Sugary drinks fuel mental health woes among youth

A first-of-its-kind study has found that while relatively few adolescents in Lesotho show signs of mental health or substance use problems, those who do face a staggering treatment gap, with most not receiving any form of care.

The population-based study, one of the first of its kind in a predominantly rural African setting, surveyed 1,351 adolescents aged 10 to 17 in the districts of Mokhotlong and Butha-Buthe.

The research, published in the Journal of Research on Adolescence, also found that just three percent of adolescents aged 10 to 17 years met clinical criteria for at least one mental health or substance use problem.

Among older teens, aged 15 to 17, the prevalence rose slightly to five percent. These rates are lower than global averages, which range from six percent to 28 percent, suggesting possible protective factors unique to Lesotho’s social and cultural environment.

“More female than male adolescents reported depressive and PTSD symptoms, while more older adolescents reported anxiety symptoms, as compared to younger adolescents. Moderate to high risk substance use was predominantly reported among male participants and older adolescents,” the study read.

“The awareness and treatment gaps among adolescents with clinically relevant mental health or substance use problems were approximately 55 percent and 85 percent, respectively, suggesting that the majority of adolescents are unaware of the severity of their issues and do not access care,” it added.

But the study also uncovered worrying gaps in care. Of those identified with a mental health condition, nearly half (45 percent) recognised they needed help, yet only 17 percent actually received care.

That leaves 83 percent without support, underscoring what researchers call an urgent need for better awareness and services.

The findings highlight the low awareness of mental health needs among young people and their families, as well as limited knowledge of where to seek help.

“Of the three percent of youth who fell within this category, fewer than half recognised the need for treatment, and only 17 percent obtained any care. This gap parallels that among adults in Rwanda, where just six percent of those with mental health problems aware of services actually used them, and in rural Ethiopia, where only 13 percent of adults with alcohol use disorder sought help,” the study read.

“Additionally, a recent scoping review in six African countries estimated that only 10 percent of children and adolescents who need mental health care obtain it. Our cascade results align with the wider regional pattern of limited problem recognition and service use, outlining the need for combined demand-and-supply-side strategies to narrow the treatment gap in Lesotho and other similar settings,” it added.

Lifestyle choices were also found to play a role. Consumption of sugar-sweetened beverages was strongly linked to both poor mental health outcomes and substance use, while physical activity showed no clear association with mental wellbeing.

Gender and age differences also emerged: girls were more likely to experience depressive and post-traumatic stress symptoms, while boys were more prone to substance use. Suicidal thoughts and substance use were more common among older adolescents.

While the lower-than-expected prevalence offers a glimmer of hope, researchers warn that urbanization and lifestyle changes could shift the trend upwards if not addressed.

They recommend adolescent-focused, culturally sensitive interventions, with an emphasis on raising awareness and building demand for care.

Ntsoaki Motaung

Ntsoaki Motaung is an award-winning health journalist from Lesotho, specializing in community health stories with a focus on sexual and reproductive health and rights, as well as HIV. She has contributed to platforms like “Be in the KNOW,” highlighting issues such as the exclusion of people with disabilities from HIV prevention efforts in Lesotho.

In addition to her journalism, Ntsoaki serves as the Country Coordinator for the Regional Media Action Plan Support Network (REMAPSEN). She is also a 2023 CPHIA Journalism Fellow.