MentAl Health Risk Factors among Older AdolesceNts living in Urban SluMs: An InTervention to Improve ResIlience (ANUMATI)

Background:

The adolescent population are the future of the country and in India they contribute to the demographic dividend of the nation. Adolescence is a vulnerable period with rapid changes in physical, mental and social levels. According to World Health Organisation, around 20% of children and adolescents suffer from a disabling mental illness, and suicide is the third leading cause of death among adolescents. It is estimated that majority of adolescent mental disorders worldwide are left untreated and unidentified. There could be a number of risk factors for mental disorders among adolescents living in slums such as violence, deprivation, social vulnerability, substance abuse/use etc.

There has been a rapid growth of urban population and more than 65 million inhabitants live in almost 14 million urban slum households in India. Slums have inadequate housing, unhealthy and poor living conditions, and inadequate systems to benefit from government schemes. In addition, members residing in such conditions have health problems worse than their non-slum counterparts. Though adolescents are an otherwise healthy group, deprived living conditions in slums may predispose them to both poor mental and physical health. Though there are studies that look into this relationship, there is however limited research that explores the inter-relationship of risk as well as resilience factors, especially among adolescents living in urban slums, and its overall influence on their mental health.

Aim:

• To explore risk and resilience factors for Common Mental Disorders among older adolescents (15-19 years) living in urban slums.
• To develop and pilot a community intervention module and provide information about its feasibility.

Research Methodology:

Project will employ a cross-sectional mixed methods design conducted in two urban slums of North (Faridabad) and South India (Hyderabad) Municipal Corporation with a population of about 10,000 each. A census of selected eligible population will be done followed by a screening of 2000 adolescents for CMDs (constituting ~20% of the total population) and assessed for risk and resilience factors. Qualitative interviews will then be conducted among adolescent girls and boys; and peers, parents, in-laws, school teachers, PHC doctors and primary health workers, local councillors/ corporators etc. An intervention will be piloted on a small scale among a different set of 100 adolescents by collecting routine programme data.

Potential Impact:

• As there is no datasets for adolescents with mental illness in urban slum communities in India, this study will establish a linkage between CMDs and associated risk and resilience factors that are most common among older adolescent girls and boys in an urban slum community context.
• The project will result in the development of a community-based intervention module in improving and enhancing resilience of adolescents living in urban slums as opposed to most school-based programmes.
• Learnings from this project could be shared with respective state governments so as to strengthen counselling centres under the Rashtriya Kishore Swasthya Karyakram (RKSK).