Mental Health Risks and Resilience Factors of Adolescents in Under-Resourced Schools

Background: Adolescent mental health has become an increasing concern globally, particularly within under-resourced urban areas where poverty, violence and limited educational resources intersect. In South Africa, adolescents in disadvantaged schools face heightened exposure to psychosocial and environmental risks that contribute to poor mental health outcomes. Understanding both the risk and resilience factors affecting this population is essential for developing culturally relevant, community-based mental health interventions. Aims: This study aimed to explore the mental health risk and resilience factors among adolescents in under-resourced schools in Johannesburg South. It further sought to examine how these factors interact within the biopsychosocial and Nsamenang's social ontogenesis theories to shape adolescent well-being. Materials and Methods: A qualitative research design was employed using semi-structured interviews, focus groups and the Incomplete Sentences projective technique. Thirty adolescents aged 13 to 18 years participated. Data were analysed using Braun and Clarke's thematic analysis. Results: Findings revealed multiple interacting risk factors across biological, psychological and social domains. Reported mental health symptoms included anxiety, sadness, sleep disturbances, intrusive thoughts and post-traumatic stress. Key risk factors were academic pressure, financial hardship, exposure to violence, substance abuse, physical health difficulties and lack of emotional support. Despite these adversities, participants demonstrated resilience through intrinsic motivation, self-care strategies, adult and peer support, and religion. Discussion: The findings underscore the biopsychosocial nature of adolescent mental health in low resource setting. These results align with mulitsystemic resilience models emphasising that resilience emerges through dynamic interactions between individual, familial, social and cultural systems. Interpersonal connectedness, particularly with trusted adults and peers, played a pivotal role in buffering the effects of chronic stress and socioeconomic disadvantage. Conclusion: This study highlights the complex interplay between risk and resilience factors shaping adolescent mental health in under-resourced schools. Effective interventions must be culturally sensitive, leveraging family, community and faith based strengths to enhance resilience. School-based mental health initiatives, teacher training and psychosocial support programmes are vital to promote well-being and reduce mental health disparities. Applying a culture based framework grounded in African social ontogenesis ensures that interventions are sustainable and contextually meaningful.