Perceptions of Brazil's Bolsa Família cash transfer programme, life opportunities and mental health in the lives of young adults from the outskirts of São Paulo: qualitative study.

Backgound: Cash transfer programmes (CTPs) provide financial support to alleviate poverty and promote economic stability. The Bolsa Família Programme (BFP), a Brazilian initiative and the world's largest CTP by number of beneficiaries, aims to improve living conditions. While poverty is closely linked to poor mental health, evidence regarding the specific effects of CTPs on young adults' mental health remains limited, underscoring the need for further research.

Aims: To understand the meaning attributed to the BFP by young adults regarding their future aspirations and mental health, as well as perspectives from providers.

Method: This qualitative study was conducted at the outskirts of São Paulo city, involving 12 in-depth interviews with young adults aged 18-24 years and 2 focus groups comprising 17 health and social assistance professionals.

Results: Thematic analysis identified four themes according with interviews and focus groups: (a) perceptions about poverty (hopelessness and lack of opportunities); (b) impact of poverty on mental health (anxiety, unpredictability and hopelessness as consequences of living in poverty); (c) young adults' needs and aspirations (job opportunities as the main expectation for a better future); and (d) BFP limitations and opportunities for improvement (BFP perceived as just one of the survival strategies but not impacting life opportunities for young adults).

Conclusions: The BFP was valued as essential for meeting poor families' basic needs. Employment opportunities were central to young adults' expectations, often causing anguish and anxiety. Expanding the BFP to include employment and income-generation policies could better support the mental health and life opportunities of vulnerable youth.