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PLOS Mental Health Community Case Studies: Confronting the Mental Health Consequences of Child Marriage

Child marriage is rooted in gender inequality and disproportionately affects girls, compromising their rights to health, education, and economic opportunity. Child marriage is often discussed in terms of its physical and reproductive health consequences, but the devastating impact it has on mental health is less widely known. Each year, 12 million girls[1] worldwide are forced to marry before the age of 18[2], robbing them of their childhoods and putting their mental health at serious risk. A recent symposium brought together global experts to shine a light on this hidden crisis and identify the next steps to help affected communities.

The half-day symposium was hosted by the University College London (UCL)-led Global Network on Mental Health and Child Marriage, in collaboration with the Child Marriage Research to Action Network (CRANK), a joint initiative of Girls Not Brides: The Global Partnership to End Child Marriage and the United Nations Population Fund (UNFPA) – United Nations Children’s Fund (UNICEF) Global Programme to End Child Marriage. It brought together researchers, practitioners, policymakers, and donors to explore the existing evidence on the mental health consequences of child marriage and chart future action on what works to support ever married girls. Speakers at the hybrid event (in-person and on Zoom) shared research and real-life stories that highlight the high risk of depression, anxiety, self-harm, post-traumatic stress disorder (PTSD), and other mental health challenges that girls and women who marry young face.

“The mental health consequences of child marriage is an important topic area, and this is underscored by the massive interest it received from nearly 30 in-person attendees, over 200 active online participants, and 600 registered attendees who will be accessing the symposium recordings later,” said Dr. Rochelle Burgess, Network Director and Associate Professor at UCL, co-Editor in Chief of PLOS Mental Health.  ” Social factors driving child marriage have independent and interactive associations with negative mental health outcomes.”

The key takeaways from the symposium were clear…

Barriers to Support: Mobility Restrictions and Mental Health Stigma

Child Marriage leads to a range of poor mental health outcomes for girls and women, yet, support services are limited and hard for these vulnerable populations to access.

Speakers emphasised that married girls often face tight restrictions on their mobility and autonomy, preventing them from seeking help independently. Additionally, deep-seated stigma around mental health issues in many communities means girls are reluctant to reach out, fearing judgement or shame.

“These girls are trapped – not only by the trauma of child marriage, but by societal barriers that keep them isolated and silent,” said Julius Ololade Baruwa, a public health researcher from the University of Cape Town.

The impact is devastating, and grows more severe the younger a girl is married. Sexual violence, unwanted pregnancy, divorce, and conflict can further compound mental health challenges for these girls. Researchers found that girls experiencing unwanted pregnancies are five times more likely to develop common mental health disorders. “We have to meet these girls where they are and empower them to access the care they so desperately need,” said Farirai Gumbonzvanda from the March-Zim project, Zimbabwe. One-stop centers for health, legal, psychosocial support and referrals may be effective – as ever-married girls’ mobility is often limited – but should be tailored to their needs.

These girls are trapped – not only by the trauma of child marriage, but by societal barriers that keep them isolated and silent

Julius Ololade Baruwa, University of Cape Town

Context Matters – One size does not fit all!

The factors that drive child marriage are complex and context-dependent. Social norms, gender inequality, family poverty, and conflict all play a role. Efforts to address the mental health impacts must therefore be nuanced and responsive to individual circumstances, such as  age, marital status, type of marriage, family/partner income, and community context, including geographical location, social norms, gender inequality, and the effect of conflict or crisis. “Context is key when it comes to child marriage,” said Kimberly Howe from Tufts University. “We need to engage directly with girls, families, and local leaders to understand the unique challenges they face.”

One promising strategy highlighted at the symposium was the use of community conversations and arts-based approaches, such as radio dramas, to foster dialogue, create safe spaces for married girls, and deepen understanding of their experiences. By exploring how child marriage intersects with other socioeconomic issues and cultural norms, these platforms can help shift harmful mindsets.

Governments, donors, practitioners, and researchers were also urged to invest in mapping trends and responses across diverse contexts. Collecting comprehensive, disaggregated data – broken down by factors like age, marital status, and geographic location – will be crucial for designing tailored interventions.

Interventions can be therapeutic for participants.

Speakers stressed the need for mental health support to be embedded throughout research and programming on child marriage. This could include facilitating access to support through community-based services and engaging families and local leaders to build a more supportive ecosystem for girls. One study found that the mere exercise of conducting research, by virtue of simply asking girls about their mental health, could be a therapeutic opportunity.

Importantly, scaling up successful small-scale pilots will require engaging policymakers from the start and aligning with national-level priorities around girls’ education and health.

“We have to treat the whole person—mind and body,” said Nicola Jones of the Overseas Development Institute. “Only then can we truly help these girls heal and build the lives they deserve.”

The symposium closed with the following next steps:

-Researchers, particularly those based in low- and middle-income countries, should be supported to publish case studies that demonstrate what is working and what is not.

-A mapping exercise to document and synthesize relevant guidelines, curricula, and resources in child marriage and mental health should be undertaken.

-Practitioners and researchers need to collaborate with WHO, UNFPA, UNICEF and others to include attention to mental health in guidance and policies related to child marriage, as appropriate.

-It is important to continue to raise global awareness of the importance of mental health support for child marriage survivors. This can be done through regular convenings and conferences.

About the author

Dr. Olubukola Christianah Omobowale is a Senior Lecturer  and Honorary Consultant in the Department of Community Medicine, College of Medicine, University of Ibadan, Nigeria, and a Consultant Community Physician at the University College Hospital Ibadan, Nigeria. She obtained her medical degree (MBBS) from the University of Ibadan and later her Master of Public Health from the same institution, where she is also pursuing her Ph.D. She is a Fellow of the West African College of Physicians’ (WACP) Faculty of Community Health and a member of the National Postgraduate Medical College of Nigeria’s (NPMCN) Faculty of Public Health. Dr. Olubukola Omobowale is a global mental health researcher, community mental health advocate, and expert in women’s health.

Dr. Omobowale’s research interests include the development and evaluation of community-based rehabilitation interventions for vulnerable groups (women, girls, children, the elderly, and those with mental health dconditions) within their communities as well as linking them with available community resources. She uses epidemiological models such as community participatory methods, coproduction, community resource mapping and community engagement to engender community health among vulnerable populations as she harnesses their lived experiences in designing these interventions.. Her two current projects are focused on providing Community Based Rehabilitation and Psychosocial Support Interventions for people living with mental health conditions in Sub-Saharan Africa (SUCCEED Africa) and the Ending Child Marriage in Nigeria through Community-led media series project (ENCASE project) Dr. Omobowale has presented her work at local and international conferences with articles published in peer reviewed journals. Dr. Omobowale is a member of several learned societies including the Global Network on Mental Health and Child Marriage, Child Marriage Research to Action Network (CRANK) as well as being a member of the Research Committee of the Consortium of Universities for Global Health.
Dr. Omobowale sings alto at her local church choir in Ibadan, Nigeria and she enjoys spending time with her husband and beautiful children.

[1] UNICEF ,2023

[2] Child, Early  Forced Marriages and  Unions   (CEFMU)

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