mental health problems during adolescence and its associated negative consequences, it has remained a neglected issue in SSA. Furthermore, mental health services are scarce in the region [ 21 ].…”