Introduction

Adolescents represent a vital and dynamic segment of the global population, shaping the future health, social, and economic landscape of societies [1,2]. According to the World Health Organization (WHO), adolescents are defined as individuals aged 10-19 years, and there are approximately 1.3 billion adolescents worldwide, accounting for nearly 16% of the total population [3,4]. Adolescence is a transitional phase between childhood and adulthood, marked by neurobiological, physiological, psychological, and social development, during which individuals are more likely to engage in risk-taking behaviors [5].

Adolescent mental health is a critical and growing public health concern worldwide. It is estimated that one in seven individuals aged 10-19 years experiences a mental disorder, contributing to approximately 15% of the global burden of disease within this age group. Among adolescents, depression, anxiety, and behavioral disorders are leading causes of illness and disability [6]. Alarmingly, suicide ranks as the third leading cause of death among individuals aged 15-29 years, underscoring the severity of unmet mental health needs during this transitional life stage [7]. Adolescents living with mental health conditions are particularly vulnerable to a range of adverse outcomes, including social exclusion, stigma, reduced help-seeking behavior, educational challenges, engagement in risk-taking behaviors, poor physical health, and exposure to human rights violations [6]. Access to mental health services also remains particularly limited in low- and middle-income countries, where health systems often face constraints in resources, infrastructure, and trained personnel [8,9]. These multifaceted impacts highlight the urgent need for comprehensive, accessible, and youth-sensitive mental health interventions.

Sri Lanka has a population of approximately 22 million people, of which nearly one-fifth comprises adolescents [10,11], highlighting the significant demographic importance of this age group. The mental health of adolescents in Sri Lanka has been affected by the long-standing armed conflict, the Easter Sunday attacks, the COVID-19 pandemic, and the foreign currency crisis, along with the associated disruptions to schooling, increased screen time, and changes in daily life [12]. Evidence from Sri Lanka indicates that mental health problems among school-going adolescents are increasingly prevalent, yet remain insufficiently explored in terms of their determinants and contextual influences [10,13]. Studies indicate that adolescents in Sri Lanka are exposed to a range of mental health-related challenges, including food insecurity, involvement in physical fights, exposure to bullying, violence victimization, not living with both parents, overprotective paternal influence, increased academic stress, and daily social media use, all of which are associated with an increased risk of mental health and psychological problems [10,11]. Additionally, family dynamics and changing community structures play a crucial role in shaping adolescent mental health outcomes in the Sri Lankan context [14].

Life skills education has been widely recognized as an effective strategy for promoting mental well-being and preventing risk behaviors among adolescents. According to the WHO, life skills are defined as adaptive and positive abilities that enable individuals to effectively cope with the demands and challenges of everyday life [15]. Previous studies in Sri Lanka have demonstrated that structured educational and psychosocial interventions can significantly improve adolescents' well-being and coping abilities [13,16]. Despite these efforts, there remains a notable gap in locally developed, comprehensive, culturally appropriate life skills development packages tailored to the needs of Sri Lankan adolescents.

In response to emerging community-level mental health challenges, a peace-building initiative was undertaken, within which a community-based Mental Health and Psychosocial Support (MHPSS) program, titled "Manohari," was developed by a multidisciplinary team, with significant contributions from Dr. M. Ganesan and support from the WHO through the World Peace Fund.

The Manohari module has been utilized in various parts of the country since 2017 and has gained acceptance among diverse community groups, including school students, teachers, village communities, district and divisional secretariats, and mothers' clubs [17]. While anecdotal, non-scientific evidence suggests its usefulness, the module has not yet undergone formal scientific evaluation. Evaluating the content validity, cultural relevance, and contextual appropriateness of such interventions prior to wider implementation is essential to ensure their sustainability and effectiveness. Judgmental validation, which incorporates expert opinion and end-user perspectives, provides a systematic approach to determining whether an intervention aligns with the intended sociocultural and practical context [18,19]. Therefore, this study aims to judgmentally validate the Manohari module using a mixed-methods approach to support its implementation among adolescents.