The prevalence and social distribution of mental disorders is not as well documented in low to middle income countries, like Morocco, as it is in high income countries. Understanding the drivers of mental health and wellbeing in specific contexts allows for prevention efforts and the improvement of population health. This study sought to fill the gap of research on social and environmental drivers that impact the wellbeing and mental health of young people, from the perspective of young people’s lived experiences. Surveying Moroccan youth between the ages of 18 and 24 years old across the 12 regions of Morocco, using the five components of the Adolescent Wellbeing Framework, revealed the top ten drivers that Moroccan youth rated as highly important. The closer examination of the drivers given the highest rating of importance allows comparison with global mental health research on drivers and the identification of any specificities that warrant further research for the Moroccan youth population.

The results of this survey, under the first component of good health and optimum nutrition, and the second component of connectedness, positive values, and contribution to society, show that young Moroccans rate very highly the importance of positive relationships within their families and with parents as well as access to essential needs such as food, water, a home, clothing, and feeling safe. These results align with a systematic review of epidemiological studies that show a strong positive association between mental disorders and poverty in low to middle income countries (13), and studies showing that poorer mental health is found among populations who reported weak social support (14). A dominant hypothesis linking these drivers of low mental health is that low socioeconomic status may increase the level, frequency and duration of stressful experiences but these risk factors may be buffered with a good family relationship which is a source of social support (15). Therefore, for many participants in the study, who may be familiar with economic stressors, positive family and parental relationships rate higher as a priority slightly before basic needs. A study on the social determinants of mental health, conducted with youth in Indonesia, similarly highlights the importance of parental relationships with the young participants in the focus-group based study expressing that communication with parents and a sense of connection function as protective factors (16). These findings can provide evidence for programming to prioritize strengthening family relationships as a protective factor which can increase young people’s resilience in the face of adversity. Under the third and fourth components, safety and a supportive environment and learning, competence, education, skills, and employability, there were some interconnected findings. One of the determinants of poor mental health for young people is academic pressure and unsafe school environments (16–18) which pose an added stressor for young people and can contribute to accumulating stressors that impact one’s mental health. Participants in this study rated highly feeling a sense of purpose, self-efficacy, and capacity to learn as well as feeling safe and not being exposed to violence as important to their mental health. Education plays an important role in a range of later life outcomes, including employment, income, and community participation, but lack of support in learning or feeling unsafe in school due to bullying, can create a two-way relationship between struggling in school and feeling less confidence and self-efficacy (17,19–22). Literature from high income countries (23) as well as from other low-to-middle income countries (24) showcase a link between academic pressure and the way it impacts young people’s mental health, sense of purpose in life, confidence, and self-efficacy leading to poorer mental health outcomes.

Connecting the fifth component and sixth component, agency and resilience as well as digital wellbeing and literacy, young people rated privacy of personal information as highly important to them. Due to its implications for their ability to have agency and make their own life choices, this area of digital wellbeing requires further research to understand the impact of the changing digital landscape and the lack of a sense of privacy on the mental health and wellbeing of young people in low to middle income settings and collectivist cultures like Morocco.

The findings of this study reflect the lived experience of young people and their tacit awareness of the protective factors that help mitigate or buffer stressors and social determinants in their environment. They rate family relationships more highly than not being exposed to poverty and a sense of purpose and capacity to learn and do more highly than safety in schools. While all the drivers together paint a picture of what young people need to promote their mental health and positive development and the differences between the highly rated items may not be large enough for statistical significance, the results of this study can inform the priorities of intervention and programming. It highlights the need to strengthen the protective factors that matter to young people and make a difference in their mental health and resilience, especially when they may be exposed to stressors like poverty and unsafe school environments.

The study’s findings must be considered in light of several limitations. Firstly, the participants were identified through existing networks, potentially resulting in a sample that does not fully represent youth with differing abilities, needs, or socio-economic backgrounds. For instance, only 1.8% of respondents identified as NEET (Not in Education, Employment, or Training), indicating that the perspectives of this group may be underrepresented. Additionally, with only 14.3% of participants coming from rural contexts, the study may not fully capture the unique challenges and experiences of rural youth, who often face different socio-economic and infrastructural conditions compared to their urban counterparts. The survey used in this study was developed by the research team based on the Adolescent Wellbeing Framework which is a relatively new framework that is yet in the process of developing universal measures. As such, the lack of previous validation for this survey and its items introduces potential concerns regarding the internal and external validity of the findings.

Nevertheless, this study is the first of its kind in Morocco. It is a comprehensive study that collected data nationwide and centers the perspectives of young people. It provides important guidance for further research, policy, and practice. This study can help inform the training of counselors and mental health professionals (25) with local guidance on drivers of mental health to help address inequities which impact young people’s mental health. It can be used to guide youth programming, especially in providing interventions that support the development of positive relationships with parents and family members, that build a sense of purpose, self-efficacy, and capacity. It can also inform policy that seeks to address inequities through the reduction of poverty and creating safer environments for young people in schools, their communities, and at home. Having the perspectives of Moroccan youth from across 12 regions speaking to the drivers of mental health from their perspective can help enhance the inclusion of youth lived experiences in policy and practice and encourage further participatory research.