Bloomberg School Faculty and Doctoral Candidate Serve as Commissioners on 2nd Lancet Commission on Adolescent Health and Wellbeing

The second Lancet Commission on Adolescent Health and Wellbeing released its latest report, A call to action: the second Lancet Commission on adolescent health and wellbeing, on May 21 at a side event to the World Health Assembly in Geneva. The report argues that adolescent health is at a tipping point, with progress falling behind that of younger children and an increase in non-communicable diseases and mental health disorders. 

This second Commission includes Bloomberg School faculty Pamela Collins, MD, chair of the Department of Mental Health; Jennifer Requejo, PhD, senior scientist in the Department of International Health; Yusra Shawar, PhD, associate research professor in International Health; and Jeremy Shiffman, PhD, professor in International Health. Augustina "Tina" Mensa-Kwao, a PhD candidate in Mental Health, served as a Youth Commissioner and spoke at the launch event.  

With 44 commissioners and an intergenerational leadership model, the second Lancet Commission on Adolescent Health and Wellbeing seeks to remove barriers to investment, propose scalable, multi-sectoral solutions, and advocate for prioritizing the unique needs and potential of adolescents as a critical strategy for securing a healthier, more equitable future for all.

In 2016, the first Lancet Commission on Adolescent Health and Wellbeing spotlighted how investment in the health of the world’s 10-24-year-olds could yield a transformational “triple dividend,” improving health now, into adulthood, and for future generations. Centered around six themes (including health equity, youth empowerment, and sustainability), the Commission galvanized global attention on adolescent health and drove progress in program funding, policy decisions, data systems, and youth participation in advocacy and policy development.  

Nine years later, the Lancet is responding to new global challenges—the climate crisis, global conflict and economic insecurity, and the educational and mental health disruptions of the COVID-19 pandemic—in its second Lancet Commission on Adolescent Health and Wellbeing. Their latest report outlines a comprehensive framework for action, including recommendations for increased accountability, equitable access to healthcare and education, and innovative approaches to address emerging threats like climate change and a rise in mental health disorders. 

Collins and Mensa-Kwao contributed their expertise and research on adolescent mental health. Shawar and Shiffman contributed analysis on the political priority to address adolescent health. Requejo contributed to the analysis, adolescent participation, and political economy of adolescent mental health.   

In this Q&A, Collins and Mensa-Kwao discuss their experiences as Commissioners, what they hope decision-makers take away from the new report, opportunities for further investment and research, and more. 

What are the key adolescent mental health takeaways from the report that you think are important to highlight? 

Pamela Collins: One of the most important takeaways is that young people view their mental health as a priority. This is a departure from the traditional areas of health linked to adolescents, such as sexual and reproductive health, but it makes sense. Adolescence is when the majority of mental disorders emerge. But the current population of adolescents around the world have lived through the isolation and disruption of a pandemic, severe climate events, and the ongoing threats associated with climate change, and a digital environment that may provide support, but also harm.  

Tina Mensa-Kwao: The report calls for the development of stronger framing, governance, and engagement around adolescent mental health. It also reinforces that school-based mental health interventions are effective and need to be scaled and integrated into school health services. Another major takeaway is the importance of creating mental health–friendly cities for young people through inclusive policies that promote civic engagement, improved access to services, and environments that foster skill-building and career readiness.

What do you hope decision-makers do with the mental health findings in the report? 

PC: First, and foremost, I hope decision-makers recognize the need to invest resources into adolescent mental health—promotion of sustained mental health, strategies for helping young people manage distress, and delivery of services for adolescents in need of mental health care. The report emphasizes the need for intersectoral change. We need more examples of broad, coordinated intersectoral attention to adolescent mental health. Our work on designing cities that support adolescent mental health also requires this kind of collaboration. This is a potential area of policy and implementation research: What are the best strategies to achieve intersectoral action toward improved adolescent mental health outcomes? 

TMK: One of the most striking takeaways from the Commission is the massive gap in investment. Adolescents make up about 25% of the global population, yet only 2.4% of development assistance is directed toward them. That imbalance shows we’re not fully recognizing—or seizing—the opportunity to invest in young people’s health and well-being. As the first Commission highlighted, investing in adolescence yields a triple dividend: it benefits young people now, supports the adults they will become, and shapes the future for the next generation. I want to see decision-makers match funding to the scale of adolescent health needs and put resources, policies, and power behind young people. Most importantly, I hope they see youth not just as beneficiaries, but as partners at the table in the process. 

What areas of adolescent mental health do you think need more attention and research? What are some bright spots in adolescent mental health research? 

PC: We need more research on the benefits and harms of digital environments, the socio-environmental determinants of mental health, and, importantly, how to respond to them. These include commercial determinants of mental health, research on responses to discrimination and inequity, as well as the effects of climate change. 

There are tremendous bright spots in adolescent mental health. A variety of organizations have sparked growing global attention to adolescent mental health in recent years, preceding the pandemic but perhaps intensifying since then. We have seen new research investments from foundations—Wellcome Trust, Fondation Botnar, Grand Challenges Canada—that focus on regions of the world where fewer research investments have landed in the past. These new resources are also oriented to equity—building a global evidence base that improves our understanding of how to intervene for young people everywhere. 

TMK: First, we need to focus more on the mental health of marginalized and underrepresented adolescents, such as LGBTQ+ youth, adolescents with disabilities, displaced youth, and those living in low-resource or humanitarian settings. These groups often face higher risks, and we need context-specific research and culturally appropriate interventions that are designed with and for them. Second, we need more research into how obstacles like urbanization and climate change affect well-being, especially as young people increasingly live in urban areas and experience rising climate anxiety.  

In terms of bright spots, one exciting trend is the shift toward youth-centered and participatory research methods. More studies are being co-designed with adolescents, helping shape research questions, interpret data, and co-author publications. We’re also seeing innovation in digital mental health tools that meet youth where they are, as well as emerging research that connects mental health to broader issues like gender identity, climate justice, and social equity.    

A promising area that I am excited about is making green spaces more accessible to urban adolescents and engaging them in shaping their environments. This can significantly improve mental health, strengthen youth engagement, and foster a greater sense of connection to their community.

What does your participation in the Commission and its work mean to you? 

PC: It was a delight and a privilege to work with such a diverse group of researchers who thought holistically about the multitude of influences on the life of young people. It means a lot to have participated in a comprehensive analysis of youth wellbeing that centered on young people and engaged so many young people from around the world in the process. 

TMK: This is the first Lancet Commission to integrate youth leadership so comprehensively, and it sets a new bar for what meaningful engagement can look like. Young people were involved at every stage—from the conceptualization of the Commission to the research and analysis, peer review, and dissemination planning. Being part of this Commission reminded me that when youth are truly included as thought partners, we shape global conversations in ways that are both innovative and deeply rooted in lived experience.