Trauma, Violence and Adolescent Mental Health: A Psycho-Legal Framework for Early Identification, Resilience, and the Prevention of Violent Behaviour A narrative and conceptual review with particular reference to Albania

Abstract

Adverse childhood experiences or ACEs can negatively affect the social development of adolescents in their adulthood. This review aimed to assess the influence of childhood adversities on health, achievement, resilience, and violence in Albania. The present analysis was based on published studies and reports in the field. It was organized according to the six key areas identified in the initial review. The information comes from the Albanian Health Behaviour in School-aged Children (HBSC, 2022) survey, representing the views of 1,877 15-year-old school students in Albania. The study estimated the prevalence of childhood adversities such as abuse and neglect among the participants. The results indicate that 33.1% of students experienced physical abuse in their lifetime, while 16.2% suffered emotional abuse. In addition, 3.7% of students were sexually abused, and 15.7% endured emotional neglect. Moreover, 7.0% of the participants had been exposed to domestic violence in their households. Furthermore, the review suggests a five-stage psycho-social framework for multi-sectorial coordination in the prevention and management of ACEs among children and adolescents in Albania. The strategy is based on awareness, assessment, safety, intervention, and follow-up. It aims to promote the collaboration and coherence of schools, health, social welfare, and law enforcement sectors when addressing the needs of the children from vulnerable families and supporting their parents. The strategy is not a ready-to-use solution but rather a flexible approach that should be adjusted according to the specific circumstances and settings in Albania. It requires further validation and elaboration, which can be achieved through its practical implementation. Thus, the strategy will be beneficial for coordinating the response to ACEs in Albanian children and adolescents. Keywords: adolescent mental health; adverse childhood experiences; child protection; trauma-informed care; Albania.