Alive: Improving adolescent mental health by reducing the impact of poverty

Poverty increases the likelihood that adolescents will develop common mental health problems such as depression and anxiety. Most of the world’s adolescents live in low and middle-income countries (LMIC), where poverty levels are high, and there are few effective interventions to prevent depression and anxiety.

Evidence shows that poverty increases the risk of adolescent depression and anxiety both directly, and through its effect on self-regulation (i.e. the ability to set goals, to maintain goal-directed behaviour in the face of distractors, and to flexibly adapt behaviour based on new information). We propose to conduct a 4-armed pilot randomised controlled trial to evaluate an intervention that includes a poverty reduction element and also strengthens self-regulation among adolescents living in urban poverty in Bogotá (Colombia), Kathmandu (Nepal) and Cape Town (South Africa).

We have designed the evaluation to allow us to eventually test whether the poverty-reduction or the self-regulation component, or both combined are most effective in preventing adolescent depression and anxiety in the three LMIC sites. We also propose to adapt and validate key measurement instruments, to assess how the intervention is delivered, how much it costs, the way in which it works and its effect. Our pilot evaluation will allow us to test all the procedures required for a future fully powered randomised controlled trial.