Adolescent mental health and social inequality in the aftermath of COVID-19 in Bogotá, Colombia: a qualitative study using a critical ecological model.

BACKGROUND: Adolescence is a stage of life characterised by significant biological, social, and emotional changes, making it a particularly challenging period for mental health. Young people face these challenges within environments shaped by social, cultural, and economic dynamics, often rooted in structural inequality. In urban contexts such as the megacity of Bogotá, many adolescents live in conditions of social inequality. The COVID-19 pandemic intensified pre-existing issues and introduced new challenges to adolescent mental health. This study explores the mental health of adolescents living in an urban setting characterised by social inequality, including both the benefits and challenges associated with the COVID-19 pandemic. METHODS: Using a qualitative approach, direct observations were conducted in public schools and socially vulnerable neighbourhoods in Bogotá. Complementary problem-centred interviews were carried out with adolescents and school counsellors at three public schools in these areas. The interviews focused on topics related to social inequality, mental health, and key experiences during the COVID-19 pandemic. A reflexive thematic analysis was conducted. The research adhered to national and international ethical guidelines. RESULTS: A total of 95 h of field observation were conducted, alongside 42 interviews with adolescents aged 12-18 (57% female) and six school counsellors, most of whom were female psychologists. The findings are presented through the the Critical Ecological Model of Adolescents' Mental Health, which illustrates adolescents' mental health and its changes concerning the pandemic across four levels: (a) personal: self-care, life plans, emotional distress, and post-pandemic coping; (b) interpersonal: family and peer relationships; (c) community: support networks, disadvantage, and violence; and (d) organisational/media: school-based support and mental health promotion and care. CONCLUSIONS: In urban settings marked by social inequality, supportive environments within families, schools, communities, and institutions are essential. Engaging with adolescents' perspectives highlights both their needs and their capacities to navigate challenges and support mental health across different contexts. Structural strategies are required to confront social inequalities and promote both individual and collective actions to support adolescent mental health, particularly in post-pandemic contexts.