Adolescent mothers in forced displacement experience intersecting risks related to adolescent development, displacement-related traumatic experiences and early motherhood. Despite these risks, their mental health needs remain understudied in humanitarian research and policy. This narrative review synthesizes evidence from conflict-affected settings. Drawing on literature published between 2000 and 2025, we propose the Triple Jeopardy Framework, a conceptual model describing how adolescence, forced displacement and motherhood interact to influence mental health outcomes, including depression, anxiety, post-traumatic stress disorder and intergenerational mental health risk. The framework distinguishes the separate risk and protective factors associated with each area, then shows how their intersections can create synergistic risk by weakening protective systems, limiting access to care and increasing psychological distress. At the same time, displaced adolescent mothers may exercise agency and draw meaning from motherhood while also experiencing significant distress and constraint. Effective responses require interventions that address structural determinants, strengthen community-based support systems, integrate maternal and mental health care and remain responsive to young mothers’ capabilities and caregiving realities. The Triple Jeopardy Framework provides a basis for developing gender-responsive, life-course approaches to adolescent maternal mental health in humanitarian settings.

This study evaluated 1) foundational helping competencies for Non-Specialist Providers (NSPs) trained in a transdiagnostic CBT-based intervention (PRO-ACT) for adolescents with anxiety and depression in Nairobi, Kenya and 2) preliminary clinical outcomes for adolescents receiving PRO-ACT. Seventeen NSPs were trained and assessed using role plays at pre-training, post-training, and post-supervision using the Enhancing Assessment of Common Therapeutic Factors (ENACT) tool, via a pre-post design (no control group). Eighteen adolescents were enrolled, received 4–6 PRO-ACT sessions, and assessed using the Patient Health Questionnaire-9 (PHQ-9) and Revised Children’s Anxiety and Depression Scale (RCADS-25). There were no significant changes in NSPs’ competencies from pre- to post-training. From pre-training to post-supervision, NSPs’ Level 1 (Potentially harmful) scores significantly decreased (−1.12 items; 95% CI: −2.10, −0.15; p = 0.026) and Level 3 or 4 (“Basic” or “Advanced competency”) significantly increased (2.12; 95% CI: 1.21, 3.04; p < 0.001). Adolescents had no significant change in mean PHQ-9 scores. RCADS scores decreased significantly for depression (−3.00 points; 95% CI: −5.45, −0.55; p = 0.020) and anxiety (−3.39 points; 95% CI: −6.17, −0.61; p = 0.020). NSPs’ foundational helping competencies improved significantly during clinical supervision. Client outcomes were promising, warranting a larger rigorous trial.

Adolescent involvement in mental health prevention research remains limited in low-resource settings. This study examined the feasibility, acceptability, processes and perceived impacts of adolescent advisory groups (AAGs) within the ALIVE research in Colombia, Nepal and South Africa. Using a convergent mixed-methods design, we analysed data collected between October 2022 and August 2025 using surveys with adolescents (t1: n = 33; t2: n = 26), focus group discussions (n = 6 with adolescents; n = 2 with caregivers), interviews (n = 8 with adolescents; n = 5 with facilitators), process documents (n = 58) and post-session feedback (n = 7). Participation was highly valued by most adolescents, who were motivated by altruism, peer connection, skill development and project incentives. Most adolescents strongly agreed they could express their views freely (t1: 79%; t2: 81%) and felt listened to (t1:76%; t2: 81%, respectively). Participants reported experiences of trust, confidence and collective agency; challenges included stigma, unequal participation and logistical barriers. Facilitators’ relational and adaptive support appeared central to sustaining engagement. Adolescent members contributed in important ways to the ALIVE research. Adolescent involvement in prevention research in low-resource settings is feasible and can be experienced by participants as valuable.

Food insecurity and child mental health difficulties frequently intersect, yet the mechanisms and pathways connecting them remain underexplored in resource-limited settings. This study developed a contextually grounded explanatory model to examine these relationships within a single rural Ugandan setting. We conducted 12 focus group discussions with 36 teachers across four schools in Masaka district, drawing on their sustained observations of children’s food insecurity and mental health difficulties across a nine-month timeframe. Data were analysed using realist thematic analysis, supported by iterative coding, nine consensus meetings and member checking. Three interrelated pathways were identified. In the social causation pathway, food insecurity, manifested through hunger-related stress, food-related stigma and irregular or inadequate meals, preceded and contributed to mental health difficulties. In the social drift pathway, preexisting mental health difficulties among caregivers and/or children disrupted household functioning and food provision, increasing vulnerability to food insecurity. A bidirectional pathway captured recursive processes in which food insecurity and mental health difficulties co-evolved and reinforced one another over time. These pathways shaped children’s mental health and educational engagement within school environments. The findings offer context-specific insights that may inform research in similar settings. They also highlight the potential value of integrated, multi-level interventions, while underscoring the need for longitudinal and intervention research.

This study examined whether mothers with schizophrenia spectrum disorder (SZSD) or mothers with bipolar disorder express less warmth, and more criticism compared to controls and whether mothers’ expressed warmth and criticism are associated with child self-esteem and mental health outcomes. Sixty mothers with SZSD, 60 mothers with bipolar disorder, and 60 control mothers, and their 7-year-old children were included from The Danish High Risk and Resilience Study VIA 7. Expressed warmth and criticism were evaluated by coding Five Minute Speech Samples using the Family Affective Attitudes Rating Scale. Child self-esteem was assessed with the “I Think I Am.” Child global functioning was assessed with the Children’s Global Assessment Scale, mental health with the Child Behavior Checklist School-age version, and KIDSCREEN-10 captured quality of life. Results showed that mothers with SZSD and mothers with bipolar disorder did not differ from controls on expressed warmth or criticism. Across groups, expressed criticism showed robust associations with poorer child mental health outcomes also when controlling for child sex and maternal functioning. Diagnostic status did not affect maternal expressed warmth or criticism toward their child. However, because more expressed criticism can be associated with adverse child outcomes, interventions promoting more positive interpretations may aid child mental health.

Youth depression is a critical target for early intervention due to its strong links with adult depression and long-term functional impairment. In low- and middle-income countries (LMICs) like the Philippines, limited epidemiological data hampers mental health service planning for youth. This study analyzed nationally representative survey data from 2013 (n = 19,178) and 2021 (n = 10,949) to estimate the prevalence of moderate to severe depressive symptoms (MSDS) among Filipinos aged 15–24 years, using the 11-item version of the Center for Epidemiologic Studies Depression Scale. Survey-weighted analyses revealed that MSDS prevalence more than doubled from 9.6% in 2013 to 20.9% in 2021. The rise was most pronounced among females (10.8% to 24.3%), non-cisgender or homonormative individuals (9.7% to 32.3%), youth with primary education or less (10.8% to 26.5%), youth from economically disadvantaged households (10.6% to 25.1%) and youth who were separated, widowed or divorced (18.3% to 41.3%). Disparities in MSDS also widened over time, with some groups bearing a disproportionate burden. These findings underscore the need to expand accessible, high-quality mental health services for youth in LMICs, such as the Philippines. Continued monitoring and targeted interventions are essential to address the rising burden of depression, particularly among underserved and disproportionately affected groups.

While many children in Africa face notable psychological problems, the majority do not receive needed mental health services. The My FRIENDS Youth Program, a universal cognitive-behavioral intervention for anxiety prevention and resilience enhancement, has demonstrated effectiveness across cultures in children and adolescents. This study explores whether the program’s effectiveness extends to Zambian children. Participants were 75 children and adolescents (53% female, ages 10–15) attending low-income schools in Zambia. Four schools were randomly assigned to an intervention (n = 44) or waitlist control (n = 31). The intervention consisted of 10 weekly sessions plus two booster sessions administered in group format. Assessments were conducted at pre-intervention, immediately post-intervention and 3-month follow-up. Data were analyzed using longitudinal multilevel modeling and controlled for child and parent sociodemographic characteristics. Intervention participation did not lead to reductions in anxiety, depression or parent-child relationship conflict but was associated with reductions in parent-reported internalizing and externalizing symptoms, attention problems and increases in positive parent-child relationships. However, both the intervention and control groups exhibited lower anxiety symptoms from Post-Intervention to 3-Month Follow-Up, suggesting potentially delayed effects. Future research may need to adapt this intervention to meet the needs of children in Zambia.

Enhancing resilience is one way to prevent future mental illnesses and encourage recovery in the face of adversity. To develop and test the acceptability and feasibility (A&F) of a combined family and individual resilience intervention in two rural/semi-rural low-income settings in India and Kenya. We developed a five-session intervention including Life Skills Education (LSE) and a model of family resiliency. Among adolescents aged 14–16 years and their families in India and Kenya, we collected socio-demographics and audio records of delivery and undertook a process evaluation. Due to COVID-19, we developed a hybrid intervention. The facilitators and participants preferred the in-person model. India: Of 17 families, 10 fully completed the intervention. They identified three critical components: 1) story-telling, 2) cooperation and working together and 3) expressing feelings. Kenya: All 15 families completed the intervention. Critical elements were 1) seeing social value in learning to make good decisions, 2) promoting an optimistic view of life, 3) hearing stories that resonated with their situation and 4) enhancing family performance through knowledge-building. We mapped the active ingredients, showing fidelity and acceptability. The intervention showed promising A&F parameters. Flexibility and local adaptation were important for delivery.

Childhood and adolescence are key developmental periods in the life course for addressing mental health, and there is ample evidence to support significant, increased investment in mental health promotion for this group. However, there are gaps in evidence to inform how best to implement mental health promotion interventions at scale. In this review, we examined psychosocial interventions implemented with children (aged 5–10 years) and adolescents (aged 10–19 years), drawing on evidence from WHO guidelines. Most psychosocial interventions promoting mental health have been implemented in school settings, with some in family and community settings, by a range of delivery personnel. Mental health promotion interventions for younger ages have prioritised key social and emotional skills development, including self-regulation and coping; for older ages, additional skills include problem-solving and interpersonal skills. Overall, fewer interventions have been implemented in low- and middle-income countries. We identify cross-cutting areas affecting child and adolescent mental health promotion: understanding the problem scope; understanding which components work; understanding how and for whom interventions work in practice; and ensuring supportive infrastructure and political will. Additional evidence, including from participatory approaches, is required to tailor mental health promotive interventions to diverse groups’ needs and support healthy life course trajectories for children and adolescents everywhere.