A Qualitative Study of How Adolescents’ Use of Coping Strategies and Support Varies in Line with Their Experiences of Adversity

Background Adolescence is associated with a rise in the incidence of mental health issues. Thus, the factors, processes, and contexts that protect and promote positive mental health in adolescence are of key interest to policymakers. Objective Our aim was twofold: First, to explore the coping strategies and sources of support that adolescents identify as protective (or not) in the face of difficulty over a three-year period; second, to examine how and why this may vary in line with the levels of adversity that they report experiencing in life. Methods Participants were attending schools in England implementing a mental health prevention programme called HeadStart. 93 semi-structured interviews were conducted with 31 adolescents (age 11-12 at the outset of the study; 58% female) once per year over three years. The interviews were analysed using thematic analysis. Results Six coping strategy themes (e.g., 'Disengaging from problems') and five support themes (e.g., 'Parents as a source of comfort and advice') were derived from the interviews. The types, quality, and consistency of reported coping strategies and support varied in line with whether adolescents were experiencing higher or lower levels of adversity in life over time, and according to the resources that they had available within their physical and social contexts. Conclusions Our findings underscore the importance for mental health prevention programmes of bolstering both individual-level coping strategies and the resources available within adolescents' environments to help them to manage adversity.