Mental health, sexual and reproductive health, substance use and connectedness among adolescents in the overseas Caribbean territories

ABSTRACT

OBJECTIVE: To analyse mental health, sexual and reproductive health (SRH) and substance use behaviours and outcomes among adolescents in the overseas Caribbean territories and their association with family and school connectedness. SUBJECTS AND METHOD: The data were collected through aschool-based survey administered to secondary school students in Aruba, British Virgin Islands (BVI), Cayman Islands, Montserrat, St Eustatius and St Maarten. Multi country analysis was conducted through pooling and weighting of the data from the six territories. Data analysis included descriptive analysis and odds ratios to examine associations between family and school connectedness and mental health, SRH and substance use. RESULTS: Data on 4883 respondents in the age group 15–19years were used for the analysis, equally divided in males(49%) and females (51%). More than half (58.8%) of the girls reported feelings of sadness or hopelessness for more than a day and 31.2% seriously considered suicide. Approximately one-third (34.9%) made a suicide plan and 70.6% of these girls attempted suicide at least once. A quarter (23.2%) of the girls and 30.1% of the boys initiated sex before age 15 years; 58.2% of the females and 57.7%of the males used alcohol in the past 30 days and 44% ofthe boys got very drunk at least once. More than half of the adolescents reported lifetime marijuana use. Statistically significant associations were found between low family and school connectedness, and feeling sad or hopeless, suicidal thought, sexual initiation before age 15years, pregnancy, alcohol and substance use. CONCLUSIONS: The results highlight the critical importance of connectedness for adolescents to be healthy and thrive.