Assessment of mental health problems among adolescents in Sri Lanka: Findings from the cross-sectional Global School-based Health Survey

Gajarishiyan Rasalingam, Arrosan Rajalingam, Miyuru Chandradasa, Mintu Nath* (Corresponding Author)

*Corresponding author for this work

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Background and Aims:
Mental health condition among adolescents is a leading cause of health-related disability in Sri Lanka. The study aims to estimate the prevalence and evaluate the associated risk factors in three major mental health domains - loneliness, anxiety and suicidal ideation - among Sri Lankan adolescents.
We conducted a secondary analysis of cross-sectional data of 3262 adolescents from the Global School-based Health Survey (GSHS) conducted by the WHO in 2016. We modeled the binary outcome variables using multivariable logistic regression models with exposures representing demography, food habits, personal hygiene, behavior, substance abuse, parental and social engagement of the respondents.
We estimated the prevalence of loneliness, anxiety and suicidal ideation as 30.8% (95% CI: 29.3, 32.5), 20.2% (95% CI: 18.8, 21.6) and 3.7% (95% CI: 3.1, 4.4), respectively, and the overall prevalence as 40.3% (95% CI: 38.6, 42.0). Mental health problems were more prevalent among females than males. Engagement with parents and close friends, adequate nutritional intake and physically active lifestyles reduced the risk of common mental health problems.
Exposure variables like food insecurity, truancy, second-hand smoking, physical fight, and being bullied increased adolescents’ risk of reported psychological problems.
We conclude that the prevalence of mental health problems in the Sri Lankan adolescent population was higher than the global average. Results suggest that future policy decisions to mitigate mental health problems among Sri Lankan adolescents should incorporate an integrated approach involving the individual, family and community to promote positive home and school environments combined with an active and healthy lifestyle.
Original languageEnglish
Article numbere886
JournalHealth Science Reports
Issue number6
Publication statusPublished - 17 Oct 2022

Bibliographical note

The authors wish to thank the World Health Organization and CDC for making the Global School-based Health Survey data publicly available. The authors also gratefully acknowledge the Ministry of Health in Sri Lanka for efforts on planning and collecting the data nationally, and thank all the participating schools, students, and other institutions for their contributions. The first author also thanks Dr Christine Kay from the School of Medicine, the University of Aberdeen
and Stephanie Whiteman from the University of the West Indies, Cave Hill Campus, Barbados,for constructive feedback.
Gajarishiyan Rasalingam was supported by the Chevening Scholarships, the UK government’s global scholarship program, funded by the Foreign, Commonwealth and Development Office (FCDO) and partner organizations. The University of Aberdeen Post Graduate Training supported the project, and the University of Aberdeen Open Access Fund supported the open access publication

Data Availability Statement

The GSHS survey data are publicly available online on the WHO website. Data are anonymized to protect individual participant’s identity. The data from Sri Lanka used in this study can also be accessed from the site. Web link:
Further details of the data policy and relevant procedures are documented in the following weblink:


  • Mental health adolescents
  • Global School-based Student Health Survey
  • Anxiety
  • Loneliness
  • Suicidal ideation


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