COVID-19 restrictions led to increased experiences of stress and anxiety among adolescent girls and young women in South Africa, found a study by the University of Cape Town (UCT) and the SA Medical Research Council (SAMRC).
Poor mental health was compounded by strained family relationships, increased fear of domestic violence, household unemployment, economic stress and food insecurity, found the study, published in the journal of Child and Adolescent Psychiatry and Mental Health.
The study focused mainly on district areas that had been identified as a priority for health interventions and that were characterised by a high HIV prevalence and increased rates of teenage pregnancy, and disproportionately affected by socio-structural drivers.
The research team conducted a telephone survey with 515 adolescent girls and young women, and in-depth interviews with 50 adolescent girls and young women, aged 15 to 24 years, between November 2020 and March 2021.
Catherine Mathews, an honorary member of UCT’s School of Public Health and Family Medicine and director of SAMRC’s Health Systems Research Unit, said: “Our findings showed how socio-economic factors drive stress, depression and poor mental health among adolescents and young people in South Africa, illustrating how the COVID-19 pandemic has exacerbated problematic socioeconomic factors.”
Zoe Duby, honorary research associate at UCT’s Division of Social and Behavioural Sciences said the young women and girls described an overwhelming sense of hopelessness about their situation at the time and the future, reports City Press. In contrast, other respondents expressed emotional resilience, describing how they managed to cope in healthy ways and retain hope.
Duby said: “Psychological resilience among adolescents and young people, their ability to manage feelings of stress, address stressors they encounter or gain a feeling of coping with their circumstances, is critical to protecting and buffering the impact on mental health.”
Mathews said the distribution of mental health resources across the country is markedly uneven, particularly in the public sector health system. She suggested that the government urgently recognise child and adolescent mental health services as a health priority to lessen the impact of COVID-19 stressors.
She further recommended that appropriate, innovative, cost-effective, scaleable, evidence-based systemic or multi-level interventions be developed by the government to promote the mental health of adolescents and young people.
According to the survey, the key to mitigating mental health stressors is tackling structural drivers like unemployment and food insecurity.
Study details
Intersections between COVID-19 and socio-economic mental health stressors in the lives of South African adolescent girls and young women
Published in Child & Adolescent Psychiatry & Mental Health on 26 March 2022
Background
In contexts where poverty and mental health stressors already interact to negatively impact the most vulnerable populations, COVID-19 is likely to have worsened these impacts. Before the COVID-19 pandemic, adolescent girls and young women (AGYW) in South Africa already faced intersecting mental health stressors and vulnerabilities. It is critical to understand how additional challenges brought on by COVID-19 have intersected with existing vulnerabilities and mental health risks AGYW faced, particularly given the intersections between psychological distress and increased risk behaviours that impact sexual and reproductive health. We aimed to examine socio-economic and mental health impacts of COVID-19 on South African AGYW in order to understand how additional challenges brought on by COVID-19 have intersected with existing challenges, compounding AGYW vulnerabilities.
Methods
Using qualitative and quantitative methods, framed by the syndemic theory, we examined the intersections between mental health and the COVID-19 epidemic among AGYW in six districts of South Africa characterised by high rates of HIV, teenage pregnancy and socio-economic hardship. Between November 2020 and March 2021 we conducted a cross-sectional telephone survey with 515 AGYW, and in-depth interviews with 50 AGYW, aged 15 to 24 years.
Results
Our findings reveal how COVID-19 restrictions led to increased experiences of stress and anxiety. Poor mental health was compounded by strained family relationships, increased fear of domestic violence, household unemployment, economic stress and food insecurity. Respondents described feelings of boredom, frustration, isolation, loneliness, fear and hopelessness. However, despite the multitude of challenges, some AGYW articulated emotional resilience, describing ways in which they coped and retained hope.
Conclusion
Various psycho-social risk factors already disproportionally affect the mental health of AGYW in these communities; the COVID-19 pandemic intersects with these pre-existing social and environmental factors. Understanding strategies AGYW have used to positively cope with the uncertainty of COVID-19 among an array of pre-existing mental health stressors, is key in informing efforts to respond to their needs. Multisectoral interventions are needed to address the drivers of poor mental health among AGYW, and bolster healthy coping mechanisms; interventions seeking to mitigate the mental health impacts on this vulnerable population need to be responsive to the unpredictable pandemic environment.
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