Perceptions of Mental Health Challenges and Needs of Indonesian Adolescents: A Descriptive Qualitative Study
Introduction Adolescents, defined as persons aged 10–19 years, experience a critical period of vulnerability and stress, characterised by conflicts with authority figures such as parents and teachers, peer acceptance, self‐discovery and romantic relationships (Núñez‐Regueiro and Núñez‐Regueiro ; World Health Organization ). Parental conflicts arise from adolescents' autonomy demands and emotional needs unmet by parents (Mastrotheodoros et al. ). High conflict and discord in teacher‐student relationships can negatively affect adolescents' socioemotional development (Ettekal and Shi ). Peer conflicts and bullying are significant stressors for adolescents, affecting their sense of safety and belonging (Skarstein, Helseth, and Kvarme ). Internalised societal beauty standards and external pressures contribute to negative body image and low self‐esteem in adolescents, hindering self‐discovery and fostering unrealistic ideals that undermine their sense of self‐worth (Tort‐Nasarre et al. ). Given these challenges, adolescents are at risk for developing mental health conditions. Mental health conditions (MHCs) represent a critical public health challenge for adolescents globally. Comprising 13% of the total disease burden in this age group, nearly one in seven adolescents experiences an MHC, with anxiety and depression accounting for nearly 40% of cases (World Health Organization ). Untreated MHC during adolescence can lead to dire consequences, including poor physical health, impaired social functioning, substance abuse disorders, self‐injurious behaviours and increased risk of suicide (Radez et al. ). MHCs amongst adolescents often persist into adulthood, leading to long‐term morbidity and posing a global socioeconomic burden (Radez et al. ). Adolescents worldwide are increasingly vulnerable to mental health conditions, a situation worsened by adverse socioeconomic factors, widespread stigma and discrimination and limited access to comprehensive psychosocial support services. (World Health Organization ). In Indonesia, one‐third of adolescents reported experiencing MHC symptoms in 2021 (Center for Reproductive Health et al. ). Anxiety and depression constitute 32% of MHCs in Indonesian adolescents (Center for Reproductive Health et al. ). Factors such as poor family connections, high academic pressure, conflicts related to spirituality and religiosit and exposure to adverse societal pressures on social media have been linked to poor adolescent mental well‐being in Indonesia (Willenberg et al. ). Moreover, cultural norms considerably influence Indonesian adolescents' perceptions of mental health (Brooks, Windfuhr, et al. ). Research has shown that mystical and supernatural forces are often seen as causes of mental illness in Indonesia (Marthoenis, Aichberger, and Schouler‐Ocak ), whereas stigma negatively impacts health conceptualisations and help‐seeking behaviours (Willenberg et al. ). Mental health literacy amongst Indonesian adolescents is generally poor, and the strong emphasis on religion and spirituality in Indonesian culture may contribute to reluctance to discuss mental health issues (Brooks, Prawira, et al. ). With mental health problems being considered taboo and highly stigmatised in Indonesian communities (Putri et al. ), adolescents with mental health conditions have reported struggling to access the healthcare support they need. Hence, understanding mental health support needs for adolescents in Indonesia is an urgent need. Mental health services in Indonesia are covered by the national health insurance programme (Presidential Regulation of the Republic of Indonesia ). Despite 33% of adolescents reporting psychological distress, only 2% use mental health support services (Center for Reproductive Health et al. ). This finding implied that Indonesia urgently needs to understand adolescents' needs and perceptions of mental health challenges and accordingly establish improved adolescent mental health education (Putri et al. ). Education and mental health services are compulsory for all schools through Indonesia's school health services programme (Indonesian Ministry of Education ). In Jakarta, 86.67% of public schools conduct mental health education, 53.3% implement mental health screening and 80% provide counselling (Kusumawardani et al. ). Teachers and students involved in mental health services highlight that the programme's curriculum has several issues, from limited funding, lack of teachers' training, parental awareness about mental health issues and traditional cultural beliefs and stigma around mental health (Kusumawardani et al. ). Hence, adolescents' mental health challenges and needs must be explored further to develop effective methods of managing mental health issues. Existing qualitative studies on Indonesian adolescents' mental health perceptions have been constrained by limited age ranges, narrow geographic coverage and reliance on group interviews and have not adequately identified adolescents' specific mental health needs (Brooks, Windfuhr, et al. ; Willenberg et al. ). Brooks, Windfuhr, et al.  provided valuable insights into adolescents' conceptualisation of mental health by including healthy individuals and those diagnosed with mental health conditions. Whilst this inclusive approach offered a broad understanding of mental health beliefs across diverse mental health statuses, it may have obscured the unique perspectives of healthy adolescents. These individuals might conceptualise mental health differently from those with diagnosed conditions. Similarly, Willenberg et al.  examined adolescents' conceptualisation of mental health and its determinants, incorporating school‐attending and non‐school‐attending individuals in focus group discussions. However, this approach may have restricted the exploration of individual experiences, particularly regarding how school‐related factors impact adolescents' views on mental health. Moreover, the use of focus groups in this study, though beneficial for facilitating collective dialogue, may have limited the depth of individualised experiences, especially concerning personal reflections on mental health. To address these research gaps, the present study aims to understand adolescents' perspectives on mental health challenges and needs, taking into account Indonesia's diverse cultural and social factors. It also considers the taboo nature of mental health discussions in Asian contexts (Cogan et al. ). By employing individual interviews and school‐attending adolescents, this study seeks to provide a nuanced understanding of mental health perceptions amongst Indonesian adolescents. 1.1 Aim and Research Question This study aimed to explore and understand Indonesian adolescents' perceptions of their mental health challenges and needs. The central research question was: What are Indonesian adolescents' views on their mental health challenges and support needs?   Aim and Research Question This study aimed to explore and understand Indonesian adolescents' perceptions of their mental health challenges and needs. The central research question was: What are Indonesian adolescents' views on their mental health challenges and support needs?   Methods 2.1 Research Design This study utilised a descriptive qualitative design and is part of a larger ongoing mixed‐methods research project. While the quantitative component focuses on factors influencing adolescents' mental health literacy and overall psychological well‐being, its findings will be reported separately (Yani et al. ). The qualitative aspect, as outlined by Sandelowski , aimed to explore comprehensive insights into Indonesian adolescents' mental health challenges, perspectives and support needs, ultimately ensuring their psychological well‐being. This study provides a deeper understanding of how Indonesian adolescents view mental health and seek help. The study was presented per the consolidated criteria for reporting qualitative research studies (COREQ) checklist (Tong et al. ). 2.2 Context A total of 615 adolescents were recruited from four public schools in West Java Province, Indonesia, for the quantitative study and 14 participated in this qualitative study. West Java Province is Indonesia's most populous province, home to approximately 49 million people and the population is predominantly Sundanese and Muslim (BPS‐Statistics of West Java Province ). 2.3 Participants Adolescent participants were purposefully selected according to the following criteria: (1) aged 13–19 years, this age range was chosen because metacognitive abilities refine up to age 13 (Geurten, Meulemans, and Lemaire ); (2) enrolled in an Indonesian public high school; (3) fluent in English or Bahasa; and (4) have varied mean mental health literacy scores ranging from 0 to 13 as measured by the mental health literacy scale (Carr et al. ; Kaligis et al. ). The Mental Health Literacy Scale comprised 13 items and higher scores indicating better mental health literacy (Carr et al. ; Kaligis et al. ). Participants were not screened for or excluded based on existing mental health conditions. Adolescents with cognitive, auditory or visual impairments, along with those having medical conditions that might hinder their ability to fully participate in the study, were excluded. Data saturation is the point at which no new information emerges from the interviews (Guest, Bunce, and Johnson ) and was reached after interviewing 12 participants. Two additional interviews were performed to confirm the findings. Transcriptions were completed promptly after each interview, allowing for concurrent analysis and enabling the researchers to identify emerging patterns and themes during the data collection process. Data collection was concluded once no new themes or insights were identified and data saturation was achieved from the additional data (Saunders et al. ). 2.4 Data Collection The study was conducted at two public schools (one junior high school and one senior high school) in West Java Province, Indonesia. After obtaining ethics approval, teachers at these schools, both females, screened and referred adolescents meeting the eligibility criteria to the research team. The primary researcher (D.I.Y.), a female PhD student registered nurse with no direct influence over adolescents' education, approached potential school participants. The primary researcher received training in qualitative interviewing techniques from an experienced qualitative researcher (S.S.). The study details were explained to adolescents and parents using a Participant Information Sheet. The parents' voluntary informed consent and adolescents' assent were obtained using an online form shared via a secure link. Sociodemographic details, e.g. age and gender, were collected online from the participants before the interviews. One‐on‐one, face‐to‐face interviews were conducted in one of the school's private meeting rooms to provide an uninterrupted and conducive environment for the interviews (Bolderston ). A semi‐structured interview guide with open‐ended questions, supplemented by follow‐up and probing questions, was developed based on the literature (Meldahl et al. ; Soria‐Martínez et al. ) and pilot‐tested before the actual interviews. Adolescents were asked questions about mental health challenges, knowledge and experiences with depression and anxiety, as well as perceived mental health needs. The interview guide used for this study is appended in Appendix . The open‐ended questions guided the main flow (Doody and Noonan ; McGrath, Palmgren, and Liljedahl ), and the follow‐up probing questions allowed the researchers to seek clarity and further insights (DeJonckheere and Vaughn ). Data collection occurred in December 2023. All the interviews were conducted in Bahasa and audio‐recorded with the participant's permission, averaging 36 min. The bilingual (fluent in speaking and writing English and Bahasa Indonesia) primary researcher and research assistants transcribed all the recordings verbatim in Bahasa and then back‐translated to English (Chen and Boore ). The field notes of nonverbal responses and expressions were documented in English after each interview and were analysed with the interviews. All the interviews were conducted by the same primary researcher (D.I.Y.). 2.5 Data Analysis All analyses were conducted using English transcripts and field notes. The data analysis followed a six‐phase thematic analysis approach: (1) data familiarisation, (2) initial coding, (3) searching for themes, (4) reviewing themes, (5) defining and naming themes, and (6) producing a report (Braun and Clarke ). All transcripts and field notes were read multiple times to gain familiarity with the collected data. An initial set of codes was then generated using a manual colour‐coding system to categorise related segments, which were subsequently organised into overarching themes and subthemes. The primary researcher (D.I.Y.) and co‐researcher (J.Y.X.C.) independently coded all transcripts. They then meticulously compared their codes, and codes with the same meaning were tallied. Approximately 87% of the codes were similar between the two authors. Extensive discussions occurred amongst all authors to compare analyses and finalise the themes. Any conflicts were resolved by consulting the senior researcher (S.S). This process of multiple analyst triangulation between the authors helped ensure the credibility of the analytical process. 2.6 Rigour To maintain trustworthiness, this study ensured credibility, dependability, transferability and confirmability (Lincoln and Guba ; Nowell et al. ). Credibility was established by thoroughly and repeatedly examining the transcripts to confirm that the resulting themes accurately reflected adolescents' perceptions of their mental health needs (Lincoln and Guba ; Nowell et al. ). To further enhance credibility, regular peer debriefing sessions were conducted. During these sessions, emerging themes and interpretations were reviewed by research team members not directly involved in data collection, with assumptions being challenged and fresh perspectives on the analysis being provided (Lincoln and Guba ; Nowell et al. ). Transferability was enhanced by providing detailed, vivid descriptions of adolescents' experiences using verbatim interview quotes (Lincoln and Guba ; Nowell et al. ). An audit trail was created to ensure confirmability and dependability by retaining copies of all transcripts (in Bahasa and English), field notes, author reflections and supporting documentation (Lincoln and Guba ; Nowell et al. ). Furthermore, all authors kept detailed personal reflective journals throughout the analysis to strengthen reflexivity and ensure the findings' authenticity (Barrett, Kajamaa, and Johnston ; Buetow ). In these journals, thoughts, feelings and potential biases related to the study were documented (Buetow ). Regular team meetings were held to discuss these reflections, allowing for a critical examination of how personal experiences and perspectives might influence data interpretation and for adjustments to be made to the approach accordingly (Nowell et al. ). 2.7 Ethical Consideration The study received ethics approval from the Universitas Padjadjaran Institutional Review Board (Reference number: 1405/UN6.KEP/EC/2023), located in Bandung, West Java Province, Indonesia. Voluntary participation was reinforced during study recruitment, and each adolescent was assigned a unique code number to protect their identity and ensure the anonymity and confidentiality of the collected data. The consent and demographic forms were securely stored on a standalone password‐protected computer, and the audio recordings and transcripts were kept on a separate computer.   Research Design This study utilised a descriptive qualitative design and is part of a larger ongoing mixed‐methods research project. While the quantitative component focuses on factors influencing adolescents' mental health literacy and overall psychological well‐being, its findings will be reported separately (Yani et al. ). The qualitative aspect, as outlined by Sandelowski , aimed to explore comprehensive insights into Indonesian adolescents' mental health challenges, perspectives and support needs, ultimately ensuring their psychological well‐being. This study provides a deeper understanding of how Indonesian adolescents view mental health and seek help. The study was presented per the consolidated criteria for reporting qualitative research studies (COREQ) checklist (Tong et al. ).   Context A total of 615 adolescents were recruited from four public schools in West Java Province, Indonesia, for the quantitative study and 14 participated in this qualitative study. West Java Province is Indonesia's most populous province, home to approximately 49 million people and the population is predominantly Sundanese and Muslim (BPS‐Statistics of West Java Province ).   Participants Adolescent participants were purposefully selected according to the following criteria: (1) aged 13–19 years, this age range was chosen because metacognitive abilities refine up to age 13 (Geurten, Meulemans, and Lemaire ); (2) enrolled in an Indonesian public high school; (3) fluent in English or Bahasa; and (4) have varied mean mental health literacy scores ranging from 0 to 13 as measured by the mental health literacy scale (Carr et al. ; Kaligis et al. ). The Mental Health Literacy Scale comprised 13 items and higher scores indicating better mental health literacy (Carr et al. ; Kaligis et al. ). Participants were not screened for or excluded based on existing mental health conditions. Adolescents with cognitive, auditory or visual impairments, along with those having medical conditions that might hinder their ability to fully participate in the study, were excluded. Data saturation is the point at which no new information emerges from the interviews (Guest, Bunce, and Johnson ) and was reached after interviewing 12 participants. Two additional interviews were performed to confirm the findings. Transcriptions were completed promptly after each interview, allowing for concurrent analysis and enabling the researchers to identify emerging patterns and themes during the data collection process. Data collection was concluded once no new themes or insights were identified and data saturation was achieved from the additional data (Saunders et al. ).   Data Collection The study was conducted at two public schools (one junior high school and one senior high school) in West Java Province, Indonesia. After obtaining ethics approval, teachers at these schools, both females, screened and referred adolescents meeting the eligibility criteria to the research team. The primary researcher (D.I.Y.), a female PhD student registered nurse with no direct influence over adolescents' education, approached potential school participants. The primary researcher received training in qualitative interviewing techniques from an experienced qualitative researcher (S.S.). The study details were explained to adolescents and parents using a Participant Information Sheet. The parents' voluntary informed consent and adolescents' assent were obtained using an online form shared via a secure link. Sociodemographic details, e.g. age and gender, were collected online from the participants before the interviews. One‐on‐one, face‐to‐face interviews were conducted in one of the school's private meeting rooms to provide an uninterrupted and conducive environment for the interviews (Bolderston ). A semi‐structured interview guide with open‐ended questions, supplemented by follow‐up and probing questions, was developed based on the literature (Meldahl et al. ; Soria‐Martínez et al. ) and pilot‐tested before the actual interviews. Adolescents were asked questions about mental health challenges, knowledge and experiences with depression and anxiety, as well as perceived mental health needs. The interview guide used for this study is appended in Appendix . The open‐ended questions guided the main flow (Doody and Noonan ; McGrath, Palmgren, and Liljedahl ), and the follow‐up probing questions allowed the researchers to seek clarity and further insights (DeJonckheere and Vaughn ). Data collection occurred in December 2023. All the interviews were conducted in Bahasa and audio‐recorded with the participant's permission, averaging 36 min. The bilingual (fluent in speaking and writing English and Bahasa Indonesia) primary researcher and research assistants transcribed all the recordings verbatim in Bahasa and then back‐translated to English (Chen and Boore ). The field notes of nonverbal responses and expressions were documented in English after each interview and were analysed with the interviews. All the interviews were conducted by the same primary researcher (D.I.Y.).   Data Analysis All analyses were conducted using English transcripts and field notes. The data analysis followed a six‐phase thematic analysis approach: (1) data familiarisation, (2) initial coding, (3) searching for themes, (4) reviewing themes, (5) defining and naming themes, and (6) producing a report (Braun and Clarke ). All transcripts and field notes were read multiple times to gain familiarity with the collected data. An initial set of codes was then generated using a manual colour‐coding system to categorise related segments, which were subsequently organised into overarching themes and subthemes. The primary researcher (D.I.Y.) and co‐researcher (J.Y.X.C.) independently coded all transcripts. They then meticulously compared their codes, and codes with the same meaning were tallied. Approximately 87% of the codes were similar between the two authors. Extensive discussions occurred amongst all authors to compare analyses and finalise the themes. Any conflicts were resolved by consulting the senior researcher (S.S). This process of multiple analyst triangulation between the authors helped ensure the credibility of the analytical process.   Rigour To maintain trustworthiness, this study ensured credibility, dependability, transferability and confirmability (Lincoln and Guba ; Nowell et al. ). Credibility was established by thoroughly and repeatedly examining the transcripts to confirm that the resulting themes accurately reflected adolescents' perceptions of their mental health needs (Lincoln and Guba ; Nowell et al. ). To further enhance credibility, regular peer debriefing sessions were conducted. During these sessions, emerging themes and interpretations were reviewed by research team members not directly involved in data collection, with assumptions being challenged and fresh perspectives on the analysis being provided (Lincoln and Guba ; Nowell et al. ). Transferability was enhanced by providing detailed, vivid descriptions of adolescents' experiences using verbatim interview quotes (Lincoln and Guba ; Nowell et al. ). An audit trail was created to ensure confirmability and dependability by retaining copies of all transcripts (in Bahasa and English), field notes, author reflections and supporting documentation (Lincoln and Guba ; Nowell et al. ). Furthermore, all authors kept detailed personal reflective journals throughout the analysis to strengthen reflexivity and ensure the findings' authenticity (Barrett, Kajamaa, and Johnston ; Buetow ). In these journals, thoughts, feelings and potential biases related to the study were documented (Buetow ). Regular team meetings were held to discuss these reflections, allowing for a critical examination of how personal experiences and perspectives might influence data interpretation and for adjustments to be made to the approach accordingly (Nowell et al. ).   Ethical Consideration The study received ethics approval from the Universitas Padjadjaran Institutional Review Board (Reference number: 1405/UN6.KEP/EC/2023), located in Bandung, West Java Province, Indonesia. Voluntary participation was reinforced during study recruitment, and each adolescent was assigned a unique code number to protect their identity and ensure the anonymity and confidentiality of the collected data. The consent and demographic forms were securely stored on a standalone password‐protected computer, and the audio recordings and transcripts were kept on a separate computer.   Results 3.1 Characteristics of the Participants The study included 14 adolescents (mean age = 14.43 years, SD = 1.22). Of these, eight (57%) were male, and six (43%) were female. Nine (64%) attended junior high school, whereas five (36%) were in senior high school. Most participants were Muslim ( n = 12, 86%) and of Sundanese ethnicity ( n = 12, 86%, Table ). The range of mental health scores of adolescents who participated in the interviews was 0–7, out of a possible range of 0–13, and the mean score was 3.93 (SD = 2.13). Adolescents' perceptions of mental health and mental health needs were consolidated into three themes and eight subthemes (Figure and Table ). The main themes were: (1) Transitioning to adulthood: journeys through emotional turmoil and societal expectations; (2) Navigating challenges: Diverse adolescent responses; and (3) Breaking the silence: empowering adolescents through comprehensive mental health education and support (Figure ). 3.2 Transitioning to Adulthood: Journeys Through Emotional Turmoil and Societal Expectations This theme highlighted the mental health challenges faced by adolescents as they transitioned into adulthood and was supported by three subthemes: emotional turmoil; growing pains; aspirations, motivations and desires. 3.3 Emotional Turmoil Many adolescents reported struggling with varied stressors and emotions in their lives, ranging from difficulties in controlling their emotions to experiencing anger outbursts and low moods without any apparent reason. A few female adolescents attributed their ‘mood swings’ to the hormonal fluctuations experienced during their menstruation. I can say I get angry easily too, and it's hard to control myself… when it's my period, the mood is always messed up. (Junior High Student 2) Some adolescents also felt self‐conscious about their outlook and afraid of being judged negatively by their peers. A few of those who were being bullied and victimised at school felt ‘stressed’ when they had no friends to ‘trust’. Some adolescents who were exploring romantic relationships with the opposite gender felt ‘worthless’ and insecure when the relationships did not work out well. When someone doesn't like me, I keep thinking about what's lacking in me. So I keep thinking and end up feeling stressed, like constantly introspecting until it becomes overwhelming. (Senior High Student 5) Family conflicts also contribute to adolescents' psychological distress. Many felt unsupported by their parents and ‘hurt’ when their parents reprimanded them ‘harshly’. Moreover, adolescents felt distressed whenever they thought about their past traumatic experiences (e.g., being sexually harassed in school) or worried about future adverse events that could happen (e.g., parents undergoing a divorce). I tend to imagine bad things that haven't happened yet, like for example, if there's an event and I imagine what if it fails… when I was in elementary school, I experienced sexual harassment… maybe every time there's a guy, I might imagine… that incident. (Senior High Student 2) 3.4 Growing Pains Some adolescents experience anxiety and stress related to school factors such as exams and academic pressure, as well as from outside activities such as sports club competitions. They felt ‘nervous’ before an exam and were ‘afraid of failure’. Like nervousness before exams, before performing, it's panic, fear… It's somewhat alleviated, but still a bit nervous but not too much… just regular anxiety. (Junior High Student 6) Adolescents also struggle with self‐esteem and body image issues. Some felt ‘shy’, ‘weak’, or labelled themselves as ‘nerds’ due to their appearance, whereas others struggled with weight concerns. These negative self‐perceptions were influenced by physical characteristics and past traumatic experiences, which had a lasting influence on self‐image. Maybe because I was a nerd, yeah, maybe because I wore glasses, they thought I was a nerd, weak, you know. Usually, others see me as weak. (Junior High Student 9) Moreover, adolescents struggle with a conflict between their desire for independence and self‐exploration and the limitations imposed by their parents. They believe it is better to ‘rely on themselves’ and not excessively on their parents. Furthermore, some adolescents have been encouraged from early life to be independent—learning, studying and reading alone. They [parents] just don't let me. Oh, yeah, they don't let me play carelessly. Going out randomly…my life is very controlled. (Junior High Student 1) 3.5 Aspirations, Motivations and Desires in Adolescence Adolescents aspire to a fulfilling career and meaningful life, with goals ranging from talent‐based careers (e.g., famous football player) to business careers for financial security (e.g., CEO of a company). However, these aspirations often differed from parental expectations. Some adolescents reluctantly gave up their dreams to meet family expectations, whereas others attempted to balance their aspirations with their parent's wishes. A few changed their minds, aligning more closely with parental views. Furthermore, some adolescents remained uncertain about their future goals and career paths. Beyond career aspirations, adolescents also valued personal fulfilment. They expressed desires for meaningful relationships, including close ‘friendships’ characterised by mutual support, trust and understanding. They also sought a sense of belonging and comfort in their social environments. Oh, my mom wants the best, I have to be the best for my mom, for my dad, so I'm pressuring myself, I have to be the best, I can't just be mediocre, I can't just be like that, you know. (Junior High Student 8) 3.6 Navigating Challenges: Diverse Adolescent Responses This theme presented adolescents' two distinctly different ways of coping with the mental health challenges they faced using two subthemes: into the shadows, which covers adolescents' maladaptive coping strategies, and balancing act, which covers adolescents' coping strategies. 3.7 Into the Shadows: Adolescents Maladaptive Coping Strategies Some adolescents had problems coping with life's stressors and they adopted maladaptive coping techniques. They avoided conflicts with friends and family members by ‘distancing’ themselves from their loved ones, staying ‘silent’ or ‘crying alone’. These adolescents were aware of risky behaviours, such as smoking, drinking and drug use, recognising their harmful nature. Just accepted it [the uncomfortable situation]. Lazy to make trouble. Just don't like having problems…just distance myself. (Junior High Student 4) A small number of adolescents experienced severe emotional distress, manifesting in various concerning behaviours. A few reported having suicidal thoughts, whereas others engaged in self‐harm using sharp tools, although without intent to die. These individuals often continued the self‐harming behaviour, experiencing an emotional release during the act, particularly when seeing blood. This troubling pattern provided a misguided sense of comfort or relief from their distress. The behaviour extended to social media interactions, with adolescents posting about their self‐harm and receiving responses from friends. In one extreme case, an individual engaged in reckless behaviour, walking carelessly on busy roads and risking her life. … I just needed peace. I just cry alone… I even used to self‐harm… When I felt upset… I self‐harmed again… As for me, when I post SW (status WhatsApp) but I like it… I often do that… help me to get a friend's attention. (Junior High Student 7) 3.8 Balancing Act: Adolescents' Coping Strategies Some adolescents employed healthy coping mechanisms to manage stress and maintain emotional balance. They engaged in various self‐chosen leisure activities, such as ‘reading’, ‘sports’, ‘listening to music’, ‘games’ and ‘drawing’. These activities served multiple purposes by providing a psychological distraction from stressors, bringing joy and promoting calmness. By engaging in these enjoyable pursuits, adolescents found stress relief, experienced positive emotions and gained control over their leisure time. Furthermore, some incorporated spiritual practices into their routines as coping mechanisms, such as ‘praying’ and ‘reciting’ the Quran. Yes, it helps… especially prayer, there was a time when I was crying and everything, it was really calming… (Senior High Student 1) Social support emerged as crucial, with many adolescents relying on friends and family for emotional support and companionship. Adolescents turned to their friends or family to share their stress and concerns. These supportive individuals played a vital role by listening attentively, offering understanding and providing encouragement. Friends and family members ‘cheered’ and ‘encouraged’ them, boosting their morale and helping them face their difficulties with renewed strength. They [close friends] cheer me up, we encourage each other. What is it, words like don't give up on exams, don't be… I don't know, just stay motivated. (Junior High Student 5) 3.9 Breaking the Silence: Empowering Adolescents Through Comprehensive Mental Health Education and Support The theme highlighted the need to empower adolescents with comprehensive mental health education and support and was supported by three subthemes: fostering mental health literacy, building bridges between parents and adolescents, creating a culture of kindness, and fostering kindness via peer support. 3.10 Fostering Mental Health Literacy Adolescents showed limited mental health literacy but expressed eagerness to learn more. They believed that their parents and teachers also needed ‘awareness’ of mental health, as mental health issues were often misunderstood or dismissed. To improve school mental health programmes, adolescents suggested incorporating engaging activities to catch their attention and create a safe environment. They emphasised using storytelling, ‘games’, and ‘icebreakers’ to promote understanding and open communication about mental health. Given the potentially sensitive nature of mental health, these interactive approaches would help make the topic approachable and memorable, allowing adolescents to engage with the material in a relaxed and comfortable setting. Just keep it relaxed, with icebreakers. Icebreakers are good… explain about mental health. (Senior High Student 4) Adolescents preferred programmes led by experienced mental health professionals with credible expertise and experience in mental health. They favoured ‘face‐to‐face’ interactions as they found in‐person interactions more ‘comfortable’ and ‘honest’. They also desired individual sessions for personal issues and large peer‐group activities to encourage engagement and shared understanding for general mental health literacy education. Because if it's in‐person, it's more comfortable, like if you want to cry, there's someone to hug or comfort you, so it's nicer… can share personal struggles. (Junior High Student 2) Actually, it's better if it's directly from the specialised healthcare workers. Because they are definitely trained and educated. sharing things in a group setting will help us to be less shy to understand mental health openly. (Senior High Student 2) 3.11 Building Bridges Between Parents and Adolescents Adolescents craved a deep connection with their parents. They longed to express their emotions openly without fear of being ‘scolded’, facing ‘anger’, or enduring ‘lectures’. Many adolescents wanted emotional support from their parents during challenging times, desiring understanding rather than criticism. Some adolescents hesitated to ‘joke’ or be light‐hearted around their parents due to unpredictable tempers or a lack of ‘quality time’. It's like we rarely meet and talk. Parents, I just want to hang out [with them] but they rarely have time. (Junior High School 4) Adolescents expressed a desire for their parents to be involved in mental health programmes, seeing these as ways to improve family connections. They suggested programmes that could teach parents about adolescent mental health, helping parents to ‘understand’ them well. These adolescents also recognised their need for education on communicating effectively with their parents. They believed parents could offer meaningful ‘support’ and ‘encouragement’ with both sides being well‐informed. However, some adolescents worried that increased parental involvement might initially cause ‘stress’ or discomfort, especially in families where communication was already challenging. …it's better to be open to our parents… so that our mental health doesn't deteriorate too much or something like that, let the teacher handle it along with the parents to help us better… (Junior High Student 7) …but with parents involved. Just so my parents understand my condition because I never talk about it, even when I'm sick I never say anything. (Senior High School 1) 3.12 Creating a Culture of Kindness and Fostering Kindness via Peer Support Adolescents wanted schools to become positive ‘environments’ where differences were embraced and mutual respect was the norm. To achieve this, they suggested improved school programmes to address bullying directly, ‘guidelines for witnesses’ and ‘consequences’ for those who bully others and strict enforcement of these anti‐bullying measures. Adolescents want to learn to be empathetic and caring towards their peers. They emphasised the need for education to promote understanding and compassion rather than ‘jealousy’ or ‘superiority’ and strengthen communication skills and supportive friendships. They wanted to embrace and respect differences, viewing this as a key approach to prevent bullying and create an inclusive environment. We should respect each other and know that there are limits to joking around and other things, not everything can be joked about. There's a limit to when we can joke or laugh at someone [with mental health issues]. (Junior High Student 5)   Characteristics of the Participants The study included 14 adolescents (mean age = 14.43 years, SD = 1.22). Of these, eight (57%) were male, and six (43%) were female. Nine (64%) attended junior high school, whereas five (36%) were in senior high school. Most participants were Muslim ( n = 12, 86%) and of Sundanese ethnicity ( n = 12, 86%, Table ). The range of mental health scores of adolescents who participated in the interviews was 0–7, out of a possible range of 0–13, and the mean score was 3.93 (SD = 2.13). Adolescents' perceptions of mental health and mental health needs were consolidated into three themes and eight subthemes (Figure and Table ). The main themes were: (1) Transitioning to adulthood: journeys through emotional turmoil and societal expectations; (2) Navigating challenges: Diverse adolescent responses; and (3) Breaking the silence: empowering adolescents through comprehensive mental health education and support (Figure ).   Transitioning to Adulthood: Journeys Through Emotional Turmoil and Societal Expectations This theme highlighted the mental health challenges faced by adolescents as they transitioned into adulthood and was supported by three subthemes: emotional turmoil; growing pains; aspirations, motivations and desires.   Emotional Turmoil Many adolescents reported struggling with varied stressors and emotions in their lives, ranging from difficulties in controlling their emotions to experiencing anger outbursts and low moods without any apparent reason. A few female adolescents attributed their ‘mood swings’ to the hormonal fluctuations experienced during their menstruation. I can say I get angry easily too, and it's hard to control myself… when it's my period, the mood is always messed up. (Junior High Student 2) Some adolescents also felt self‐conscious about their outlook and afraid of being judged negatively by their peers. A few of those who were being bullied and victimised at school felt ‘stressed’ when they had no friends to ‘trust’. Some adolescents who were exploring romantic relationships with the opposite gender felt ‘worthless’ and insecure when the relationships did not work out well. When someone doesn't like me, I keep thinking about what's lacking in me. So I keep thinking and end up feeling stressed, like constantly introspecting until it becomes overwhelming. (Senior High Student 5) Family conflicts also contribute to adolescents' psychological distress. Many felt unsupported by their parents and ‘hurt’ when their parents reprimanded them ‘harshly’. Moreover, adolescents felt distressed whenever they thought about their past traumatic experiences (e.g., being sexually harassed in school) or worried about future adverse events that could happen (e.g., parents undergoing a divorce). I tend to imagine bad things that haven't happened yet, like for example, if there's an event and I imagine what if it fails… when I was in elementary school, I experienced sexual harassment… maybe every time there's a guy, I might imagine… that incident. (Senior High Student 2)   Growing Pains Some adolescents experience anxiety and stress related to school factors such as exams and academic pressure, as well as from outside activities such as sports club competitions. They felt ‘nervous’ before an exam and were ‘afraid of failure’. Like nervousness before exams, before performing, it's panic, fear… It's somewhat alleviated, but still a bit nervous but not too much… just regular anxiety. (Junior High Student 6) Adolescents also struggle with self‐esteem and body image issues. Some felt ‘shy’, ‘weak’, or labelled themselves as ‘nerds’ due to their appearance, whereas others struggled with weight concerns. These negative self‐perceptions were influenced by physical characteristics and past traumatic experiences, which had a lasting influence on self‐image. Maybe because I was a nerd, yeah, maybe because I wore glasses, they thought I was a nerd, weak, you know. Usually, others see me as weak. (Junior High Student 9) Moreover, adolescents struggle with a conflict between their desire for independence and self‐exploration and the limitations imposed by their parents. They believe it is better to ‘rely on themselves’ and not excessively on their parents. Furthermore, some adolescents have been encouraged from early life to be independent—learning, studying and reading alone. They [parents] just don't let me. Oh, yeah, they don't let me play carelessly. Going out randomly…my life is very controlled. (Junior High Student 1)   Aspirations, Motivations and Desires in Adolescence Adolescents aspire to a fulfilling career and meaningful life, with goals ranging from talent‐based careers (e.g., famous football player) to business careers for financial security (e.g., CEO of a company). However, these aspirations often differed from parental expectations. Some adolescents reluctantly gave up their dreams to meet family expectations, whereas others attempted to balance their aspirations with their parent's wishes. A few changed their minds, aligning more closely with parental views. Furthermore, some adolescents remained uncertain about their future goals and career paths. Beyond career aspirations, adolescents also valued personal fulfilment. They expressed desires for meaningful relationships, including close ‘friendships’ characterised by mutual support, trust and understanding. They also sought a sense of belonging and comfort in their social environments. Oh, my mom wants the best, I have to be the best for my mom, for my dad, so I'm pressuring myself, I have to be the best, I can't just be mediocre, I can't just be like that, you know. (Junior High Student 8)   Navigating Challenges: Diverse Adolescent Responses This theme presented adolescents' two distinctly different ways of coping with the mental health challenges they faced using two subthemes: into the shadows, which covers adolescents' maladaptive coping strategies, and balancing act, which covers adolescents' coping strategies.   Into the Shadows: Adolescents Maladaptive Coping Strategies Some adolescents had problems coping with life's stressors and they adopted maladaptive coping techniques. They avoided conflicts with friends and family members by ‘distancing’ themselves from their loved ones, staying ‘silent’ or ‘crying alone’. These adolescents were aware of risky behaviours, such as smoking, drinking and drug use, recognising their harmful nature. Just accepted it [the uncomfortable situation]. Lazy to make trouble. Just don't like having problems…just distance myself. (Junior High Student 4) A small number of adolescents experienced severe emotional distress, manifesting in various concerning behaviours. A few reported having suicidal thoughts, whereas others engaged in self‐harm using sharp tools, although without intent to die. These individuals often continued the self‐harming behaviour, experiencing an emotional release during the act, particularly when seeing blood. This troubling pattern provided a misguided sense of comfort or relief from their distress. The behaviour extended to social media interactions, with adolescents posting about their self‐harm and receiving responses from friends. In one extreme case, an individual engaged in reckless behaviour, walking carelessly on busy roads and risking her life. … I just needed peace. I just cry alone… I even used to self‐harm… When I felt upset… I self‐harmed again… As for me, when I post SW (status WhatsApp) but I like it… I often do that… help me to get a friend's attention. (Junior High Student 7)   Balancing Act: Adolescents' Coping Strategies Some adolescents employed healthy coping mechanisms to manage stress and maintain emotional balance. They engaged in various self‐chosen leisure activities, such as ‘reading’, ‘sports’, ‘listening to music’, ‘games’ and ‘drawing’. These activities served multiple purposes by providing a psychological distraction from stressors, bringing joy and promoting calmness. By engaging in these enjoyable pursuits, adolescents found stress relief, experienced positive emotions and gained control over their leisure time. Furthermore, some incorporated spiritual practices into their routines as coping mechanisms, such as ‘praying’ and ‘reciting’ the Quran. Yes, it helps… especially prayer, there was a time when I was crying and everything, it was really calming… (Senior High Student 1) Social support emerged as crucial, with many adolescents relying on friends and family for emotional support and companionship. Adolescents turned to their friends or family to share their stress and concerns. These supportive individuals played a vital role by listening attentively, offering understanding and providing encouragement. Friends and family members ‘cheered’ and ‘encouraged’ them, boosting their morale and helping them face their difficulties with renewed strength. They [close friends] cheer me up, we encourage each other. What is it, words like don't give up on exams, don't be… I don't know, just stay motivated. (Junior High Student 5)   Breaking the Silence: Empowering Adolescents Through Comprehensive Mental Health Education and Support The theme highlighted the need to empower adolescents with comprehensive mental health education and support and was supported by three subthemes: fostering mental health literacy, building bridges between parents and adolescents, creating a culture of kindness, and fostering kindness via peer support.   Fostering Mental Health Literacy Adolescents showed limited mental health literacy but expressed eagerness to learn more. They believed that their parents and teachers also needed ‘awareness’ of mental health, as mental health issues were often misunderstood or dismissed. To improve school mental health programmes, adolescents suggested incorporating engaging activities to catch their attention and create a safe environment. They emphasised using storytelling, ‘games’, and ‘icebreakers’ to promote understanding and open communication about mental health. Given the potentially sensitive nature of mental health, these interactive approaches would help make the topic approachable and memorable, allowing adolescents to engage with the material in a relaxed and comfortable setting. Just keep it relaxed, with icebreakers. Icebreakers are good… explain about mental health. (Senior High Student 4) Adolescents preferred programmes led by experienced mental health professionals with credible expertise and experience in mental health. They favoured ‘face‐to‐face’ interactions as they found in‐person interactions more ‘comfortable’ and ‘honest’. They also desired individual sessions for personal issues and large peer‐group activities to encourage engagement and shared understanding for general mental health literacy education. Because if it's in‐person, it's more comfortable, like if you want to cry, there's someone to hug or comfort you, so it's nicer… can share personal struggles. (Junior High Student 2) Actually, it's better if it's directly from the specialised healthcare workers. Because they are definitely trained and educated. sharing things in a group setting will help us to be less shy to understand mental health openly. (Senior High Student 2)   Building Bridges Between Parents and Adolescents Adolescents craved a deep connection with their parents. They longed to express their emotions openly without fear of being ‘scolded’, facing ‘anger’, or enduring ‘lectures’. Many adolescents wanted emotional support from their parents during challenging times, desiring understanding rather than criticism. Some adolescents hesitated to ‘joke’ or be light‐hearted around their parents due to unpredictable tempers or a lack of ‘quality time’. It's like we rarely meet and talk. Parents, I just want to hang out [with them] but they rarely have time. (Junior High School 4) Adolescents expressed a desire for their parents to be involved in mental health programmes, seeing these as ways to improve family connections. They suggested programmes that could teach parents about adolescent mental health, helping parents to ‘understand’ them well. These adolescents also recognised their need for education on communicating effectively with their parents. They believed parents could offer meaningful ‘support’ and ‘encouragement’ with both sides being well‐informed. However, some adolescents worried that increased parental involvement might initially cause ‘stress’ or discomfort, especially in families where communication was already challenging. …it's better to be open to our parents… so that our mental health doesn't deteriorate too much or something like that, let the teacher handle it along with the parents to help us better… (Junior High Student 7) …but with parents involved. Just so my parents understand my condition because I never talk about it, even when I'm sick I never say anything. (Senior High School 1)   Creating a Culture of Kindness and Fostering Kindness via Peer Support Adolescents wanted schools to become positive ‘environments’ where differences were embraced and mutual respect was the norm. To achieve this, they suggested improved school programmes to address bullying directly, ‘guidelines for witnesses’ and ‘consequences’ for those who bully others and strict enforcement of these anti‐bullying measures. Adolescents want to learn to be empathetic and caring towards their peers. They emphasised the need for education to promote understanding and compassion rather than ‘jealousy’ or ‘superiority’ and strengthen communication skills and supportive friendships. They wanted to embrace and respect differences, viewing this as a key approach to prevent bullying and create an inclusive environment. We should respect each other and know that there are limits to joking around and other things, not everything can be joked about. There's a limit to when we can joke or laugh at someone [with mental health issues]. (Junior High Student 5)   Discussion This study aimed to understand Indonesian adolescents' perceptions of mental health challenges and needs. These findings showed that adolescents experienced symptoms of psychological distress, such as stress, anger outbursts and rumination tendencies. Some managed to cope with these stressors successfully by engaging in leisure activities and spiritual practices and obtaining support from friends and family. The distribution of male participants, junior high students, Sundanese ethnicity, and Islamic affiliation amongst participants closely mirrored the demographics of the study setting (West Java Province) (BPS‐Statistics of West Java Province ; Directorate General of Early Childhood Education ). Adolescents in this study experienced varied stressors and mental health concerns, from having low self‐esteem to being bullied and stressed to having suicidal thoughts. Previous research on Indonesian adolescents has similarly reported significant mental health concerns. Studies have found that 29.1% of adolescents have experienced depression, whereas the overall 12‐month prevalence of psychological distress is 7.3% amongst this population (Idris and Tuzzahra ; Marthoenis and Schouler‐Ocak ). Previous local studies reported that most Indonesian adolescents use adaptive to maladaptive coping mechanisms to cope with their mental health challenges (Batubara et al. ; Fine et al. ). To cope with stress using adaptive techniques, adolescents talk to trusted peers, avoid triggers and engage in healthy activities, such as exercise, relaxation, hobbies and prayer (Kaligis et al. ). Prayer in Islam has been found to help reduce sadness and boost life satisfaction (Aziz, Salahuddin, and Muntafi ). However, this study found that when adolescents cannot cope with life's stressors, they engage in maladaptive coping strategies, such as withdrawal, self‐harm, and suicide ideation and attempts, which Marthoenis and Schouler‐Ocak  similarly reported. These behaviours may arise from prolonged social withdrawal, coupled with psychological pain and hopelessness that outweigh feelings of social connectedness. Contributing vulnerability factors include experiences of defeat or humiliation (Kirshenbaum et al. ; Zhu, Lee, and Wong ). Local studies have found that 23.1% of adolescents have engaged in self‐harm (Juliansen et al. ). In contrast, nearly 10% have experienced suicidal ideations or have developed a suicide plan (Marthoenis and Schouler‐Ocak ). The current study indicated that adolescents' inability to cope can be due to their lack of knowledge of mental health issues. The problem of lacking mental health literacy, which can lead to difficulties in coping, has been reported in previous studies conducted amongst Indonesian adolescents (Brooks, Prawira, et al. ; Juliansen et al. ). Mental health literacy programmes have been suggested to improve adolescents' mental health literacy (Juliansen et al. ). Given that this study showed that adolescents were willing to learn about mental health, organising mental health literacy programmes needs to be planned for Indonesian adolescents crucially. Previous studies have not thoroughly explored the specific needs of Indonesian adolescents regarding mental health literacy programmes (Brooks, Windfuhr, et al. ; Willenberg et al. ). This current study reported how adolescents would like mental health literacy programmes such as school‐based, face‐to‐face programmes delivered by local mental health experts, and a mixture of one‐on‐one or group sessions, depending on the topic covered. As such, local mental health experts can enhance adolescent education through culturally competent, specialised knowledge and in‐person interactions that offer stronger connections, empathetic care, and immediate support, which adolescents often prefer to online alternatives. Schools provide convenient, feasible venues for mental health literacy programmes, offering universal access and support to all adolescents regardless of risk status (Ishikawa et al. ). Therefore, future studies could involve school personnel such as teachers and healthcare providers in planning and implementing face‐to‐face mental health literacy programmes in Indonesian schools, leveraging local expertise to deliver effective interventions. This study found that adolescents experienced critical issues during their adolescent phase, including academic and peer pressure, body image concerns, romantic relationships, and a struggle for autonomy. These challenges are unique to adolescents as they mature and grow, coinciding with significant cognitive and emotional development (National Academies of Sciences et al. ). Underlying these experiences, adolescent brain development, particularly in regions such as the amygdala and cortex, is linked to the refinement of emotion regulation strategies such as cognitive reappraisal and expressive suppression, contributing to improved emotional control and cognitive abilities, ultimately resulting in the ability to achieve complex, integrated thoughts and actions (Ferschmann et al. ; Fombouchet et al. ). Given these developmental factors, mental health programmes need to address these specific issues that adolescents face to improve their emotional well‐being. This study also reported that, despite these stressors, adolescents aspire to achieve a meaningful life and career. Previous research has shown that such aspirations are common during this adolescent phase (Yamasaki et al. ). Having positive aspirations is beneficial because it can help them increase their chances of achieving success and leading meaningful and fulfilling lives (Napolitano et al. ). Mental health programmes can also incorporate career coaching to support these aspirations. Engaging career coaches to advise adolescents on post‐high school education and career choices can provide valuable guidance (Napolitano et al. ). This approach can help adolescents understand how to achieve their goals and navigate their future paths. Adolescents also reported having problems with bullying. This pervasive issue is common amongst adolescents in Indonesia and worldwide. (Biswas et al. ). The study indicated that adolescents also want to learn how to forge meaningful and supportive friendships because they feel that friends can provide valuable support. Adolescents value meaningful and close friendships. (Costello et al. ). Peer support enhances psychological well‐being by fostering connection and mutual understanding, promoting adjustment and stress management through emotional validation, and boosting motivation and self‐esteem via supportive relationships. (Costello et al. ). Hence, future mental health programmes can address bullying and promote healthy peer relationships. As suggested in this study, these programmes could be delivered with some group‐based elements to promote peer support amongst adolescents. Previous research has shown that group‐based mental health programmes enhance social and emotional well‐being, facilitating peer support and shared learning experiences, cultivating a sense of community, and promoting positive outcomes (Fassnacht et al. ). Thus, group‐based aspects can be added to adolescent mental health programmes, including forming peer support groups at school. Adolescents in this study wanted to build a strong connection with their parents as they believed their family could provide them invaluable support. Adolescents want good relationships with their parents (Branje ). Parents shape adolescents' development by adapting to their children's evolving needs (Branje ). Parents balance support and independence, guiding adolescents through conflicts and decisions (Branje ). This nuanced approach nurtures the social, emotional, and cognitive growth essential for the transition to adulthood (Branje ). Hence, adolescents suggested having their parents be involved in their mental health programmes to learn about the topic and understand them well. Previous studies have shown that parental involvement in mental health programmes can facilitate parent–child bonding and help parents learn how to support their children effectively without any stigma attached during their adolescence period (Ford et al. ; Lechuga‐Peña et al. ). Therefore, mental health programmes can incorporate parental involvement by implementing joint sessions for parents and children.   Strengths and Limitations This study provided valuable insights into adolescents' experiences and perceptions of mental health challenges and needs and highlighted key points on how to improve the mental health of adolescents in Indonesia. Current findings are essential in guiding future research on developing comprehensive mental health educational and supportive programmes that address mental health challenges for adolescents in Indonesia. However, this research has certain limitations. As this study only recruited adolescents from city‐based public schools, current findings might not be representative of all adolescents in Indonesia. Moreover, collecting data only from adolescents may not provide a holistic view of the mental health challenges and needs of adolescents and future research should consider collecting and triangulating data from their parents and school educators as well.   Conclusion This study explored adolescents' mental health challenges and needs. The current findings indicate that adolescents face particular challenges related to emotional regulation, body image and self‐esteem, academic pressure, and the influence of social media. In response to these adversities, adolescents employed a range of coping mechanisms, both adaptive and maladaptive. Additionally, they expressed a strong interest in developing strategies to manage these challenges and achieve their future career goals. The findings highlight that while adolescents face psychosocial distress, they showed interest in mental health education, favouring school‐based interventions by local experts. Findings emphasised the need for comprehensive school programs to improve mental health literacy, teach coping skills, address body image, promote autonomy, offer career guidance, and foster healthy relationships. Although parents, teachers, and healthcare professionals were not participants in this study, adolescents frequently cited them as important sources of support. Hence, the development of future mental health programmes would require collaborative efforts to be undertaken by parents, teachers, healthcare professionals, and mental health experts. Such programmes could enhance adolescents' mental health and well‐being, creating supportive environments at school and home.   Relevance for Clinical Practice Findings suggest a need for comprehensive school‐based mental health literacy programs in Indonesia involving local experts, school staff, and health providers. These should address academic and peer pressure, body image, relationships, and autonomy struggles. Incorporating career coaching can help adolescents navigate their future paths. Furthermore, these initiatives should address bullying and promote healthy peer relationships through peer support groups. It is recommended that adolescents involve their parents in joint sessions to enhance understanding and engagement. Mental health programmes could significantly improve adolescents' well‐being by addressing identified challenges and capitalising on their interests. Future studies should include diverse adolescents from urban and rural areas attending private and public schools to ensure more representative findings and inform the development of effective, culturally appropriate interventions. Future research could explore digital mental health education options for Indonesian adolescents, asking them specifically what would be helpful and how to tailor these programmes to their evolving needs.   Made substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data; D.I.Y., J.Y.X.C., S.S. Involved in drafting the manuscript or revising it critically for important intellectual content; D.I.Y., J.Y.X.C., S.S. Given final approval of the version to be published. Each author should have participated sufficiently in the work to take public responsibility for appropriate portions of the content; D.I.Y., J.Y.X.C., J.C.M.W., M.P., Y.S.S.G., S.S. Agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. D.I.Y., J.Y.X.C., J.C.M.W., M.P., Y.S.S.G., S.S.   The authors declare no conflicts of interest.   Appendix S1. Table S1.   