Factors Impacting Sustainable Implementation of Adolescent Mental Health Interventions: A Qualitative Stakeholder Analysis

Background: Mental health challenges comprise a significant share of the global disease burden among adolescents. In many global settings, mental health services are limited and few adolescent mental health interventions (AMH) exist or have been sustained. This qualitative study sought to explore stakeholder perspectives on factors that influence sustainable implementation of AMH interventions in East and Southern Africa, and to explore youth leaders’ perspectives on and experiences with delivering a mental health intervention tailored to adolescents living with HIV in Tanzania. Methods: In-depth interviews lasting between 30-60 minutes were conducted virtually with 12 participants. One focus group discussion with six participants lasting 1.5 hours was conducted in Tanzania. Data were recorded and transcribed and then coded and analyzed using Nvivo 12 Pro software. Results: Sufficient political will, civil society involvement, multisectoral approaches, health system integration, and mental health awareness are important factors for sustainable implementation. Major constraints to sustainable implementation include the absence of these factors, as well as stigma, low mental health literacy, and insufficient funding and health system capacity. Conclusions: Mental health awareness, contextual fit, and the meaningful engagement of key stakeholders influences the sustainable implementation of AMH interventions. These findings have several important implications for policy and practice.