Diliniya Stanislaus Sureshkumar

Substance use is a common problem among young people in Latin America and has significant consequences for their mental health. One of the variables associ

Purpose: Improving youth mental health is a major societal challenge. In low-income urban areas in South America, this cohort study explored rates and predictors of recovery among young people with depression and/or anxiety symptoms over two years. Methods: Adolescents (15–16 years old) and young adults (20–24 years old) with depression and/or anxiety symptoms (≥ 10 on Patient Health Questionnaire-8 and/or Generalised Anxiety Disorder-7) from low-income areas in Bogotá, Buenos Aires and Lima, were recruited from community organisations and educational institutions between April 2021 and November 2022 and reassessed after 6, 12 and 24 months. Sociodemographic characteristics, substance use, stressful life events, resilience, coping strategies, social capital, perceived social support, sports and arts activities, and social media engagement were explored as predictors of recovery. Results: We recruited 1437 young people. Overall recovery rates were 30.3% after 6 months, 32.6% after one year and 37.3% after two years. In a multivariable model, female gender, younger age group, more severe initial depression and anxiety symptoms, more stressful life events in the last year and before that, lower resilience levels and higher social media engagement all predicted lower recovery rates. Interaction analyses showed a decreasing effect of baseline depression symptoms over time and a poorer recovery in female adolescents, but not young adults. Conclusions: Most young people with mental distress in low-income urban areas in South America do not recover over a two-year period. Programmes to strengthen resilience and reduce social media engagement should be developed to improve outcomes of mental distress in young people.

Background: Involving people with lived experience in research has been increasingly recognised as a priority. This article details the development and implementation of three Lived Experience Advisory Panels (LEAP) and reports their evaluation of the experience. The LEAPs involved young people from Latin America with experiences of emotional distress, aimed at advising a youth mental health research programme. Methods: Online meetings were conducted within each LEAP in Bogotá, Lima and Buenos Aires to gather feedback at different stages of the programme. Additional activities included a Joint LEAP meeting and a focus group to explore the members’ experiences of LEAP participation. Results: During the LEAP meetings, 25 members (Bogotá n = 9, Lima n = 10, Buenos Aires n = 6) provided feedback on study data collection tools and materials, recruitment and dissemination strategies, and discussed preliminary results, which were significant in shaping study materials and processes. They valued the comfort and connection with researchers and peers during discussions about mental health topics, as well as the opportunity to inform a large-scale project with their lived experiences. However, challenges in the recruitment and engagement led to fluctuating participation, while socioeconomic and cultural barriers may have influenced access. Conclusions: The implementation of the LEAPs is an example of involving young Latin Americans with experiences of emotional distress in research. Future efforts should focus on overcoming structural limitations and fostering equitable collaboration, emphasising the need for youth perspectives in mental health research, particularly in low- and middle-income countries.

Background: Many young people achieve recovery from mental health problems by using strategies to manage emotional distress and enhance well-being. Given that little is known about the functions of these strategies, especially in Latin American countries, this study aims to describe the usefulness of the resources used by youth from deprived urban neighborhoods in Bogotá (Colombia), Buenos Aires (Argentina), and Lima (Perú) in managing emotional distress. Methods: 112 in-depth interviews about strategies for dealing with emotional distress and their perceived function were conducted with young people from three Latin American cities. The sample included young adults and adolescents in a longitudinal cohort study. A thematic content analysis was carried out. Results: Participants identify different functions linked to their strategies to cope with emotional distress or increase their well-being. However, "coping with distress," "perceived support," and "distraction" are the three main functions of the strategies used by them in situations of emotional distress. Each of these functions comprises several aspects, some of which overlap between functions, such as motivation, emotional expression, companionship, and regulation. Conclusion: The variety of functions linked to the strategies used by young people to cope with emotional distress or enhance their well-being could guide the facilitation of a favorable social and interpersonal context through public policies and a community approach that promotes young people's access to strategies to cope with emotional distress.

Background: Colombia is a middle-income country in South America, which has historically had high rates of mental health problems, coupled with a scarcity of mental health care. There is growing concern for the mental health of the adolescent population within this region. There is a significant treatment gap for young people, especially those living in the most vulnerable areas. DIALOG+ is a low-cost patient-centered intervention that can potentially improve the delivery of care and quality of life for adolescents with mental health problems. Objective: This exploratory randomized controlled trial aims to evaluate the effectiveness, acceptability, and feasibility of an adapted version of the DIALOG+ intervention (DIALOG-A) in the community treatment of Colombian adolescents with depression and anxiety. Methods: In total, 18 clinicians and 108 adolescents will be recruited from primary health care services in Bogota and Duitama, Colombia. Clinicians will be randomized 2:1 to either the intervention (12 clinicians:72 adolescents) or control group (6 clinicians:36 adolescents). In the intervention arm, clinicians will use DIALOG-A with adolescents once per month over 6 months. The control arm will continue to receive routine care. Outcomes will be measured at baseline, 6 months, and 9 months following randomization. Semistructured interviews with all clinicians and a subset of adolescents in the intervention arm will be conducted at the end of the intervention period. Quantitative and qualitative analysis of the data will be conducted. Results: Trial recruitment was completed toward the end of October 2022, and follow-up is anticipated to last through to October 2023. Conclusions: This is the first study to test an adapted resource-orientated intervention (DIALOG-A) in the treatment of adolescents with depression and anxiety attending primary care services. If the results are positive, DIALOG-A can be implemented in the routine care of adolescents with these mental health problems and provide valuable insight to other middle-income countries. Trial Registration: ISRCTN Registry ISRCTN13980767; https://www.isrctn.com/ISRCTN13980767?q=ISRCTN13980767 International Registered Report Identifier (IRRID): DERR1-10.2196/43401