136 - Agency, Access, and Aid: A Qualitative Study of Adolescents’ Perspectives on Their Mental Health

Publication Number: 1126.136

Angela Gummadi, University of Virginia School of Medicine, Charlottesville, VA, United States; Kirstin Griffin, Virginia Commonwealth University School of Medicine, Richmond, VA, United States; Jessica Forrester, University of Virginia School of Medicine, Charlottesville, VA, United States; Elana M.. Brown, University of Virginia, Chicago, IL, United States; Farah Contractor, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Britney Guzman-Cornelio, James Madison University, charlottesville, VA, United States; Justus R. Garland, UVA Health System, Charlottesville, VA, United States; Liz Nigro, Voices for Virginia's Children, Richmond, VA, United States; Irène Mathieu, University of Virginia School of Medicine, Charlottesville, VA, United States

Background: Amid a youth mental health crisis, with increasing rates of anxiety, depression, and unmet behavioral health needs, it is essential to center adolescent voices in developing effective mental health supports. The Teen Wellness Team (TWT), a youth participatory action research (YPAR) initiative at an academic medical center, conducted a qualitative study to assess adolescents' perspectives on mental health and well-being.

Objective: To explore adolescents' beliefs, barriers, and supports related to their mental health.

Design/Methods: This cross-sectional qualitative study was co-designed and implemented by youth and adult researchers from the TWT (process detailed in Figure 1). Young people actively participated in all aspects of the project, from research question generation to data analysis and results dissemination. Recruitment occurred via school and community partnerships. Semi-structured interviews were conducted by interviewer pairs (youth-adult or adult-adult), covering mental health perceptions, stressors, sources of support, and recommendations for community-based interventions. Thematic analysis was conducted collaboratively.

Results: Participants (N=18; ages 14-17) defined mental health as emotional well-being, self-acceptance, and the ability to cope with challenges. External stressors (academic pressure, family conflict, peer relationships) and internal barriers (stigma, fear of vulnerability) were stated as factors that heighten mental health challenges. Lack of personal agency further impacts youth well-being. Relational support from family, peers, educators, and mental health professionals was described as essential but inconsistently accessible. There is a need for increased access to therapy, peer support groups, and safe, nonjudgmental spaces within schools. Emergent themes are outlined in Table 1. To disseminate findings, the TWT created and distributed zines addressed to key youth mental health interest holders, including parents, teens, and schools (see Figure 2).

Conclusion(s): This youth-co-led investigation demonstrates the utility of YPAR in tackling complex pediatric health issues. Study results highlight the importance of agency, relational support, and accessible resources in promoting adolescent mental wellness. Clinical implications of our findings include the need to develop and adapt interventions that prioritize youth voice and reduce mental health stigma. Additionally, this study calls for expanded access to culturally responsive mental health services and expanding the number of adult caregivers and mentors who are adequately trained to support youth's mental well-being.

Figure 1. YPAR Process
This figure depicts the structured youth participatory action research (YPAR) process undertaken by the Teen Wellness Team initiative at an academic medical center.


Table 1. Thematic Analysis
Summary table presents quotes/data gathered from thematic analysis of semi-structured interviews with youth participants, highlighting their lived experiences with and perceptions of mental health. Themes are organized alphabetically and supported by direct quotations that illustrate key concerns.

Figure 2. Zines
This image shows panels of three zines created by the TWT, addressed to parents (top), educators (middle), and youth themselves (bottom).. Each zine blends research themes with collective advocacy and resources, addressing topics such as emotional safety, identity, stress, and support systems.