Adolescent mental health in vulnerable urban contexts in Paraguay post-COVID-19 pandemic.

This study explored the mental health and well-being of 267 adolescents in two vulnerable urban communities in Paraguay, using a mixed-methods convergent triangulation design. Quantitative measures included the Psychological Well-Being Scale for Youth (BIEPS-J), the Depression, Anxiety, and Stress Scale (DASS-21), and the Drug Abuse Screening Test (DAST-10). Qualitative data on mental health subjective experiences and community perspectives were collected through semi-structured focus groups. Results revealed that a significant portion of adolescents reported moderate-to-extremely severe levels of depression and anxiety, the majority reported no or only mild stress. Overall psychological well-being scores were favorable, scoring highest in self-acceptance and interpersonal relationships, and lowest in personal projects. Multiple regression analyses showed that stress and drug use were significant negative predictors of psychological well-being, while anxiety, stress, and age positively predicted depression. Qualitative findings highlighted risk factors such as emotional isolation, pressure, and stigma; as well as protective resources, including supportive friendships, community groups (e.g., parish, sports) and future aspirations. These findings underscore the importance of community-based psychosocial interventions that address distress while reinforcing protective factors already present in adolescents' environments.