Adolescent Mental Health in Vulnerable Urban Contexts: A Qualitative Study

Abstract Background Adolescent mental health is a global priority due to rising affective and behavioural disorders. In Colombia, structural inequalities, family and community conflict, and limited mental health services worsen the situation. Additionally, the COVID-19 pandemic further disrupted adolescents’ emotional development. This study explores mental health among adolescents in vulnerable areas of Bogotá, focusing on their experiences in different everyday contexts. Methods From October 2022 to May 2023, the study combined 42 semi-structured interviews with adolescents and six with school counsellors, alongside 95 hours of non-participant observation in schools and neighbourhoods. Data were analysed using reflexive thematic analysis to interpret the data. Results Observation notes, adolescents (aged 12-18, mostly Colombian girls), and professionals (mainly psychologists) described adolescents’ mental health through four overarching themes: a) Personal incl. self-care, life goals shaped by socio-economic conditions, emotional distress (monotony, low self-esteem), and post-pandemic coping; b) Interpersonal incl. family dynamics, peer and romantic relationships, loneliness, and conflict; c) Community incl. neighbourhood conditions and solidarity; d) Institutional/media incl. schools, health services, internet and social media. The COVID-19 pandemic intensified emotional challenges, especially in fragile settings, but also revealed resilience via stronger family ties, coping strategies, and appreciation of support networks. Conclusions Adolescent mental health is shaped by emotional distress, relational tensions, and social inequality. The pandemic worsened these challenges but also triggered resilient responses. Findings highlight the need for context-sensitive psychosocial interventions that recognise both adolescents’ struggles and agency. Key messages • Adolescents in vulnerable settings face psychosocial challenges but show resilience. • Adolescents’ voices must guide relevant and effective interventions.