Adolescent aspiration models influence people’s behavior choices and exposure to risk and protective factors, which influence adult mental health1. There have been various public health and clinical studies that are aimed at improving these models to try to change behavior and decrease risk factors with the ultimate aim of improving psychological wellbeing2. The objective of this study was to identify adolescent aspiration models in a high-risk, rural Nepali setting to identify potential areas of intervention to improve adolescent mental health. The study used well-established social sciences elicitation techniques to understand the cultural pathway for adult life course(3,4). Life Trajectory Interviews (LTI) were conducted among adolescents aged 15-19 years, their parents and teachers (n=20). Qualitative analysis of the interviews formed the basis for identification of items for a card sorting activity. Card sorting was then conducted among adolescents aged 15-19 years (n=72).
Culture and the transition process to adulthood were seen as the major factors shaping the adolescent’s perception of how an “ideal person” should look. This, along with gender as a confounding factor, shaped their life goals. Education and employment were seen as top priorities, both in terms of importance and timeline. Four risk factors were identified: violence, disruptive behavior, alcoholism and suicide. Alcoholism was the strongest risk factor that further led to violence and suicide. Increased acceptability of alcohol across caste and gender was also identified.
There is a need to engage in culturally compelling models for promotion of adult mental health. In Jumla, interventions need to be focused on improving education and opportunities for employment with delayed engagement in marital and family goals. Interventions should also focus on peer transmission of cultural models related to risky behaviors such as alcohol use, violence and attempted suicide5.
Reference:
1. Clarke, P., et al., The social structuring of mental health over the adult life course: advancing theory in the sociology of aging. Social Forces, 2011. 89(4): p. 1287-1313.
2. Jordans, M.J.D., et al., Evaluation of a classroom‐based psychosocial intervention in conflict‐affected Nepal: a cluster randomized controlled trial. Journal of Child Psychology and Psychiatry, 2010. 51(7): p. 818-826.
3. Bernard, H.R., Research methods in anthropology: Qualitative and quantitative approaches. 2011: Rowman Altamira.
4. Brown, R.A., et al., The Life Trajectory Interview for Youth (LTI‐Y): method development and psychometric properties of an instrument to assess life‐course models and achievement. International journal of methods in psychiatric research, 2006. 15(4): p. 206-15.
5. Birmaher, B., et al., Psychosocial functioning in youths at high risk to develop major depressive disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 2004. 43(7): p. 839-846.