Abstract
Child and adolescent mental health (CAMH) are a growing concern, particularly in socioeconomically disadvantaged urban areas where exposure to violence, poverty, and limited access to healthcare services exacerbate vulnerabilities. This study explores mental health and identifies key risk and resilience factors among adolescents in the Johannesburg South Education District, South Africa. Using a sequential explanatory mixed methods approach, the research combines quantitative and qualitative data to offer a comprehensive understanding of adolescent mental health within this context. Quantitative data were gathered through a web-based tool, the Child and Youth Mental Health Profiling System (CYMHPS), which included biographical questions and standardised self-report questionnaires, including tools such as the Adverse Childhood Experiences (ACE) Questionnaire, Strengths and Difficulties Questionnaire (SDQ), the Child and Youth Resilience Measure (CYRM), the DSM 5 Self-Rated Level 1 Cross-Cutting Symptom Measure, and the About Me Questionnaire (AMQ). A total of 681 questionnaires were collected and analysed using SPSS 29.0.
The quantitative phase informed the selection of participants for the qualitative phase, where semi-structured interviews, focus groups, and Incomplete Sentences provided in-depth insights into adolescents’ lived experiences of adversity and resilience. Participants were selected based on their ACE and CYRM scores. Those who scored highest for risk and resilience were invited to participate. The sample included 30 participants representative of gender, race, and age.
The findings highlighted significant mental health difficulties such as symptoms of anxiety, depression, posttraumatic stress disorder (PTSD), and sleep difficulties. Female, black African and participants in higher grades were at higher risk for exposure to ACEs, alcohol and drug use, and academic pressures and uncertainty. Despite these challenges, resilience factors like intrinsic motivation, peer support, guidance from trusted adults, religion, and coping strategies emerged with younger participants showing higher resilience. The integration of the biopsychosocial and Nsamenang’s social ontogenesis theories provided a culturally sensitive framework,
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highlighting how individual, community, and societal influences shape child and adolescent mental health.
This study contributes to the limited research on child and adolescent mental health in under-resourced urban environments in South Africa. It underscores the need for multi-level interventions, including school-based mental health programmes, teacher training, and community-driven support systems, tailored to the unique challenges faced by children and adolescents in this district. The findings also offer valuable insights for policy development, emphasising the importance of early interventions and mental health education to support vulnerable youth populations.
Keywords: biopsychosocial theory, child and adolescent mental health (CAMH), Johannesburg South Education District, mixed methods study, resilience factors, risk factors, social ontogenesis theory.