Peer-reviewed article
Political economy of adolescent mental health and well-being globally.
Biermann O, Shawar YR, Shiffman J, Brown SL, Bain M et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This global analysis examines why adolescent mental health and well-being remain under-prioritized despite affecting 1.3 billion young people, mostly in low- and middle-income countries. The study identifies four major barriers: stigma against adolescents with mental health problems, insufficient data on burden and solutions, fragmented approaches to framing the issue, and a disorganized stakeholder landscape. The authors recommend developing unified frameworks with adolescent leadership, leveraging global platforms for advocacy, and building coordinated coalitions to improve global prioritization and action on adolescent mental health.
Key points
- Stigma and discrimination against adolescents with mental health problems hampers global attention to the issue
- Limited data on burden and evidence of effective interventions leads decision-makers to view adolescent mental health as intractable
- Diverse framings of adolescent mental health are seen as weak alignment rather than coalition-building opportunities
- Stakeholder landscape is fragmented despite growing number of actors involved in adolescent mental health
- Recommendations include developing adolescent-led umbrella framing, engaging youth with lived experience, and establishing global governance structures
Limitations
This is a qualitative analysis of stakeholder perspectives and policy barriers rather than an assessment of interventions or programmes. It cannot tell us about the effectiveness of specific mental health services or what actually works to improve adolescent mental health outcomes in practice.
Abstract
Background The current generation of 1.3 billion adolescents (10-19-year-olds), most of whom live in low- and middle-income countries, face large and growing mental health problems. Collective action that could lead to significant improvement in adolescent mental health and well-being (AMH) remains limited. We analyse the factors shaping the global prioritization of AMH for funding and action and reflect on a way forward. Methods We triangulate data from interviews with key informants knowledgeable in AMH; focus group discussions with youth representatives who are mental health advocates, some with lived experience of mental ill-health; and document review. We collected the qualitative data from 2021 to 2023, followed by thematic analysis and stakeholder consultations. Results We identify four themes which shape the global prioritization of AMH. First, prevailing interpersonal and institutional stigma and discrimination directed against adolescents with mental health problems hamper attention to AMH. Second, limited data on the burden of mental health problems and evidence of what works have led to the perception among decision-makers that AMH is an intractable problem. Third, diverse ways of framing AMH are often viewed as a sign of weak alignment rather than as opportunities for coalition-building. Fourth, a wide variety and increasing number of stakeholders are involved in AMH, while the stakeholder landscape remains fragmented, inhibiting coalition-building for AMH. Conclusions To overcome the barriers that currently impede the prioritization of AMH, we recommend that (1) stakeholders conduct an adolescent-led consultative process to develop an "umbrella framing", supported by common metrics, (2) advocates use existing global platforms to shape the political priority for AMH, (3) decision-makers, funders and research partners invest in meaningful engagement of adolescents (with lived experience), researchers and implementing partners (4) identify a leadership, governance and accountability structure for a global coalition that could transform AMH and (5) conduct context-specific analyses to inform coalition-building nationally.