Multi-level determinants of mental health in young people: an umbrella review
J Dratva, M Dey, S Feer, L Abegg, I BaumannAbstract
Background
Mental health problems in young people have shown increasing trends. Identifying modifiable risk and protective factors is essential to inform prevention and policy. This umbrella review synthesizes current evidence on determinants of mental health among individuals aged 6–24 years.
Methods
Systematic reviews and meta-analyses published since 2015 were identified through PubMed. Predefined inclusion and exclusion criteria were applied. The determinants reported in the included reviews were classified across ecological levels; some reviews contributed to multiple levels.
Results
Overall, 157 systematic reviews and meta-analyses were included, comprising 7–341 primary studies each, including ≤30% European studies. Most evidence focused on individual-level determinants (n = 116), such as physical activity and social media use. Family-related factors (e.g., parental mental disorder) were examined in 56 publications, followed by broader social network factors (e.g., peer bullying) in 43, environmental influences (e.g., access to green space) in 30, and societal-level determinants (e.g., social inequality) in 14. Depression and anxiety were the most common outcomes, while positive mental health indicators were underrepresented.
Conclusions
Key gaps include limited longitudinal evidence, sparse European data, underrepresentation of higher ecological levels, limited multilevel analyses, and insufficient attention to intersectionality.