Prevalence and Severity of Depression, Anxiety, and Stress Among Tribal and Nontribal Adolescents in a Rural Block of Jharkhand: A Cross-Sectional Study
TL;DR
Rural adolescents in Jharkhand bear a high mental health burden, with tribal adolescents disproportionately affected by depression, and mental health screening programs that are school-based and culturally acceptable interventions can address this mental health crisis.
Abstract
Background: Adolescent mental health in India is an emerging health concern, particularly in the tribal population. Tribal populations are particularly vulnerable due to structural disadvantages arising from lower educational status, poverty, and limited health care access. While tribal communities make up a substantial proportion of Jharkhand’s population, epidemiological information on the mental health of tribal adolescents remains underrepresented. Methods: Between December 2024 and June 2025, a cross-sectional comparative investigation was undertaken in the Rural Health Training Centre’s field area, Ormanjhi Block, Rajendra Institute of Medical Sciences, Ranchi. The enrolled study population comprised 310 adolescents aged 10-19 years, of whom 137 were tribal and 173 were nontribal. Assessment of socioeconomic status was carried out based on the modified B.G. Prasad Scale 2024, and depression, stress, and anxiety were evaluated using the Depression, Anxiety, and Stress Scale-21. Intergroup differences were examined using chi-square tests, Mann-Whitney U tests, and independent t-tests, with a p value of 0.05 considered statistically significant. Results: Symptoms of stress and depression were each observed in 63.5% of the study participants, whereas anxiety was identified in 79.0%. Tribal adolescents experienced depression more frequently than their nontribal counterparts (71.5% vs. 57.2%; χ² = 6.76, p = 0.009, odds ratio = 1.88, 95% confidence interval: 1.16-3.03). The pattern of depression severity also varied between the two groups (χ² = 14.7, p = 0.005), with moderate-to-extremely severe depression affecting 59.1% of tribal adolescents compared with 39.8% of nontribal adolescents. In addition, the average depression score was significantly greater in tribal adolescents (15.5 ± 9.27 vs. 12.8 ± 9.61, p = 0.014). Conclusions: Rural adolescents in Jharkhand bear a high mental health burden, with tribal adolescents disproportionately affected by depression. Structural determinants, including parental education and socioeconomic status, along with psychosocial factors such as social support, are important potential covariates. Mental health screening programs that are school-based and culturally acceptable interventions can address this mental health crisis.