Strengthening Adolescent Well-Being: A Call for Integrated Mental Health and Sexual Reproductive Health Policies in East and Southern Africa

Introduction Adolescence, a period between 10 to 19 years, is a crucial stage of life representing the transition from childhood to adulthood. This period is a unique stage of human development characterized by physiological, emotional, and sexual development, shaping a sense of identity and individuality. During this period, adolescents have unique health, social, emotional, and developmental needs that must be met to help them acquire knowledge and skills, to manage and cope with their emotional, biological, and physical changes. It is a period vital for the development of sexual and reproductive capacities, characterized by rapid growth of reproductive organs, onset of menstruation, and beginning of sexual activity. For some adolescents, this phase also marks the onset of several mental health disorders, with available evidence suggesting that half of all such conditions begin before the age of 152. Globally, one in seven adolescents aged 10 to 19 suffer from a mental disorder, with depression, anxiety, and behavioral disorders being the most pervasive causes of illness and disability in this age group. Sexual and reproductive behavior significantly impacts adolescents’ mental health. For instance, exposure to sexual violence, unintended pregnancy, and sexually transmitted infections, including HIV infection, have all been linked to poor mental health in adolescents. Additionally, evidence suggests that young people with depression and other mental disorders often engage in risky sexual behaviors. These may include having multiple sexual partners and inconsistent use of contraceptives or condoms, which can lead to a higher incidence of unintended pregnancies and an increased risk of sexually transmitted infections, including HIV5. Mental disorders can elevate adolescents’ risk of adverse sexual and reproductive health (SRH) outcomes.

Given the bidirectional relationship between adolescent sexual reproductive health (ASRH) and mental health, addressing both areas through integrated services can broaden service provision and access, which will in turn enhance ASRH and mental health outcomes. Integrating sexual and reproductive health and rights (SRHR) and mental health means leveraging opportunities within the overall healthcare system to offer SRHR services and mental health and psychosocial support (MHPSS) services. It also involves incorporating SRHR into MHPSS policies on or related to adolescents and young people. Providing clear policy direction is essential for the successful integration of MHPSS into SRHR and vice versa. However, there is limited evidence of the extent to which MHPSS and SRHR policies address service integration.