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Perowne R, Rowe S, Gutman LM. Understanding and Defining Young People's Involvement and Under-Representation in Mental Health Research: A Delphi Study. Health Expect 2024; 27:e14102. [PMID: 38872473 PMCID: PMC11176595 DOI: 10.1111/hex.14102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 06/15/2024] Open
Abstract
INTRODUCTION The mental health of young people (aged 16-25 years) is a growing public health concern in the United Kingdom due to the increasing numbers of young people experiencing mental health difficulties, with many not in contact with mental health services. To design services that meet the needs of all young people, a diversity of young people must be involved in mental health research, beyond being participants. This Delphi study aimed to identify different types of 'involvement' and to define and describe 'under-representation' in young people's involvement in mental health research. METHODS Twenty-seven experts in young people's mental health research completed a series of online questionnaires. The experts were academic researchers, patient and public involvement (PPI) professionals and young 'experts by experience'. Round 1 generated panellists' views on 'involvement' and 'under-representation'. Round 2 summarised panellists' responses from Round 1 and sought consensus (minimum 70% agreement) in nine question areas. Round 3 validated the findings of the previous rounds. RESULTS Consensus was achieved in eight out of nine areas, resulting in a matrix (with definitions) of the different types of young people's involvement in mental health research, from being advisors to involvement ambassadors. The findings generated an agreed-upon definition of under-representation, an identification of when in the research process there is under-representation and the characteristics of the young people who are under-represented. Experts further agreed on demographic data that should be collected to improve reporting on involvement. CONCLUSIONS This study adds to our understanding of involvement and under-representation in the context of young people's mental health research through expert consensus. It provides a practical resource for researchers considering involving young people in the research process and suggests the data that should be collected to improve reporting on the diversity of the young people involved. PATIENT AND PUBLIC CONTRIBUTION A research oversight group of five young people advised on this study. They contributed throughout the project-from endorsing the research question to commenting on the findings and dissemination. Two of the group reviewed all participant materials and piloted the initial questionnaire.
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Affiliation(s)
- Rachel Perowne
- UCL Centre for Behaviour Change, Division of Psychology and Language Sciences, University College London, London, UK
| | - Sarah Rowe
- Division of Psychiatry, University College London, London, UK
| | - Leslie Morrison Gutman
- UCL Centre for Behaviour Change, Division of Psychology and Language Sciences, University College London, London, UK
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Yamaguchi S, Tuong J, Tisdall EKM, Bentayeb N, Holtom A, Iyer SN, Ruiz-Casares M. "Youth as accessories": Stakeholder Perspectives on Youth Participation in Mental Health Policymaking [Part II]. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:84-99. [PMID: 36357818 PMCID: PMC9648874 DOI: 10.1007/s10488-022-01230-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 10/12/2022] [Indexed: 11/12/2022]
Abstract
PURPOSE To elicit stakeholder perspectives on the findings from our scoping review on youth participation in mental health policymaking, we conducted a global consultation with young people and adults directly involved in mental health policymaking. METHOD Forty-four stakeholders from 16 countries, including 15 young people, 9 policymakers and 20 facilitators of youth participation, took part in individual interviews and/or focus groups. They were asked about how the review findings contrasted with their own experiences in mental health policymaking. The transcribed data were thematically analyzed. RESULTS All participants viewed lived experience as valuable in identifying policy gaps. Youth pointed out that children and youth with disabilities, diverse sexual orientations, and/or gender identities were often excluded, and spoke about feelings of being an "accessory", illustrating a lack of power-sharing in a tokenized policymaking process. Adult participants' accounts highlighted the challenges inherent in policymaking such as the need for political knowledge and institutional time constraints. A range of cultural, socio-economic, and political barriers to youth participation, that were often context-specific, were identified. CONCLUSIONS The diverse perspectives of stakeholders extended the review results. Based on our findings, we recommend that adults and institutions: (1) recognize lived experience as expertise in shaping mental health policies; (2) include diverse groups; (3) reduce tokenistic relationships through the creation of safer spaces, adult feedback, co-production, and social accountability; and (4) adopt an intersectional approach to address cultural, socio-economic, and political barriers to participation. Methodologically, our work demonstrates why stakeholder consultations are an essential component of scoping reviews.
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Affiliation(s)
- Sakiko Yamaguchi
- CHILD-BRIGHT Network, Research Institute of the McGill University Health Centre, Montreal, QC, Canada. .,School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada. .,Department of Psychiatry, McGill University, 1033 Pine Ave W, H3A 1A1, Montreal, QC, Canada.
| | - Josie Tuong
- grid.14709.3b0000 0004 1936 8649Department of Anatomy and Cell Biology, McGill University, Montreal, QC Canada
| | - E. Kay M. Tisdall
- grid.4305.20000 0004 1936 7988Childhood and Youth Studies, MHSES, University of Edinburgh, Edinburgh, UK
| | - Naïma Bentayeb
- grid.459278.50000 0004 4910 4652SHERPA University Institute, CIUSSS du Centre-Ouest-de-l’île-de-Montréal, Montreal, QC Canada ,grid.420828.40000 0001 2165 7843École Nationale d’Administration Publique, Montreal, QC Canada ,grid.14709.3b0000 0004 1936 8649School of Social Work, McGill University, Montreal, QC Canada
| | - Alexandra Holtom
- grid.14709.3b0000 0004 1936 8649School of Social Work, McGill University, Montreal, QC Canada
| | - Srividya N. Iyer
- Douglas Research Centre, ACCESS Open Minds (Youth Mental Health Network), Montreal, QC Canada ,grid.14709.3b0000 0004 1936 8649Department of Psychiatry, McGill University, 1033 Pine Ave W, H3A 1A1 Montreal, QC Canada
| | - Mónica Ruiz-Casares
- grid.459278.50000 0004 4910 4652SHERPA University Institute, CIUSSS du Centre-Ouest-de-l’île-de-Montréal, Montreal, QC Canada ,grid.14709.3b0000 0004 1936 8649Department of Psychiatry, McGill University, 1033 Pine Ave W, H3A 1A1 Montreal, QC Canada ,School of Child and Youth Care, Toronto Metropolitan University, Toronto, ON Canada
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McCabe E, Amarbayan M(M, Rabi S, Mendoza J, Naqvi SF, Thapa Bajgain K, Zwicker JD, Santana M. Youth engagement in mental health research: A systematic review. Health Expect 2022; 26:30-50. [PMID: 36385452 PMCID: PMC9854331 DOI: 10.1111/hex.13650] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/21/2022] [Accepted: 10/22/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Patient engagement in youth mental health research has the potential to inform research on the interventions, services and policies that will benefit youth. At present, there is little evidence to guide mental health researchers on youth engagement. This systematic review aims to describe the impacts of youth engagement on mental health research and to summarize youth engagement in mental health research. METHODS We searched the following databases: MEDLINE, EMBASE and PsycINFO, using a combination of subject headings, keywords and synonyms for the concepts 'patient engagement', 'youth' and 'mental health'. Articles that described engaging youth in mental health research were included. Two reviewers performed the study selection. Study characteristics, research activities performed by youth, impacts of youth engagement, challenges, and facilitators to engagement and recommendations for youth engagement described by authors were extracted. Quality appraisal involved determining the level of engagement of youth and the stage(s) of research where youth were involved. RESULTS The database search returned 2836 citations, 151 full-text articles were screened and 16 articles, representing 14 studies, were selected for inclusion. Youth were involved at nearly all stages of the research cycle, in either advisory or co-production roles. Youth engagement impacts included enhancing relevant research findings, data collection and analysis and dissemination to academic and stakeholder audiences. Both youth and academic researchers reported personal development across many domains. One negative impact reported was the increase in funding and resources needed for engagement. We produced a list of 35 recommendations under the headings of training, youth researcher composition, strategy, expectations, relationships, meeting approaches and engagement conditions. CONCLUSIONS This study provides an understanding of the impacts and recommendations of youth engagement in mental health research. The findings from this study may encourage researchers to engage youth in their mental health research and support youth engagement in funding applications. PATIENT AND PUBLIC CONTRIBUTION We consulted three youths with experience being engaged in mental health research about the review findings and the discussion. One youth designed a visual representation of the results and provided feedback on the manuscript. All youth's input informed the way the findings were presented and the focus of the discussion.
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Affiliation(s)
- Erin McCabe
- Department of Pediatrics, School of Public PolicyUniversity of CalgaryCalgaryAlbertaCanada
| | | | - Sarah Rabi
- Department of Community Health SciencesUniversity of CalgaryCalgaryAlbertaCanada
| | - Justino Mendoza
- Department of Biology, Faculty of Science and TechnologyMount Royal UniversityCalgaryAlbertaCanada
| | - Syeda Farwa Naqvi
- Department of Community Health SciencesUniversity of CalgaryCalgaryAlbertaCanada
| | | | - Jennifer D. Zwicker
- Department of Social Policy and Health, School of Public PolicyUniversity of CalgaryCalgaryAlbertaCanada
| | - Maria Santana
- Department of Pediatrics, Community Health SciencesUniversity of CalgaryCalgaryAlbertaCanada
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Meldahl LG, Krijger L, Andvik MM, Cardenas NE, Cuddeford O, Duerto S, Game JR, Ibenfeldt M, Mustafa M, Tong M, Viksveen P. Characteristics of the ideal healthcare services to meet adolescents' mental health needs: A qualitative study of adolescents' perspectives. Health Expect 2022; 25:2924-2936. [PMID: 36074720 DOI: 10.1111/hex.13600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Despite increased focus on development of mental health services worldwide, many adolescents still hesitate to reach out to the services when they need them. This might be linked to the lack of adolescent involvement in the development of services. This study aimed to explore adolescents' perspectives on the ideal healthcare services to meet their mental health needs. METHODS A two-stage qualitative study was carried out to explore the perspectives of adolescents on the healthcare services to support their mental health. In the first stage, data from 295 adolescents attending a mental health seminar were analysed using qualitative content analysis. In the second stage, in-depth perspectives of 10 adolescent coresearchers were gathered through self-reflection and group discussions to further explore the categories developed in the first stage. Thematic analysis was used to develop the themes answering the research question. Ten adolescent coresearchers planned the study, collected and analysed data and authored the manuscript, with the support of a senior researcher. RESULTS Five themes describe adolescents' perspectives on the ideal healthcare services to meet their mental health needs: (1) Culturally Sensitive and Responsive; (2) Communication of Information; (3) Easy Access; (4) Variety of Support; and (5) Consistency. Culturally Sensitive and Responsive services influenced all other themes. The themes describe suggestions for mental health service improvement, including how to manage the barriers that adolescents face to receive help from the mental health services. DISCUSSION This study highlights the importance of culturally sensitive and responsive services. It raises the need for an expanded definition of culture going beyond nationality and ethnic background. Adolescents need flexible services that meet their individual mental health needs. This has implications for practitioners, educators, system organizers and researchers, who should also involve adolescents in planning, implementing and assessing the services. There is a need for a self-learning system to continuously adapt to user feedback. CONCLUSION This study provides insight into adolescents' perspectives on the ideal mental health services. It offers suggestions for ways to improve services to better meet the individual mental health needs of adolescents. Additional research is needed to further develop and implement service changes, as well as to assess their acceptability, effectiveness, cost-effectiveness and safety. PATIENT OR PUBLIC CONTRIBUTION This is a study lead by adolescents. Adolescent coresearchers have, with the support of a senior researcher, planned and carried out the study, collected and analysed data and authored the manuscript.
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Affiliation(s)
- Laia G Meldahl
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Lou Krijger
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,ESCP Europe (Business Management), Ecole Supérieure de Commerce de Paris, Paris, France
| | - Maren M Andvik
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,School of Medical, Veterinary and Life Sciences (Zoology), University of Glasgow, Glasgow, Scotland
| | - Nicole E Cardenas
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,School of Psychology (Psychology), University of Aberdeen, Aberdeen, Scotland
| | - Oliver Cuddeford
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Faculty of Art Design and Architecture (Architecture), University of Huddersfield, Huddersfield, UK
| | - Samuel Duerto
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Faculty of Philosophy, Theology and Religious Studies (Philosophy, Politics and Societies), Radboud University, Nijmegen, The Netherlands
| | - Julia R Game
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Faculty of Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Maya Ibenfeldt
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Faculty of Biology, Medicine and Health (Pharmacology), University of Manchester, Manchester, UK
| | - Murad Mustafa
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Faculty of Health Sciences (Nursing), University of Stavanger, Stavanger, Norway
| | - Mathias Tong
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Department of Chemical Engineering and Analytical Science (Chemical Engineering), University of Manchester, Manchester, UK
| | - Petter Viksveen
- Department for Quality and Health Technology, SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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