Geographies of adolescent distress: A need for a community-based psychosocial care system in Nepal
Nawaraj Upadhaya1, Carola Tize2, Ramesh P Adhikari3, Dristy Gurung4, Ruja Pokhrel5, Sujen M Maharjan6, Ria Reis7
1 MA, MSc, Project Coordinator at the Department of Research, Transcultural Psychosocial Organization Nepal, Kathmandu, Nepal
2 MSc, PhD Candidate at the Amsterdam Institute for Social Science Research (AISSR) Department of Anthropology, University of Amsterdam, Amsterdam, The Netherlands
3 MA, MPhil, Research Coordinator at the Department of Research, Transcultural Psychosocial Organization Nepal, Kathmandu, Nepal
4 MSc, Project Coordinator at the Department of Research, Transcultural Psychosocial Organization Nepal, Kathmandu, Nepal
5 MA, Senior Research Officer at the Department of Research, Transcultural Psychosocial Organization Nepal, Kathmandu, Nepal
6 MA, Programme Manager at the Mental Health and Care Practices (MHCP) Department, Action Contre la Faim (ACF), Kathmandu, Nepal
7 MA, PhD, Professor, Department of Public Health and Primary Care, Leiden University Medical Center, the Netherlands; Associate Professor, Department of Anthropology, University of Amsterdam, the Netherlands; Honorary Professor at the Children’s Institute, University of Cape Town, Cape Town, South Africa
Department of Research, Transcultural Psychosocial Organization Nepal, Kathmandu
Source of Support: None, Conflict of Interest: None
This paper presents the findings of an ethnographic study conducted among high school students in Nepal. Participant observations, in-depth interviews and focused group discussions were conducted among 35 students (20 girls and 15 boys). The findings suggest three geographies (home, school and community), where adolescents experience distress. Common experiences of adolescent distress included discrimination, domestic violence, heavy workload, poverty, bullying, physical punishment, unsupportive behaviour of the parents and teachers and a lack of basic materials. These findings largely support Bronfenbrenner’s socio-ecological model, emphasising the complex reciprocal interactions between the individual and his/her immediate environment. They also suggest that not only a reciprocal relationship between the sub-systems of the ecological model, but also a ‘mobility’ between and among these sub-systems affects the individual’s emotional-relational well-being. We argue that the micro-systems in which children grow up not only have a social dimension, but a spatial dimension as well. Building on this insight, a five building-block intervention model is presented to help address adolescent distress.
Key implications for practice
- Given adolescents' mobility between home, school and community, a community-based psychosocial care system is proposed that also addresses distress related to the in-between travelling spaces.
- Such a system would comprise family support, peer-to-peer education, community mobilisation and school mental health.
- School counsellors should provide counselling in the school, but also use home visits and in-between travelling spaces as implementation sites for interventions.