Pioneering African mental health study receives millions in funding from Wellcome

Academics from University of Leicester are set to join an innovative new international collaborative study to examine the network of risk factors and resilience resources that predict depression among NEET youth in Africa.

Led by the University of Pretoria’s Professor Linda Theron, this study of African NEET (“Not in employment, education or training”) youth is a joint effort involving South African Medical Research Council, University of Ibadan (Nigeria), University of Leicester, University of Nottingham, and Dalhousie University (Canada).

According to the study’s authors, thousands of young people across the continent are battling mental health issues such as depression. Challenges, such as poverty, make young people even more vulnerable to mental illness.

Across Africa, one in five youths are NEET – and this high number makes African youth disproportionately vulnerable to depression. In Nigeria and South Africa, at least one in three youths is NEET (36.7% and 34.3% respectively).

The researchers working on this study say it will help to identify combinations of resources that offset risk factors and thus enable people working in the field to put resource combinations in place to help.

“It’s a complex study, and challenging to measure multisystemic factors at the same time,” Professor Theron says. “But we are pioneering a methodology, and we are confident we can do it. There is too little understanding of which combination of resources can support young people to do well in life, especially in Africa. This work is vital to pre-empting depression and informing precision interventions tailored to the needs of African youth who are NEET”.

“We are talking about psychological, physiological, biological, structural and physical ecology resources. Most researchers have in the past just concentrated on one or two of these systems during their resilience studies. But these don’t consider how factors across systems combine to support youth to be OK when life is relentlessly hard. We have to move forward from these incomplete studies and find a more complete response to vulnerable communities where we find these youth.”

While the team members are world leaders in studying multisystemic resilience and youth well-being, they still do not know which precise combination of physical, psychological, social, institutional, and environmental risks and resources predicts stable, low or improving versus chronic, high or worsening depression trajectories among African youth.

Dr Zainab Mai-bornu (School of History, Politics and International Relations) and Dr Diane Levine (School of Criminology) are leading the research at University of Leicester.

The study has been made possible through the prestigious £5 million (about R119 million) Wellcome Discovery Award awarded to Prof Theron and her collaborators, and is titled ‘Protecting African youth who are NEET against depression: An investigation of differentially impactful, multi-systemic resilience enablers’.

She adds that once the study’s results illuminate the combination of resources that works best, it will provide service providers, like mental health professionals, with the know-how to approach mental health differently using multi-systemic thinking.

Morag Foreman, Head of Discovery Researchers at Wellcome, said: “We’re excited to see this ambitious programme begin, which demonstrates the importance of supporting discovery research in social science. There is a clear need to improve our understanding of the physical, social and environmental factors that predict depression, particularly in young people.

“We hope the impact of this approach will provide mental health professionals with a better understanding of how to support young people across Africa, especially to those in the most vulnerable communities.”

The 66-month study comprises two phases: Phase 1 will follow 1 600 young people aged 18 to 24 who are based in stressed communities in South Africa’s Gauteng province and Nigeria’s Niger Delta. This phase will take a closer look at NEET youths’ physical, psychological, social, ecological, and economic risks and resources.

Phase 2 will focus on the 500 young adults who reported the highest risks and lowest depression versus the highest risks and highest depression.

This phase will include the study of anthropometric indicators such as stress hormone levels, lung capacity and physical well-being; environmental factors like air quality, noise levels and temperature; and psychosocial factors like, political, social and cultural contexts.

Prof Theron says, “We chose these two locations because both countries have elevated levels of stressed communities.”

She says one- or two-dimensional resilience studies have been done in other African countries before, but it’s the first time Africa’s youth are the sole focus of multi-systemic research.

“This study is entirely Africa-led, and is about how young people cope during times of difficulty. Previous studies were mostly done with Global North populations. Africa’s youth population is growing exponentially, and everyone is excited about it. But there are challenges to this potential, so we have to rein in the excitement. We need cutting-edge studies to boost young people’s wellbeing for the benefit of our continent and the world.”

Prof Theron says both depression and resilience to depression are not studied closely enough in African youth populations: “It’s hard to manage depression in contexts like Africa, where mental health services are limited. If we don’t get to transform the current limited understanding of Africa’s youth resilience to depression, Africa and its global partners will be hard-pressed to realise the potential dividends of a rapidly growing population of African youth.”

Ultimately, the authors say this study will help redress the dominance of Western accounts of youth resilience.