SUZANNE PETRONI

Firstly, how did you enter this field?

I have been working on issues related to adolescent sexual and reproductive health for more than 20 years, and engaging on child marriage has increasingly been an important element of that. In 2014, I was reading the newly released WHO Health for the World’s Adolescents report, when I stumbled upon the fact that suicide was the leading cause of death for older adolescent girls, surpassing maternity-related causes. I began researching the topic and found very little attention in global development arenas to suicide, depression, and the mental health and wellbeing of adolescent girls in low and middle-income countries, particularly as compared to evidence on sexual and reproductive health amongst this population. I wrote a popular blog, which generated some media attention (see here and here, for example), and then a commentary in The Lancet, postulating that gender inequitable norms and practices, such as child marriage, may have a role in diminishing the mental health of adolescent girls, as well as adolescent boys. I have been at least tangentially engaged in the issue since.    

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

Understanding how child marriage affects a range of outcomes over the life course, including mental health, may help us to meet the needs of girls and women who were married as children, as well as to advocate for an end to this harmful practice. Further, mental health is a critical part of health and wellbeing, albeit one that has too often been neglected by global health and development actors. If we can gain a better understanding of the linkages between mental health and other issues of concern to development actors, such as child marriage, we can help them to design and implement more holistic solutions that better address the multitude of intersecting issues and deprivations faced by girls – particularly the poorest and most marginalized.

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

While the evidence base is expanding, the fact is that we can’t truly distinguish the mental health consequences of child marriage from the mental health consequences of broader gender inequalities. The type of experimental research that might help us definitively say that depression is caused by child marriage, as opposed to it being an outcome of girls’ lack of opportunity or agency because they live in a gender inequitable society, for example – that type of research just cannot be done in the real world. Qualitative research can tell us a great deal, and yes, we can run regression analyses to get a better idea of the relationships, but we likely won’t ever be able to state conclusively what causes what. And that is ok. Because what is important is creating supportive and equitable conditions in which girls and boys can grow up. Fostering more gender equal societies where girls and young women have equal access to safe, quality education, rewarding employment, and equal participation in civil society and governance, for example – all of this will contribute to reductions in child marriage and improved mental health.

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

Researchers haven’t always been very good at sharing their findings with advocates and implementers. Where research has been done that can elucidate these consequences, including especially from the perspectives of girls and women who were married as children, researchers should be sure to “translate” their findings for advocates. This might require collaboration with those who can help them communicate these findings to broader audiences. Such “research utilization” efforts could include, for example, engaging with the media, as well as implementing workshops where researchers collaborate with implementers, advocates, and policymakers to understand what the findings mean for their programs and policies.