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Depression is prevalent among adolescent girls, but few receive mental health treatment. Adolescent girls often forgo needed mental health treatment because they fear responses of peers about depression. Understanding the processes of how adolescent girls respond to peers with depression is an important first step to improve access to mental health treatment. This qualitative study describes the knowledge, perceptions, and behaviors of adolescent girls about depression and mental health treatment within their peer group. The investigators conducted two focus groups, with adolescent girls (n=21), in a public high school in the southern U.S. Grounded theory methods were utilized to identify a beginning substantive theory about perceptions and behaviors of adolescent girls related to depression in their peers. Participants cognitively processed mental health concepts similarly to adults. However, their affective responses to peers with mental illness fluctuated between adult and child perspectives. Participants expressed concerns about individuals with depression that have previously been identified in adults, but expressed unique perspectives that reflect their transitional stage of development. Findings provide new information about how adolescent girls respond to peers with depression, define areas for further investigation, provide directions for constructing developmentally appropriate mental health educational interventions for adolescent girls, and elucidate the need to provide guidance to women with whom adolescent girls have sustained contact.

How Adolescent Girls Understand and Manage Depression Within Their Peer Group: A Grounded Theory Investigation