What Works in Schools? Stakeholder Perspectives on Mental Health Intervention for Adolescents in Nepal

Access to child and adolescent mental health (CAMH) services in Nepal remains extremely limited. Most CAMH efforts focus on treatment-oriented, resource-intensive interventions that are difficult to scale. School-based mental health promotion and illness prevention offer a promising alternative, yet evidence from Nepal remains scarce. This formative study explored stakeholder perspectives to inform the development of a universal, school-based mental health promotion and illness prevention intervention. Objective To explore adolescents’, parents’, and teachers’ views on priority content, delivery approaches, and suitable delivery agents for a school-based prevention program for mental health problems. Methods The study was conducted in six community schools in Kanepokhari Rural Municipality, Nepal. Semi-structured interviews were conducted with teachers (n = 6) and parents (n = 4), alongside seven focus group discussions with adolescents (n = 47) and parents (n = 19). Framework analysis was used for data analysis. Results Participants identified bullying, menstruation-related stigma, sexual and reproductive health, substance use, and parent–child communication as priority intervention content. They recommended interactive delivery methods, sessions during school hours, and parental involvement. Preferences varied regarding group composition and facilitator selection, with many favoring trained external facilitators. Perceived benefits included improved emotional expression, strengthened family relationships, and enhanced psychosocial wellbeing. Conclusion Findings highlight the importance of contextually tailored, school-based mental health promotion and illness prevention intervention in Nepal, emphasizing relevant content, engaging methods, and meaningful parental participation to support adolescent wellbeing.