JOANNA MORRISON

"The mental health effects of child marriage are not often researched or discussed, and there has been a focus on the health effects of early pregnancy and the effect of child marriage on girls’ education. My research in Nepal has shown that boys and girls suffer mental stress associated with marriage, their increased responsibilities, and family upheaval."

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Firstly, how did you enter this field?

I first became interested in the drivers and consequences of child marriage while I was researching maternal and new-born survival in rural Nepal. This research really highlighted the need to intervene women get pregnant to address causes of morbidity (injury and illness) and death. Nepal has high rates of child marriage and social expectations often mean that girls get pregnant when they are young, which exposes them to tremendous risk of ill health and death.    


Could you tell us why you are interested in the mental health effects of child marriage?

The mental health effects of child marriage are not often researched or discussed, and there has been a focus on the health effects of early pregnancy and the effect of child marriage on girls’ education. My research in Nepal has shown that boys and girls suffer mental stress associated with marriage, their increased responsibilities, and family upheaval. In Nepal, girls often move to their in-laws homes and are expected to take on most of the housework after marriage, and boys are expected to provide for their new wife and (expected) children. Both girls and boys have limited access to social support during this time. Little is known about how to prevent and deal with this stress, and this ‘invisible’ health effect of child marriage needs to be understood and researched.


Can you tell us about some of the misconceptions (if any) that may exist when it comes to mental health and child marriage?

There is a reluctance to engage with families and children who are more at risk of child marriage to proactively try to prevent the stresses that occur as a result of child marriage, and therefore there is little evidence about what could work for whom and in what contexts. Mental health support is often conceived of as individually focused, but my research has shown that community wide interventions can help to change contexts to support better mental health, and there is a need for interventions to be developed which work at multiple levels – individual, family, community and policy levels. I think that a common misconception is that boys remain relatively unscathed by child marriage there is a need to include their voices when we research and develop interventions to support adolescents.

How do you think we could raise awareness on the topic of mental health consequences of child marriage in general?

My research and public engagement work about child marriage has used community film screenings and small and large group discussions to stimulate conversations about the drivers of child marriage. The film was made in consultation with those who were married as children and it focuses on the issues which those participants sought to highlight. The film has been viewed over a million times on YouTube and has been used by the United Nations across the terai (plains) areas of Nepal in coordinating events focused on the girl child.  In other projects in Nepal and Bangladesh I have used art, social drama, music, photography, games and written pieces to highlight health issues and research findings which have increased engagement and opened up spaces for dialogue. We need to be clever and creative in our methods, centring the voices of those affected, communicating in ways that resonate with different audiences.

Tell us, how do you think other people could contribute and help make a difference?

As researchers we need to connect with stakeholders and systems that could sustain interventions that are developed and found to be effective, and we need to connect during the initial stages of our research. Networking with a broad range of funders, donors, media, government, mental health services and community-based and non-governmental organisations (both youth and community focused) is a key component to developing successful interventions.

Finally, how do you think we could encourage future research in this field?

Building capacity and supporting researchers from countries and communities/groups where child marriage is prevalent can enable diverse partnerships, participatory approaches, and locally appropriate interventions to be developed. Providing small grants to researchers from these communities in conjunction with mentorship and networking opportunities would help build capacity and encourage future research leaders.

Reviewing the evidence about what works and why may help to spotlight the gaps in our knowledge and encouraging young researchers to take an interest in this field through integrating it into courses within and beyond the mental health field. Finding ways to communicate about the effects of child marriage to different audiences in varied sectors may increase the advocacy platform which is needed to leverage focused funding for more research.

 

Dr Joanna Morrison specialises in qualitative and participatory methodologies with marginalised groups to develop an understanding of contexts, and understand the barriers to, and facilitators of healthy behaviours in low- and middle-income countries.
Her research enables the participation and engagement of a wide variety of stakeholders in the development of health interventions that directly address problems as they are experienced, in the systems that they are experienced. She has applied these research methods to non-communicable diseases, child marriage, maternal, newborn & child health, nutrition, and health systems.