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Young people and mental health: a systematic review of research on barriers and facilitators

What do we want to know?

Promoting good mental health has been identified as a high priority for health policy, and young people are a key group for action. Our objectives were to provide a summary of evidence to help develop, implement and evaluate interventions for promoting good mental health amongst young people aged 11 to 21 years. We had a particular focus on young people from socially excluded groups and on interventions to prevent suicide and self-harm, and associated depression, and the promotion of self-esteem and coping strategies

Who wants to know?

Practitioners, policy-makers, researchers, young people.

What did we find?  

A small number of well-designed evaluations were identified and these revealed mixed evidence on effectiveness. Interventions to promote self-esteem were more likely to be effective if this was the main focus of the intervention, and skill development was more effective than information alone. There was some evidence that interventions to prevent suicide may be harmful.

Young people had clear perspectives on their mental health and how it could be promoted. These included the inappropriateness of the terms such as ‘mental health’; their sophisticated understandings of coping strategies; their wide range of concerns; and the irrelevance of many interventions to young people's pragmatic, everyday worries. Evaluated interventions tended to neglect physical and material factors identified as important by young people for their mental health (e.g. money, unemployment).

What are the implications?

Because the evidence is mixed, there should be careful consideration about which interventions to implement to promote young people’s health or whether to intervene at all. It cannot be assumed that what is implemented will be effective.

There is a need to develop and strengthen the evidence-base in this area, including attention to socially excluded groups and inequalities in health. Future studies should evaluate interventions which take the views of young people as a starting point and build on their coping strategies. Promising interventions suggested by young people’s views include reducing school work loads, improving social relationships, and tackling material and physical circumstances.

How did we get these results?

The review map was based on 345 studies. Exhaustive searches and critical appraisal identified 24 studies for the in-depth review: seven systematic reviews; five high quality evaluations from around the world which studied the effects of interventions to promote mental health; and 12 qualitative and other types of studies of young people’s views in the UK.

This summary was prepared by the EPPI-Centre

This report should be cited as: Harden A, Rees R, Shepherd J, Brunton G, Oliver S, Oakley A (2001) Young people and mental health: a systematic review of research on barriers and facilitators. London: EPPI-Centre, Social Science Research Unit, Institute of Education, University of London. 

  
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