Listen to youth voices to better intersectional mental health support

Executive summary

• One in five children and young people (aged 8-25) had a probable mental health disorder in 2023, and the pandemic led to increased isolation and stress.
• Half of adulthood mental health challenges begin by the age of 14 and 75% of mental health issues are established by the age of 24, making the need for youth focus clear.
• In the UK, around 75% of young people experiencing a mental health problem are forced to wait so long their condition gets worse, or they are unable to access any treatment at all. According to UK doctors, funding and staffing levels are not sufficient to provide appropriate mental health support.
• Existing literature evidences that children and young people are more likely to have poor mental health if they experience living in poverty, parental separation or financial crisis, or parents with poor mental health; if they identify as LGBQT+; and when they experience structural racism and discrimination along class, gender, or sexuality often cause and/ or exacerbate poor mental health.
• An intersectional lens is therefore crucial to understand the causes and impact of youth mental health.

Policy recommendations

1. Establish a Cultural Competency Quality Assessment Framework and promote Diversity Experience Days and cultural competency training for all mental health professionals. The training and framework should be developed alongside young people, relevant communities and organisations to a) establish formal standards and guidelines for working with various diverse backgrounds (culture, gender, class, etc.) and b) give organisations a stamp to demonstrate their competency.
2. Increase levels of support to help young people navigate the mental health system, through advocates with understanding of the young person’s background.
3. Ensure Youth Mental Health spaces in both educational and NHS are designed by young people from different backgrounds, with an accountability process that ensures the end design of these spaces accurately reflects input from young people.
4. Make it compulsory for all educational staff members in schools, colleges, and universities to be trained in mental health to increase early intervention and improve respect for those experiencing mental health issues.
5. Promote co-production with young people at the forefront: School staff members, medical and support service providers, parents and charities should be able to collaborate in a positive way with young people to facilitate access to appropriate mental health support.

About the research

We worked with young people (16-25) through a series of participatory research and participatory democracy projects on youth mental health. We used Legislative Theatre, digital participation on the civi tech platform Decidim, and participatory research methods, to rethink mental health from the perspectives of young people, diverse along class, ethnic, and gender lines. Project partner42nd Street (CYP Mental Health Charity) also led a participatory peer research study ‘You’re helping me just by listening’ into the experiences of young adults accessing support for their mental health.

Legislative Theatre is about creating a performance based on people’s lived experience to develop new policies and practices. The young people developed two plays representing their experience; during the performance they worked with an audience of community members and policymakers to co-create policy proposals that can make a difference to their wellbeing.

“Experiences in mental health establishments where your practitioners and your doctors don’t look like you can be isolating. It feels like being at crisis point is the only way to be heard.” Legislative theatre peer facilitator.

This process of youth-led democracy translated into a Manifesto for change in youth mental health (Bussu et. al, 2024).

“Counselling and mental health support can’t be universal because every person is different. And a lot of it can be affected by your culture. I come from an Indian background and it’s very taboo to have mental health concerns. It took years with my parents to want to have conversations about it. But you can’t blame them because that’s their background. It’s about addressing those concerns. So you need to have a supportive counsellor that gets that.” Peer researcher.

Across all this work, young people highlighted their need to feel heard and ensure a stronger intersectional perspective to respond to the mental health epidemics of an increasingly diverse youth population.

An intersectional lens needs to underpin mental health policy and practice

Mental health is complex and often depends on experiences, stressors, and socio-economic dynamics, and how these interact with a person's multiple and intersecting identities. In our work we found that young people experience multiple intersectional discriminations as they navigate mental health support in the health system as in educational settings.

Young people need to be at the forefront of policymaking on youth mental health

Participatory processes are about agency. The characters of a Legislative Theatre work to challenge the oppressions they face and seek allies among community members and policymakers to co-create solutions. As part of our work, we also enabled young people to self evaluate their own experience of participation and perceived social impact, recognising the importance of lived experience to shape policies and understand their impact.

Contact

Dr Sonia Bussu, University of Birmingham, PI of the Mindset Revolution project
s.bussu@bham.ac.uk

Partners

Niamh Carroll (research lead), Kenzye Roberts and Sofija Zindule (peer researchers) 42nd Street
Dr Zarah Eve, Research Fellow, Manchester Metropolitan University
Katy Rubin, Legislative Theatre expert.
Olivier Schulbaum, Platoniq Foundation Goteo

The Mindset Revolution young people: Ali Coleman, Bolu Onalaja, Charlie, Cicka, Chimwemwe Chirwa, Dan O' Donnell, Destiny, Jordan, Juliet Oduro, Lee Grant, Lee, Linton Rainford, Maame, Millissa, Mahdiyyah Ahmed, MJ Changwereza, Oscar Greer, Prateek Gupta, Saira Ali, Sam Dixon, Ummay Shabbir, Zainab Maria, Zara.

Read the full brief: Listen to youth voices to better intersectional mental health support (PDF, 238KB).