Using Generative AI to Co-Design Digital Mental Health Interventions With Adolescents in Rural South Africa: Qualitative Thematic Analysis of Participatory Workshops

Editorial reading guide · Respect

Does an AI creation reflect my teenager’s culture and intentions?

Participants enjoyed ownership and personalization but also identified cultural bias, while most needed prompt support. Preferred media were not necessarily therapeutically appropriate: some remembered lessons absent from the AI stories.

Study context

Twenty-three English-comfortable adolescents in rural Mpumalanga, South Africa, who had previously used the Kuamsha mental-health app created stories, images, and music.

Age / stage: Adolescents aged 15–19 years

Read with three questions

1. Which outputs supported ownership and which reproduced cultural bias?
2. How did facilitator and language support affect who could participate?
3. Why do enjoyment and preference fail to establish mental-health benefit?

Keep the limits in view

The same adolescents created and compared the AI content, introducing ownership and familiarity biases. English eligibility excluded some local voices, and generated media were not designed around therapeutic principles or tested for clinical effectiveness.