Working with the United States Agency for International Development (USAID), YouthPower Learning led a multi-country analysis of GSHS to investigate the associations between bullying, violence and other risk and protective factors that contribute to poor mental health among in-school adolescent girls and boys (ages 13-17). USAID was interested in investigating the gendered drivers of poor mental health and its association with other health and development outcomes including substance use, sexual activity, violence and suicide. The GSHS, developed by the World Health Organization (WHO) in collaboration with UNICEF, UNESCO and UNAIDS, uses a cross-sectional study design to assess self-reported student health and risk behaviors. This study includes data from six countries from different regions around the world—Cambodia, El Salvador, Ghana, Iraq, Maldives, and Swaziland—that participated in the GSHS between 2009 and 2013. The GSHS assesses a broad range of health behaviors (including mental health, sexual and reproductive health questions, and protective factors) for in-school adolescents.
Poor mental health was assessed using questions across all six countries that focused on feeling lonely, worry that affected sleep, and suicide plans within the past 12 months. Using multiple logistic regression analyses, we used the GSHS data to investigate the associations between gender and school-related risk factors (bullying), substance use, parenting factors (whether a parent understands the adolescent’s worries or problems, monitors his/her homework, or is aware of what s/he does on her/his free time), and mental health. We assessed peer victimization using a question about how often a student was bullied in the past 30 days.