The Role of Schools in Adolescent Mental Health in Low- and Middle-Income Countries: Considerations and Future Directions

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About this Research Topic

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Background

Globally, there are an estimated 1.2 billion adolescents aged 10-19. Most of them live in low- and middle-income countries. The burden of mental illness continues to disproportionately affect young people. The burden of disease and injury caused by mental health conditions accounts for 16 percent of the global burden in adolescents. Depression is the leading cause of illness and disability among adolescents while suicide is the fourth leading cause of death in 15-19 years old. The consequences of adolescent mental health problems include personal distress, family distress, functional impairment (e.g., inability to study or work), and stigma and discrimination. In the long run, the consequences of not addressing adolescent mental health conditions extend to adulthood, compromising both physical and mental health and limiting opportunities for adults to lead fulfilling lives, and into the next generation. Yet, the response to adolescent mental health needs is grossly inadequate, particularly in low- and middle-income countries.

With the expansion of education, especially in LMICs, including secondary education, tremendous opportunities have emerged for leveraging health benefits. Young people can benefit from the health benefits that schools provide both as a platform for delivering health services and interventions, and as a social environment for learning. Particularly, whole-school interventions that are integrated into daily practice and school culture, involve all staff, students, and parents, reinforce skills through classroom and extracurricular activities and coordinate with outside agencies and the local community resulting in improved mental health, social, emotional, and educational outcomes for adolescents. Whole-school mental health programs, previously limited to high-income countries, are now spread around the world and, with globalization, complexities of conceptualization and application are increasing. Our global school health programs should consider lessons from places where poverty and civil unrest prevail, places in which basic rights are not respected, and places in which basic literacy and numeracy have not been developed. Hence, this Research Topic seeks to understand the mechanisms that have been developed to support school integration and their effectiveness in addressing mental health conditions of adolescents in low- and middle-income countries.

This Research Topic welcomes manuscripts on, but not limited to, the following topics:

• Effective, cost-effective, and affordable packages of whole-school interventions for promoting mental health and preventing mental health disorders among adolescents in low- and middle-income countries
• Feasibility of providing mental health interventions in educational settings, including human resources, screening, and clinical services, and health education
• The potential approaches to integrate mental health and psychosocial support into existing school health programs
• The mechanisms by which schools affect adolescents' mental health, such as attendance, engagement, aspirations, and the school's physical and social environment
• The best approaches to engaging parents, families, healthcare providers, and the broader community for school mental health programs for adolescents in low- and middle-income countries
• Reflections on sustaining and scaling up the school mental health interventions in low- and middle-income countries

Keywords: adolescents, mental health, school, low- and middle-income countries, LMIC

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