Bringing an end to the silence: identifying priorities and solutions to addressing the mental health consequences of child marriage.

Despite its inclusion in Sustainable Development Goal 5 to end all harmful gendered practices by 2030, child, early and forced marriages continue to be a pervasive problem globally. While there is consistent evidence on the physical health consequences of child marriage, there is a lack of evidence and inquiry into the mental health consequence. We completed a change-oriented Delphi study to establish consensus on priority areas of research and intervention in relation to the mental health consequences of child, early and forced marriages. Invited experts (n = 11), survivors (n = 27) and professionals (n = 30) participated in our Delphi. Four rounds of data collection included: a blended in-person and online workshop with invited experts, an online mixed-methods questionnaire, focus groups in Zimbabwe with women who are survivors of child marriage and a repeat questionnaire sent to the first round of experts. Quantitative data were analysed using descriptive statistics and ranking methods, consistent with other Delphi studies. Qualitative data were analysed using thematic network analysis. Findings coalesced around three areas: perspectives on the relationship between mental health and child marriage, policy actions and treatment-driven solutions. Consensus was reached on 16 items across these areas which included the need to prioritize psychosocial and social interventions to improve mental health outcomes for women and girls in existing marriages. They also called for new approaches to advocacy to drive awareness of this issue in policy circles. Implications for future practice are discussed.

Overlooked and unaddressed: A narrative review of mental health consequences of child marriages.

Child Marriage (before the age of 18) affects over 12 million young women globally, annually. Despite acknowledgement of the negative impacts of the practice on reproductive health, mental health consequences are largely overlooked. Given the ability for poor mental health to intensify other health and social challenges, understanding the mental health consequences linked to child marriage is vital. Our study is the first to examine how mental health is approached in current literature on child marriage. Our conceptual framework was informed by a rapid assessment of key issues in the field. Systematic searches of papers published between 2000-2020 were completed on four electronic databases with no language restrictions. Our protocol was registered on Prospero (CRD42019139685). Articles were assessed using PRISMA guidelines, and their quality assessed using the Joanna Briggs Institute Critical Appraisal Tools. Of the 4,457 records identified, 21 papers meeting inclusion criteria were analysed using narrative synthesis. The final sample included 5 qualitative, 1 mixed-methods and 15 quantitative studies (14 cross-sectional and 1 longitudinal study) reporting on data from 12 countries, largely in the global south. Intimate partner violence, poverty, challenges in childbirth and isolation were identified as social factors linked to emotional distress by those married as children. Depression was the most reported mental disorder. Anxiety, phobias, psychological distress, substance misuse, negative well-being and anti-social personality disorder were reported less frequently. Findings highlight that while significant emotional distress and specific mental health conditions are linked to child marriage, gaps in our understanding remain. Future studies are needed to; clarify directionality in these relationships; understand the mental health needs of young men, LGBTQI communities and those in humanitarian settings. Given the well documented cyclical relationship between social determinants and mental health conditions, we outline a series of community-oriented interventions which blend psychological, social and structural support to promote mental health and wellbeing in the contexts of child marriage.

A Scoping Review of the Factors That Influence Families' Ability or Capacity to Provide Young People With Emotional Support Over the Transition to Adulthood.

The transition to adulthood is typically marked by changes in relationships with family members, peers, and romantic partners. Despite this, the family often maintains a prominent role in young adults' lives. A scoping review was conducted to identify the factors that influence families' ability or capacity to provide young people with emotional support during the transition to adulthood, and to understand the gaps in this research area. Title and abstract searches were conducted from January 2007 to February 2021 in multiple databases, including PsycINFO, MEDLINE, and Sociological Abstracts. Fifteen semi-structured interviews were also conducted with stakeholders (professionals from relevant sectors/working within this field). In total, 277 articles were eligible for inclusion in the review. Following data extraction, 19 factors were identified. Factors with the most research (more than 20 articles) included: family proximity or co-residence; mental health; sex or gender differences; and family communication. Factors with less research included: societal context; young person's sexual orientation or gender identity; social networks; and adverse life events. Gaps in the research area were also identified, including methodological issues (e.g., lack of mixed methods and longitudinal study designs), a disproportionate focus on the parent-child relationship, and a lack of contextually situated research. Our findings indicate that future research in this area could benefit from taking an intersectional, multi-method approach, with a focus on the whole family and diverse samples.