Understanding How Adolescents Experience Violence and Its Perceived Impacts on Mental Health: A Qualitative Study Across 13 Countries.

Purpose: There are limited data on how adolescents globally perceive violence as impacting their mental health. The present paper explores similarities and differences in adolescents' experiences of violence and their perceived impacts on mental health by sex and context.

Methods: Adolescents aged 12-19 participated in 71 focus group discussions across 13 countries: Belgium, Chile, China, the Democratic Republic of the Congo, Egypt, Indonesia, Jamaica, Jordan, Kenya, Malawi, Sweden, Switzerland, and the United States. Each country held between four and 10 focus group discussions segregated by sex and age. Almost all adolescents were sampled from low- or middle-income urban communities. An inductive thematic analytical approach was used to analyze emerging themes.

Results: Across countries, both girls and boys discussed concerns about emotional, physical, and sexual violence within their homes, peer groups, schools, and neighborhoods. Notably, while boys were more likely to discuss physical violence, girls primarily focused on sexual violence. Results also highlight adolescents' vulnerability to violence victimization and emotional distress, with gender, poverty, and cultural context interacting to produce risk. Additionally, inequitable gender norms were discussed as key factors in increasing aggression for boys and sexual harassment and assault for girls.

Discussion: While the manifestations of violence differ by sex and context, it is clear that violence is experienced by adolescents globally and takes a high emotional toll. Although the provision of mental health services is important, it is equally critical to address societal and family structures with community and national commitments to address the issues that predispose adolescents to experiencing distress.