Commentary: Are we over-pathologising young people's mental health? Locked inside our own building - on disorderism and the need to deflate our language.

Since the growth of research into neighbourhood effects on young people's health in the 1980s, there have been major societal changes and scientific methodological advancements. In this systematic review we will, therefore, discuss the recent (>2009) literature on the association between neighbourhood deprivation and young people's (0-19 years old) mental health and well-being. We focus on whether neighbourhood deprivation effects exist, and how and for whom the neighbourhood matters. Together, the thirty studies included in the review indicate that overall there are neighbourhood effects on young people's mental health and well-being. The comparison of results from these studies suggests that such associations were more commonly found for well-being and externalising problem behaviour rather than internalising problem behaviour. Also, mental health and well-being seemed to be more often associated with the neighbourhood social environment than neighbourhood socio-economic status and neighbourhood disorder. Studies investigating mediating processes between the linkage between neighbourhood deprivation and mental health and well-being were rare although there was some evidence that processes within the family and peer context are important mechanisms in this linkage. Inconsistent evidence was found regarding the moderating role of age, gender, and ethnicity. There are ongoing challenges of researching the how and for whom neighbourhoods are important. We should work towards rigorous theory and evidence on how different features of residential contexts matter and on differential exposure and vulnerability to these contexts.

Teenpath COVID is a mixed-methods, participatory study exploring the experiences of young people in Ireland since the COVID-19 pandemic and its impacts on existing health inequalities. As part of an exploratory sequential research design, we conducted a stakeholder analysis, online survey, and participatory arts programme evaluation to identify cross-cutting issues impacting the health and well-being of young people in Dublin and across Ireland. Interviews conducted with stakeholders spanning youth service, public health, and education sectors, and young people aged 16-25 explored individuals’ experiences of the pandemic; adaptations to working and maintaining engagement online; key concerns about young people's health and wellbeing; and priorities for future research and policy. Thematic analysis identified impacts of the pandemic on health inequalities with potential policy implications. This informed a subsequent online survey exploring young people's mental health since the pandemic, and an ethnographic case study of a participatory arts programme exploring key issues important to young people in Dublin. Our findings suggest the pandemic has impacted predominantly on young people's mental health and access to youth mental health services; disruption to work, education and social and peer support networks; and health behaviours. Protective measures, from accessing and maintaining social support networks, to developing coping strategies were important for young people's mental health. However the extent to which these were possible was shaped significantly by individuals’ personal circumstances at the time. These findings show the importance of social participation and support for young people in navigating the uncertainties and difficulties of growing up in a pandemic. Participatory approaches can be a pathway for aligning healthy priorities and policy that contributes unique and rich insights into community health, and places young people at the centre of change. Key messages • Young people in Ireland have experienced significant impacts to their mental health since the COVID-19 pandemic began, particularly regarding disruptions to education and social support networks. • Participatory approaches to research and youth engagement with young people is important for gathering high quality and diverse data on complex topics such as mental health and health inequalities.

Misleading News Coverage of Research Findings Poses a Risk to Youth Mental Health and Safety

Youth mental health is a rapidly developing field with a focus on prevention, early identification, treatment innovation and service development. In this perspective piece, we discuss the effects of COVID-19 on young people's mental health. The psychosocial effects of COVID-19 disproportionately affect young people. Both immediate and longer-term factors through which young people are affected include social isolation, changes to the delivery of therapeutic services and almost complete loss of all structured occupations (school, work and training) within this population group. Longer-term mechanisms include the effects of the predicted recession on young people's mental health. Opportunities within this crisis exist for service providers to scale up telehealth and digital services that may benefit service provision for young people's mental health in the future.

The novel coronavirus (COVID-19) pandemic in Canada has increased attention and concern paid to young people's well-being and mental health. Narratives of isolation, exacerbated inequalities, and potential unequal recovery for young people, in particular, have been presented as a result of school closures across the country. Through these narratives, young people are framed as vulnerable, passive recipients of adult decisions and interpretations of their experiences. This research examines these narratives by conducting ethnographic fieldwork with a group of young people living in a rural Ontario town through the pandemic. This thesis presents and analyzes these young people's experiences of the pandemic related to mental health and well-being to reveal the missing nuances of adult narratives and to propose suggestions for future inclusive, accessible, rights-respecting programs for young people's mental health and well-being post-pandemic based on young people's accounts. Keywords: ethnography, COVID-19 pandemic, rural young people, mental health and well-being, children's rights

Young people's mental health globally has been in decline. Because of their low perceived need, young people's services tend to be the first cut when budgets are reduced. There is a lack of evidence on how a reduction in services and opportunities for young people is associated with their mental health. Additionally, how this may be magnified by place and the assets and challenges of place. The aim of this study is to explore trends in young people's mental health measured by GHQ-12 over time in the twelve regions of the UK. We estimated an interrupted time series model using 2010 as a break point from which there was a shift in government policy to a prolonged period of large reductions in central government funding. Repeated cross-sectional data on young people aged 16–25 is used from the British Household Panel Survey and its successor survey UK Household Longitudinal Survey. Results showed a statistically significant reduction in mental health for young people living in the North East, Wales, and the East of England. The North East was the region with the largest reduction in funding and saw the greatest reduction in young people's mental health. Next, we look at how reductions in local government expenditure related to services for children and young people: children's social services, education, transportation, and culture; explain the observed decline in mental health. We employ a Blinder-Oaxaca Decomposition approach comparing young people's mental health between 2011 and 2017. Results show a marginally statistically significant decrease in young people's mental health over this time. Unobserved factors related to transport spending and children's social services explain some of this gap. Area level factors such as deprivation, infrastructure, and existing assets need to be considered when distributing funding for young people's services to avoid exacerbating regional inequalities in mental health.

Australia and England show high rates of psychological distress and mental health problems in young people. Both are high-income countries and have stated their intention to improve the delivery of health care to young people in primary care settings. Australia has an international reputation for improving care through innovative services and educational initiatives. England has taken a different direction and has concentrated more on developing policy and making recommendations to improve access for young people. To describe a Churchill Fellowship visit to Australia to observe initiatives in primary care based youth-friendly mental health care and to reflect upon the observations, comparing and contrasting with the English model. The observations and reflections presented draw on field notes from site visits and meeting with key players, accessing web resources and referring to the literature, both grey and published. Australia offers plurality in health care delivery and innovative responses to addressing youth mental health. There are two key approaches. The first is the development of services specializing in youth mental health. The second approach is to build capacity of existing primary care services to recognize the particular bio-psychosocial needs of adolescents (and their families). In contrast, England has tended to focus primarily on policy development and improving youth access. The paper draws attention to a number of political, clinical and educational developments in both Australia and England. Both countries demonstrate different strategies in response to the high levels of psychological distress in young people. Learning from colleagues in other settings can inform our own practice. Ultimately responding to young people's mental health needs is best served by youth-friendly policy which prepares clinicians for effective practice, informed by applied research and supported by adequate resources. Investment in young people's health must be a priority for us all.

There is an increasing focus on structural and social determinants of inequalities in young people's mental health across different social contexts. Taking higher education as a specific social context, it is unclear whether university attendance shapes the impact of intersectional social identities and positions on young people's mental health outcomes. Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) was used to predict the odds that mental distress during adolescence, sex, socioeconomic status, sexual identity, ethnicity, and their intersections, were associated with young people's mental health outcomes at age 25, and whether this differed based on university attendance. Data from the Longitudinal Study of Young People in England cohort study were analysed with the MAIHDA approach, and the results did not reveal any evidence of multiplicative intersectional (i.e., aggravating) effects on young people's mental health outcomes. However, important main effects of social identities and positions (i.e., an additive model) were observed. The findings suggested that being female or identifying as a sexual minority increased the odds of young people experiencing mental health problems at age 25, although the odds of self-harming were half the size for sexual minorities who had attended university. Black and Asian individuals were less likely to declare a mental illness than White individuals. Young people who grew up in a more deprived area and had not attended university were more likely to experience mental health problems. These findings imply that mental health interventions for young people do not necessarily have to be designed exclusively for specific intersectional groups. Further, university attendance appears to produce better mental health outcomes for some young people, hence more investigation is needed to understand what universities do for young people, and whether this could be replicated in the wider general population.

Providing the growing number of children and young people seeking mental health support with timely access to care poses a significant challenge. Increased use of digital technology in the delivery of children and young people's mental health services has been proposed as a means of increasing access to treatment. We conducted three interrelated studies to provide multi-perspective insights into the use of digital therapeutic interventions within children and young people's mental health services in the UK. Study 1 used semi-structured interviews and an online survey to collect the views of digital therapeutic interventions of families who self-identified as facing additional barriers to accessing mental health support (n=13). Study 2 involved eight focus groups with children and young people's clinicians, service managers, commissioners, and policy leads (n=28), exploring participants' views and experiences of implementing and sustaining digital therapeutic interventions. Study 3 was a consensus exercise which aimed to identify actions needed to bridge the gap between the development and use of digital therapeutic interventions for children and young people's mental health through focus groups with parents/carers and professionals (n=17), and three Delphi-survey rounds. Our findings revealed considerable enthusiasm for the increased use of digital mental health interventions for children and young people across stakeholder groups, but also identified key barriers to their implementation. Actions perceived to facilitate more effective implementation included: a) co-producing interventions, commissioning decisions and implementation plans with children and parents/carers, b) enhancing national guidance and local leadership, c) integration of digital offers within existing clinical pathways, and d) efforts to ensure accessibility and inclusivity. Digital therapeutic interventions offer a promising solution to the challenge of improving access to mental health support for children and young people. Strengthened guidance and leadership, sustained funding and further evidence-generation are urgently needed to enable this promise to be realised.

British Journal of School NursingVol. 13, No. 10 RepresentationSchool nursing's potential to have an impact on the prevention agenda and mental health outcomes: A position statementSharon WhiteSharon WhiteSearch for more papers by this authorSharon WhitePublished Online:18 Dec 2018https://doi.org/10.12968/bjsn.2018.13.10.514AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References British Youth Council. Our School Nurse: Young people's views on the role of the school nurse. 2011. BYC Google ScholarDay P. Motivating Teen Spirit: Early metal health intervention. BJSN. 2016;11(2): 93 Link, Google ScholarDepartment of Health. Healthy Child Programme: 5 to 19 years old. 2009. https://bit.ly/2rk8dmA Google ScholarDepartment of Health. Chief Medical Officer annual report 2012: children and young people's health. 2013. https://bit.ly/1iTKqlz Google ScholarDepartment of Health. Future in mind—Promoting, protecting and improving our children and young people's mental health and wellbeing. 2015. https://bit.ly/2Kr7RTn Google ScholarDepartment of Health, Department for Education. Transforming Children and Young People's Mental Health Provision: a Green Paper. 2017. https://bit.ly/2H51qGU Google ScholarDepartment of Health, Public Health England. Maximising the school nursing team contribution to the public health of school-aged children—Guidance to support the commissioning of public health provision for school aged children 5–19. 2014. DH, PHE Google ScholarDepartment of Health and Social Care. Prevention is better than cure: our vision to help you live well for longer. 2018. https://bit.ly/2SLpZvG Google ScholarDepartment of Health and Social Care, Public Health England. Overview of the 6 early years and school aged years high impact areas. Health visitors and school nurses leading the Healthy Child Programme. 2018. https://bit.ly/2AqfGVG Google ScholarKay CM, Morgan DL, Tripp JH, Davies C, Sykes S. To what extent are school drop-in clinics meeting pupils self-identified health concerns? Health Education Journal. 2006;65(3):236–251 Crossref, Google ScholarKelly N, Greaves C, Buckland L, Rose J. ‘School nurses: well placed to address challenging behaviour’. Community Practitioner 2005;78(3):88–92 Google ScholarMarmot. Fair society, healthy lives: The Marmot Review: strategic review of health inequalities in England post-2010. 2010 Google ScholarMasters R, Anwar E, Collins B, Cookson R, Capewell S. Return on investment of public health interventions: a systematic review. J Epidemiol Community Health. 2017 Aug;71(8):827-834. doi: https://doi.org/10.1136/jech-2016-208141 Crossref, Google ScholarPublic Health England. All Our Health: about the framework. 2018. https://bit.ly/2qipnAM Google ScholarRoyal College of Nursing. 2017. The Best Start: The Future of Children's Health: Valuing school nurses and health visitors in England. https://bit.ly/2Rwu2uG Google Scholar FiguresReferencesRelatedDetailsCited byExtending the mental health expertise of school nurses: Evaluating a training programmeStephen Abbott, Rosamund Bryar, Ruth Cohen, Jane Gibbons, Lucy Marks15 November 2019 | British Journal of School Nursing, Vol. 14, No. 9 2 December 2018Volume 13Issue 10ISSN (print): 1752-2803ISSN (online): 2052-2827 Metrics History Published online 18 December 2018 Published in print 2 December 2018 Information© MA Healthcare LimitedAcknowledgments:Thanks go to Kate Murdock, children's health service manager, South Locality—Trafford Division, and Sallyann Sutton, professional lead—school nursing, for leadership in pulling together this position statement on behalf of SAPHNA.PDF download

This study aimed to investigate coaches' awareness of mental health in youth sport, as well as their perceived role breadth and ability to support young people's mental health. Interviews were conducted with 13 sports coaches of young people aged 12–18 from Canberra, Australia. Interview transcripts were analysed using a combination of inductive and deductive qualitative content analysis. Coaches recognised that their role breadth allows them to be a useful source of support for young people's mental health by way of identifying concerns, facilitating help-seeking behaviour and promoting engagement in sports. Further training in mental health would boost coaches' ability to assist confidently and effectively, leading to benefits for young people's mental wellbeing and sporting experience. Coaches are in a position to positively impact young people's mental health, and set expectations for themselves to actively support young people in this way. Supporting mental health may be an area of future growth for the role of a youth sports coach.

The impact of the Covid-19 pandemic on young people's (YP) mental health has been mixed. Systematic reviews to date have focused predominantly on quantitative studies and lacked involvement from YP with lived experience of mental health difficulties. Therefore, our primary aim was to conduct a qualitative systematic review to examine the perceived impact of the Covid-19 pandemic on YP's (aged 10-24) mental health and wellbeing across Europe. We searched MEDLINE, PsycINFO, Embase, Web of Science, MEDRXIV, OSF preprints, Google, and voluntary sector websites for studies published from 1st January 2020 to 15th November 2022. European studies were included if they reported qualitative data that could be extracted on YP's (aged 10-24) own perspectives of their experiences of Covid-19 and related disruptions to their mental health and wellbeing. Screening, data extraction and appraisal was conducted independently in duplicate by researchers and YP with lived experience of mental health difficulties (co-researchers). Confidence was assessed using the Confidence in the Evidence from Reviews of Qualitative Research (CERQual) approach. We co-produced an adapted narrative thematic synthesis with co-researchers. This study is registered with PROSPERO, CRD42021251578. We found 82 publications and included 77 unique studies in our narrative synthesis. Most studies were from the UK (n = 50; 65%); and generated data during the first Covid-19 wave (March-May 2020; n = 33; 43%). Across the 79,491 participants, views, and experiences of YP minoritised by ethnicity and sexual orientation, and from marginalised or vulnerable YP were limited. Five synthesised themes were identified: negative impact of pandemic information and restrictions on wellbeing; education and learning on wellbeing; social connection to prevent loneliness and disconnection; emotional, lifestyle and behavioural changes; and mental health support. YP's mental health and wellbeing across Europe were reported to have fluctuated during the pandemic. Challenges were similar but coping strategies to manage the impact of these challenges on mental health varied across person, study, and country. Short-term impacts were related to the consequences of changing restrictions on social connection, day-to-day lifestyle, and education set-up. However, YP identified potential issues in these areas going forward, and therefore stressed the importance of ongoing long-term support in education, learning and mental health post-Covid-19. Our findings map onto the complex picture seen from quantitative systematic reviews regarding the impact of Covid-19 on YP's mental health. The comparatively little qualitative data found in our review means there is an urgent need for more high-quality qualitative research outside of the UK and/or about the experiences of minoritised groups to ensure all voices are heard and everyone is getting the support they need following the pandemic. YP's voices need to be prioritised in decision-making processes on education, self-care strategies, and mental health and wellbeing, to drive impactful, meaningful policy changes in anticipation of a future systemic crisis.

The COVID-19 pandemic significantly impacted young people's mental health, leading to increased distress and reduced life satisfaction worldwide. Among the worst-hit countries, Italy saw mental health services shift online, prioritizing urgent cases. Consequently, therapy for many individuals was interrupted, leaving young people largely neglected. In response, the Italian government allocated €8 million for youth mental health initiatives during the pandemic, and the Veneto region utilized €2 million to establish the District Functional Unit for Adolescents (UFDA) within its public Child and Adolescent Mental Health Services to provide specialized care for young people. The pilot phase was implemented between April and December 2022. This study reports preliminary findings on UFDA's effectiveness in Padua's Local Health Unit. The main objectives include describing patient characteristics and assessing the intervention outcomes. The study involved 255 youths, representing 71.43% of patients at UFDA (mean: 14.4; range: 12-24 years), and 170 parents. Self- and informant-report versions of the Strengths and Difficulties Questionnaire (SDQ) were administered. A regional questionnaire was used to describe the patient profiles, and the intervention progress record documented anamnestic data and clinical progress of patients. The study revealed positive intervention outcomes despite the limited number of psychotherapy sessions. Results of the SDQ highlighted improvements in all difficulty scales after the intervention. The UFDA pilot project underscores the potential of a preventive, youth-centered approach to address young people's mental health needs. The insights from this study can inform strategies to enhance youth mental health care in post-COVID-19 Italy.

ABSTRACTThere is growing evidence that climate anxiety is associated with significant effects on the mental health and wellbeing of young people. However, the relative importance of climate anxiety for young people's mental health has hitherto been unclear, as climate anxiety has largely been studied in isolation from other common stressors. This study sought to contextualize the significance of climate anxiety for the mental health of UK young adults relative to other concurrent psychological stressors. We surveyed university students (N = 461) and a general population sample aged 18–25 (N = 400). The results showed that while climate anxiety was significantly associated with poorer mental health and worse insomnia when examined alone, this association became nonsignificant or greatly diminished when other stressors were considered. Loneliness was found to be the most important predictor of mental health, and financial anxiety the most important predictor of insomnia severity. The findings suggest that climate anxiety, while concerning, may not be an especially dominant factor in young people's mental health. Our research highlights the need to consider the broader context of young people's lives, and the complex interplay of various psychological stressors, in efforts to map pathways between climate change and mental health.

Mental health is an issue for the whole community. Effective support and intervention for mental health can be carried out across a range of contexts. This paper investigated teachers' and coaches' relative involvement in promotion, prevention and early intervention activities for young people's mental health. A set of activities representing promotion, prevention and early intervention for mental health was developed through expert consensus and was used in an online survey completed by 124 teachers and 147 coaches within Canberra, Australia. Results indicated both teachers and coaches frequently performed activities which promote young people's mental health. Teachers more commonly engaged in behaviour that supported prevention and early intervention for mental health than coaches. Encouraging adults in community-based roles to take early action in supporting young people's mental health is important to reduce the burden of mental health problems among young people and strengthen available pathways to mental health care.