Development of a Family-Based Prevention Model for Adolescent Mental Health Problems: A Socio-Ecological Approach in the Indonesian Context.

Abstract

Background: Adolescent mental health is a growing global concern, particularly in low- and middle-income countries where preventive frameworks remain underdeveloped. In Indonesia, existing adolescent mental health initiatives remain largely school- and health-service oriented, with limited operational integration of families as preventive actors. This study aimed to develop a Family-Based Prevention Model for Adolescent Mental Health Problems using a socio-ecological approach tailored to the Indonesian context.

Methods: Employing an exploratory sequential mixed-methods design, qualitative data from adolescents, parents, educators, health providers, and policy stakeholders were analyzed to construct a conceptual model, followed by quantitative validation through a three-round Delphi process with 14 experts.

Results: The qualitative phase identified five key dimensions of the socio-ecological model: individual, family, organizational, community, and policy, with the family dimension emerging as the most influential factor in adolescent mental health prevention. Within the socio-ecological framework, the family dimension emerges as a central determinant in adolescent mental health, given its position as the closest and most immediate environment to adolescents. The themes identified within the family dimension included family attachment, family supervision, family communication, parenting practices, family relationships, and family support. Quantitative findings achieved full expert consensus across six elements, confirming the model's coherence and applicability.

Conclusion: The model positions family engagement as the core preventive mechanism, rather than a family-only approach, reinforced by cross-sectoral collaboration and enabling policy environments. This study contributes to the body of knowledge by integrating family processes within the socio-ecological model and offering a culturally grounded framework for adolescent mental health promotion. Further empirical testing is required to evaluate the model's effectiveness across diverse Indonesian regions and adolescent age groups. The model has the potential to inform national strategies and guide future empirical evaluations aimed at strengthening family-based prevention and intersectoral collaboration in Indonesia.