Adolescent Mental Health and Teachers’ Health Literacy: A Mixed-Methods Exploration and Assessment of Coping and Support Mechanisms in Puducherry Schools

Background: Globally, adolescents face a significant mental health burden, with unique challenges in India. Teachers are pivotal in early identification and support but often lack adequate mental health literacy (MHL). This mixed-methods study assessed the prevalence of mental health problems among adolescents, their coping strategies, and teachers' MHL in Puducherry, India. Methods: A convergent parallel design was employed. Cross-sectional surveys using the Strengths and Difficulties Questionnaire (SDQ) were conducted with 420 adolescents (10-19 years) from 4 schools (2 urban, 2 rural). Focus group discussions (FGDs; n=32 students) and in-depth interviews (IDIs; n=16 teachers) explored coping mechanisms, support systems, and MHL. Quantitative data were analysed using SPSS (v21); qualitative data underwent thematic analysis via NVivo 12. Results: 35.2% (n=148) of adolescents screened positive for significant mental health difficulties. Peer problems (43.8%), emotional difficulties (25.7%), conduct problems (24%), and hyperactivity (15.7%) were prevalent. Rural adolescents reported significantly higher domestic violence exposure (28.8% vs. 17.1%; p=0.004) and lower psychosocial support (13.6% vs. 39.2%; p<0.001). Key qualitative themes included: 1) Academic/family stress as primary triggers; 2) Predominant use of maladaptive coping (avoidance, emotional suppression); 3) Critical barriers (teacher training gaps, stigma, absent counselling); 4) Variable teacher MHL reliant on experience, not formal training. Conclusion: High adolescent mental health needs coexist with insufficient teacher capacity and school support systems. Integrating standardized MHL training into teacher education, deploying school counsellors under national programs (e.g., Ayushman Bharat), and implementing student resilience programs are urgent priorities.