Background: Adolescent poor mental health is a significant problem in India, with suicide being a leading cause of adolescent death. The Indian government recognises and is acting to respond through the development of policies and legislation. Despite these advances, knowledge gaps remain in relation to evidence, measures and theory specific to Indian adolescents, which may be hindering progress. Further, much current knowledge stems from western research and data, with Indian adolescent voice being largely absent. As evidence shows that culture influences the experience and expression of positive and poor mental health, the generation of more in-country, localised knowledge may support response efforts. Therefore, advancement in these areas, with attention to culture and decolonising practices, could progress research, policy and actions relating to adolescent mental health in India.
Aim: To contribute new knowledge relating to adolescent wellbeing theory, knowledge and measures of mental health to support research, policy and practice in India.
Method: Multiple methodological approaches were employed. The first phase of work employed think aloud interviews and a validation study to begin the cultural validation of a popular measure of anxiety and depression for use with Indian adolescents. The second phase of work consisted of a literature review of dominant wellbeing theories, a narrative synthesis study and a focus group study which informed a Multi-Grounded Theory approach to develop a theory of positive emotional wellbeing specific to adolescents in India.
Findings and conclusion: First, multiple problems were identified with a popular measure of anxiety and depression in a sample of Indian adolescents resulting in the development of a rephrased version, which showed promising psychometrics in this population. Second, findings suggest that, although useful, existing universal theories of wellbeing may be incomplete in identifying the determinants of wellbeing across all cultures, indicating that further research is needed to continually investigate and build more culturally sensitive wellbeing theory. Third, additional specific factors influencing adolescent wellbeing were identified from existing literature and Indian adolescents themselves, filling knowledge gaps surrounding factors influencing their wellbeing. Finally, a theory of positive emotional wellbeing specific to Indian adolescents was developed, proposing determinants of wellbeing which operate through layers of influence that may be unique to an Indian adolescent population. Findings add to the growing body of research suggesting that culture significantly influences mental health and wellbeing, alongside furthering mental health knowledge, measures and theory relating to adolescents in India.
