Yan Cheng1, XianChen Li2, Chaohua Lou3, Freya L Sonenstein4, Amanda Kalamar4, Shireen Jejeebhoy5, Sinead Delany-Moretlwe6, Heena Brahmbhatt4, Adesola Oluwafunmilola Olumide7, Oladosu Ojengbede8. 1. Department of Epidemiology and Social Science Research on Reproductive Health, Shanghai Institute of Planned Parenthood Research, Shanghai, People's Republic of China. 2. School of Public Health, Fudan University, Shanghai, People's Republic of China. 3. Department of Epidemiology and Social Science Research on Reproductive Health, Shanghai Institute of Planned Parenthood Research, Shanghai, People's Republic of China. Electronic address: Chaohual@yahoo.com. 4. Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. 5. Population Council, New Delhi, India. 6. Wits Reproductive Health & HIV Institute, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa. 7. Institute of Child Health, College of Medicine, University of Ibadan/University College Hospital, Ibadan, Oyo State, Nigeria. 8. Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan/ University College Hospital, Ibadan, Oyo State, Nigeria.
Abstract
PURPOSE: Globally, adolescents are at risk of depression, traumatic stress, and suicide, especially those living in vulnerable environments. This article examines the mental health of 15- to 19-year-old youth in five cities and identifies the social support correlates of mental health. METHODS: A total of 2,393 adolescents aged 15-19 years in economically distressed neighborhoods in Baltimore, MD; New Delhi, India; Ibadan, Nigeria; Johannesburg, South Africa; and Shanghai, China were recruited in 2013 via respondent-driven sampling to participate in a survey using an audio computer-assisted self-interview. Weighted logistic regression and general linear models were used to explore the associations between mental health and social supports. RESULTS: The highest levels of depression and posttraumatic stress symptoms were displayed in Johannesburg among females (44.6% and 67.0%, respectively), whereas the lowest were among New Delhi females and males (13.0% and 16.3%, respectively). The prevalence of suicidal ideation ranged from 7.9% (New Delhi female adolescents) to 39.6% (Johannesburg female adolescents); the 12-month prevalence of suicide attempts ranged from 1.8% (New Delhi females) to 18.3% (Ibadan males). Elevated perceptions of having a caring female adult in the home and feeling connected to their neighborhoods were positively associated with adolescents' levels of hope across the sites while negatively associated with depression and posttraumatic stress symptoms with some variation across sites and gender. CONCLUSIONS: Adolescents living in the very economically distressed areas studied register high levels of depression and posttraumatic stress. Improving social supports in families and neighborhoods may alleviate distress and foster hope. In particular, strengthening supports from female caretakers to their adolescents at home may improve the outlooks of their daughters.
PURPOSE: Globally, adolescents are at risk of depression, traumatic stress, and suicide, especially those living in vulnerable environments. This article examines the mental health of 15- to 19-year-old youth in five cities and identifies the social support correlates of mental health. METHODS: A total of 2,393 adolescents aged 15-19 years in economically distressed neighborhoods in Baltimore, MD; New Delhi, India; Ibadan, Nigeria; Johannesburg, South Africa; and Shanghai, China were recruited in 2013 via respondent-driven sampling to participate in a survey using an audio computer-assisted self-interview. Weighted logistic regression and general linear models were used to explore the associations between mental health and social supports. RESULTS: The highest levels of depression and posttraumatic stress symptoms were displayed in Johannesburg among females (44.6% and 67.0%, respectively), whereas the lowest were among New Delhi females and males (13.0% and 16.3%, respectively). The prevalence of suicidal ideation ranged from 7.9% (New Delhi female adolescents) to 39.6% (Johannesburg female adolescents); the 12-month prevalence of suicide attempts ranged from 1.8% (New Delhi females) to 18.3% (Ibadan males). Elevated perceptions of having a caring female adult in the home and feeling connected to their neighborhoods were positively associated with adolescents' levels of hope across the sites while negatively associated with depression and posttraumatic stress symptoms with some variation across sites and gender. CONCLUSIONS: Adolescents living in the very economically distressed areas studied register high levels of depression and posttraumatic stress. Improving social supports in families and neighborhoods may alleviate distress and foster hope. In particular, strengthening supports from female caretakers to their adolescents at home may improve the outlooks of their daughters.
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