Drivers of youth engagement in mental health initiatives among Moroccan youth: findings from a nationwide cross- sectional survey

Background: Engaging youth in the design and implementation of mental health initiatives has been shown to improve effectiveness, however evidence on what drives such engagement in Morocco remains scarce. Similar to many low- and middle-income countries (LMICs), youth mental health initiatives in Morocco face persistent challenges related to engagement and uptake. This study investigates the possible drivers of youth engagement in available mental health initiatives by youth in the specific context of Morocco. It examines their levels of engagement, awareness and attitudes toward mental health issues and initiatives, while exploring the support and additional resources required to enhance their active involvement. Methods: We conducted a nationwide cross-sectional study in 12 regions of Morocco, including young Moroccans aged 18-24 years. Using an online self-administered questionnaire, we assessed participants' levels of engagement in mental health activities, attitudes toward mental health, awareness about mental health issues, and their support needs, and perceived importance. Descriptive statistics, clustering analysis, and logistic regression analyses were used to identify predictor factors of youth engagement in mental health. Results: A total of 1,183 participants were included. Predictors of engagement in mental health initiatives included higher education (OR = 2.23, p < 0.001), unemployment (OR = 1.07, p = 0.035), and positive attitudes toward mental health (OR = 1.04, p < 0.001). Cluster analysis showed that highly engaged participants reported greater awareness and more positive attitudes toward mental health. The most frequently cited needs to support youth engagement were access to mental health professionals (63.0%), followed by mental health education (42.4%). Conclusions : This study provides the first empirical evidence on drivers and factors influencing youth engagement in mental health initiatives in Morocco, highlighting how effective utilization of youth mental health resources may be shaped by specific cultural factors. Key recommendations include embedding mental health counselling and structured programs within schools and youth centers, particularly in rural areas, to normalize conversations, reduce stigma, and improve resource utilization through culturally relevant, youth-co-designed initiatives.