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

Promoting good mental health has been identified as a high priority for health policy. Young people are a key group for action. Putting policy into practice means developing and implementing effective interventions for, and with young people. An important step in this process involves examining what we can learn from existing research. Our objectives were to provide practitioners, policy-makers and researchers with a summary of evidence to help them develop, implement and evaluate interventions for promoting good mental health among young people. We had a particular focus on young people from socially excluded groups and upon interventions to prevent suicide and self-harm, and associated depression, and the promotion of self-esteem and coping strategies.

Exhaustive searches were undertaken of multiple sources to identify relevant studies. The methodological quality and findings of studies meeting specific inclusion criteria were assessed using standardised tools. Two types of study were included: international studies evaluating the effectiveness of interventions, and UK studies examining young people’s own views about their mental health. A total of 33 studies met our inclusion criteria: 12 examined young people’s views; 7 were previous systematic reviews of the effectiveness of mental health promotion; and 14 were potentially rigorous studies not already included in systematic reviews.

The evidence from effectiveness research was mixed and few good-quality studies were identified. Interventions to promote self-esteem were more likely to be effective if this was the main focus of the intervention. There was some evidence that interventions to prevent suicide may be harmful. Findings from young people's perspectives included the inappropriateness of 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.

A comparison across study types identified effective interventions that have addressed young people’s concerns about teachers, parental divorce and conflict; bereavement; and peer rejection. Major gaps were effective interventions addressing concerns around academic achievement and engagement in school; future employment and financial security; access to leisure facilities; dealing with loss of friends and family; violence and bullying; physical appearance. A further gap was effective interventions building on talking to friends as a favoured coping strategy.

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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