Participatory systems mapping to address the mental health of adolescents growing up in poverty

Abstract Background The mental health of adolescents growing up in poverty is shaped by a complex system of interconnected individual, sociocultural and environmental factors. Acknowledging and addressing this complexity is vital for effective intervention. This study aims to provide insight into the mechanisms underlying the mental health of adolescents growing up in poverty according to different stakeholders (adolescents, parents, professionals, policymakers) and to identify impactful leverage points for improvement. Methods To collect this information, we organized participatory sessions and three rounds of Group Model Building (GMB) workshops with adolescents, parents, professionals and policymakers in two local neighborhoods in the Netherlands. GMB is a participatory qualitative method that engages different types of stakeholders to collectively consider the causes of complex problems, visualizing the problem in a Causal Loop Diagrams (CLDs). Results The results showed that according to participants, growing up in poverty impacts adolescent mental health primarily through (1) fitting in with peers, (2) venturing out onto the streets (3) working besides school or study, (4) opportunities at school, and (5) feeling ashamed. As part of these five mechanisms, fourteen leverage points were identified that could offer pathways to enhance adolescent mental health. Conclusions This study illustrates the complexity of the mental health of adolescents growing up in poverty and offers stakeholders suggestions for possible leverage points. Policy, practice and research efforts should address the family's financial situation and the complex mechanisms in the school and neighborhood environment to improve the mental health of adolescents growing up in poverty. Key messages • Tackling several complex mechanisms in the school and neighborhood environment can improve adolescent mental health. • Addressing the family's financial situation is needed for long-term improvement of adolescent mental health.