Abstract
<title>Abstract</title> <p>Background Mental health is an essential part of complete well-being, and mental health disorders are a major public health concern worldwide, specifically among adolescents, who undergo critical transforming physical, emotional, and social developmental phases. Adolescent mental health is a growing concern in Pakistan, particularly in culturally distinct and undeveloped regions such as Chitral. Situated in a culturally rich yet geographically isolated region, Upper Chitral presents unique mental health challenges for its adolescents. Aim This study explores the sociocultural, economic, and geographical factors influencing adolescent mental health outcomes in Upper Chitral, Pakistan, with a focus on understanding the influence of family dynamics, social norms, cultural values, and systemic barriers. Methods This qualitative study investigates the mental health challenges faced by adolescents aged 12 to 18 in Chitral. Using semi-structured interviews with adolescents, parents, educators, and mental health professionals, the study applies Braun and Clarke’s thematic analysis to explore key factors influencing adolescent mental health within this distinct socio-cultural context. Results Six primary themes emerged: family dynamics and mental health, relationships within the community network, social taboos and cultural values, coping approaches and suggestions for improvement, self-identity evaluation and perceptions, and professional assistance obstacles. The findings reveal that excessive parental expectations, communication barriers within families, societal stigma, and limited access to professional services significantly contribute to the psychological distress experienced by adolescents. Adolescents often feel unheard, unsupported, and constrained by cultural silence around mental health, which impedes early intervention and recovery. Conclusion This study underscores the urgent need for culturally sensitive and community-informed mental health interventions. It advocates for increased awareness among families, educators, and policymakers about the critical role of cultural context in mental health delivery. By centering the lived experiences of youth and their communities, the research offers a grounded foundation for transforming adolescent mental health care in Chitral and similarly marginalized regions.</p>