Research
A key objective of the TRIUMPH Network was to support public mental health research across three core themes:
While any young person can experience difficulties with their mental health, some groups are more likely to experience problems. Some young people may live in particularly complex and challenging families, in places with fewer opportunities for education or employment, or in societies where their identities are not treated equally and fairly. TRIUMPH focussed on two key groups of young people that are at greater risk of poor mental health and wellbeing:
– Care-experienced young people, including those who may have lived in foster care, residential care, kinship care, hostels or independently.
– LGBTQ+ young people, including those who are lesbian, gay, bisexual, trans, queer or questioning, or who may define their sexual orientation and/or gender identity in other ways.
TRIUMPH has supported research aiming to better understand what young people with experience of being in these groups think are the causes of poorer mental health and wellbeing, and what they think is useful for reducing these inequalities. We aimed to co-create new and sensitive ways of improving mental health and wellbeing among those with the greatest need.
Relationships with friends and family, and other social interactions can affect young people’s mental health and wellbeing in both positive and negative ways. At present, we have intuitions and evidence about the importance of young people having “one trusted adult” they can turn to if they need support; the role of having a few “close friends” to provide emotional support; or how mental wellbeing can be supported by having many social connections as compared to having little or no connections.
Simply counting the number and types of social connections is only the beginning of trying to understand how connections and relationships influence our mental health and wellbeing. TRIUMPH has supported research to find out what sorts of social connections and relationships are the most important for young people’s mental health. We aimed to better understand what young people think about their social connections, find out what relationships are most helpful and harmful for mental health, and come up with new ways to help improve mental health and wellbeing.
Schools and other education settings can play an important role in supporting the mental health and wellbeing of young people and provide a unique opportunity to deliver programmes to a wide audience of young people. They are also important settings for identifying and challenging things that can have negative impacts on mental health and wellbeing such as bullying, victimisation and negative or violent relationships. Emerging evidence suggests the way schools are organised, the level of meaningful pupil involvement in decision making and staff/pupil relationships can contribute to wellbeing. However, school and health service support for those most in need is often lacking and we don’t know enough about how best to support key groups of young people at the greatest risk of mental ill health. The TRIUMPH Network has supported research into new programmes that can be delivered within schools and other education settings that positively influence the mental health and wellbeing of pupils.
We worked with young people, researchers, policymakers and practitioners from across the UK to determine priority areas for future research into youth mental public health within each of these themes. You can read about these priorities in our report.
Network funded research projects
Through our plus-funding call the TRIUMPH Network has supported four exciting projects focussed on supporting young people’s mental health. Watch each video to find out more about the project aims, key findings and how researchers, practitioners and young people successfully worked together to deliver these projects.
Co-production or adaptation of online interventions for foster care: Promoting the mental health and wellbeing of care-experienced children and young people
Rhiannon Evans (Cardiff University)
Dawn Mannay (Cardiff University)
Maria Boffey (The Fostering Network)
Charlotte Wooders (The Fostering Network)
Lorna Stabler (Cardiff University)
Rachel Vaughan (Cardiff University)
Brittany Davies (CASCADE Voices)
Young people who have been in care are at increased risk of poor wellbeing and mental ill-health. There are range of programmes and services that aim to offer support, but the majority of these are delivered in-person. Recently, there has been a move to deliver services online, especially during the Covid-19 pandemic. This has highlighted a number of challenges for those working with care-experienced young people, as it may be difficult to conduct risk assessments digitally or ensure child protection. There are also issues about young people having limited access to phones or computers.
This project looked at how to best develop online programmes for care-experienced young people, or how to or adapt them from in person to online delivery. Young people from CASCADE Voices and The Fostering Network Young Person’s Council were involved in the design and delivery of the project.
The team interviewed 23 participants including care-experienced young people, health and social care professionals and foster and kinship carers. These participants discussed their experiences and the strengths and challenges of online and in-person services, as well as offering recommendations for future practice and interventions. From these interviews, a final list of policy and practice recommendations were developed in collaboration with foster and kinship carers from The Fostering Network Wales’ Advisory Forum and care-experienced young people from Cascade Voices and The Fostering Network’s Young People’s Care Forum. Recommendations cover six key areas: research; training; awareness and access; resources; choices and flexibility; safety, and protection and risk.
STEP Study: Schools Training to Enhance support for LGBTQ+ young People
Charlotte Woodhead (King’s College London)
Angela Mascolo (Exposure Organisation)
Lukasz Konieczka (Mosaic LGBT+ Young Persons Trust @TheMosaicTrust)
Catherine el-Zerbi (King’s College London)
Juliet Dyrud (Mosaic LGBT+ Young Persons Trust)
Kate Rimes (King’s College London)
Sally Marlow (King’s College London)
Gemma Knowles (King’s College London)
Helen Ward (Jack Drum Arts)
Josh Conlon (Jack Drum Arts)
Tom Makepeace (Jack Drum Arts)
Schools are key to public mental health approaches supporting young LGBTQ+ persons. Teachers and other school staff who understand LGBTQ+ students can create more accepting environments and help prevent mental health issues. However, little is known about the training needs of staff in relation to LGBTQ+ mental health from young people’s or staff perspectives, the extent to which they involve students, or incorporate their perspectives into training, development or delivery.
This project aimed to optimise training around LGBTQ+ mental health for schools, by:
- Identifying the UK-based LGBTQ+ training available to schools and what relevance it has to young persons’ mental health and how this compares to staff training needs identified by LGBTQ+ pupils and school staff.
- Understanding what influences training uptake by schools and identifying ways to encourage uptake.
Young people from Mosaic LGBT+ Young Persons Trust and Jack Drum Arts were involved as part of a research advisory group and as trained peer researchers.
The project team undertook a scoping review of existing training courses and providers, and conducted interviews and focus groups with young people, school staff and training providers to find out more about the existing training provision and what young people and school staff wanted from the training. Findings support the need for intersectionality informed, contextually adaptable, “Whole School Approaches” to inclusion. This involves action and collaboration across all parts of schools – including senior leaders, teachers and non-teaching staff, as well as parents, carers, community services and the wider community. The research emphasised the need to shift the narrative about sexual orientation and gender identity in schools, moving away from deficit thinking and ‘othering’, towards an approach in which young people’s intersecting identities are respected, validated and celebrated, and which is supportive of all young people’s developing gender and sexual identities.
Reprezent’s On the Level – Covid-19 mental health programme in schools
Liat Levita (University of Sheffield)
Jilly Gibson Miller (University of Sheffield)
Liam Mason (University College London)
Christine Cox (Reprezent)
Shane Carey (Reprezent Youth Radio Station)
Reprezent Youth Mental Health Advisory Panel
Watch this video to find out more about Reprezent’s team of researchers, young presenters and the importance of designing research with young people and measuring impact.
Reprezent, a youth radio station in Brixton, has won awards for mental health programmes for young people in education establishments. Their programmes are designed by young people, alongside mental health practitioners and are delivered by youth presenters. Reprezent run high-tech assemblies using apps and digital platforms designed to raise awareness and offer tools to identify anxiety with steps to manage mental health effectively.
Since the Covid-19 outbreak Reprezent, in consultation with young people, teachers and educational psychologists, developed a new programme to train school staff and support young people in the wake of the pandemic. The programme takes a whole-school approach, including year group specific classroom sessions, virtual assemblies, mental health training for teachers, in addition to developing School Mental Health Ambassadors.
This research project aimed to evaluate the new programme, and measure the impact on mental health of young people and school environments. Members of Reprezent’s Youth Advisory Panel helped to develop the new programme and were be involved in delivering the project.
The programme was evaluated using data was collected through online survey tools during the show to evaluate the show’s impact
on participants mental health. The findings indicate good feasibility and acceptability of the show among participants. The show also prompted some young people to access further mental health support through NHS commissioned digital health online services. The project was awarded the prestigious HSJ Mental Health Innovation of the Year Award 2021. The team have plans to follow-up this pilot study with a larger trial, and to roll out the On the Level programme in more local authority areas in England.
Read the research paper: Feasibility of a secondary school-based mental health intervention: Reprezents’ On The Level
CESAME: Culturally Engaged and Sensitive Approaches to Mental health Education
Sneha Raman (The Glasgow School of Art)
Andrea Taylor (The Glasgow School of Art)
Abdul Moiz Siddiqi (Young Researcher, Leaders Unlocked)
Nadzeya Svirydzenka (De Montfort University)
Raghu Raghavan (De Montfort University)
Kadra Abdinasir (Centre for Mental Health)
Transition from primary to secondary school can be exciting, but it is also a very stressful experience for young people and can have a negative impact on their mental health. Black, Asian and Minority Ethnic (BAME) young people may be particularly poorly supported in the transition process, and we have very little knowledge of their transition experiences.
This project focused on BAME young people, and the transition from primary to secondary school. The project aimed to:
- Explore the mental health needs and aspirations of BAME young people during the primary to secondary school transition.
- Develop recommendations for policy and practice, particularly education providers.
- Explore early stage design concepts for new culturally sensitive approaches—such as learning and teaching resources—to support BAME young people.
The project involved young people from the youth organisation, Leaders Unlocked. Using a participatory design approach the research team worked with a group of seven young people in a series of four workshops to understand current context and perceptions of mental health and mental health support; to visually capture young people’s experiences of transition to secondary school; to identify key issues and opportunities for developing culturally sensitive approaches; and to prioritise ideas and develop recommendations. Key implications for schools, research, policy and practice have been published on the study website.
Youth-led research
Feeling Understood’ - how young people can feel better understood by adults
The TRIUMPH Network provided funding to support the Youth Advisory Group to conceptualise and design their own project, with support from TRIUMPH staff. The project became ‘Feeling Understood’, and explores the subjective emotional experiences of young people when they feel understood – or misunderstood – by adults in their lives who support them.
The project used a ‘beyond co-production’ approach, which challenged traditional academic power dynamics by providing space for the research to be led by young people who were supported by academic staff. The TRIUMPH Network provided young people with the means, tools and training to conceptualise, design and carry out the project from its outset. Young people were employed on University contracts as peer-researchers, to ensure that they felt valued and to reduce any financial barriers that may have prevented their involvement in the project.
The project was split into two phases: the first phase involved hosting workshops with young people across the UK to get a sense of how young people conceptualise and experience feeling understood or misunderstood by adults, and how they impacts their mental health. Phase two involved in-depth interviews with young people to discuss their experiences in more detail.
Youth engagement awards
In October 2022 the TRIUMPH Network hosted a workshop with 60 young people aged 12–25 from across the UK and asked them the question “What does a mentally health society look like for young people?”. Young people worked in groups and were asked to envisage this society with questions like what would it look like, how would it make them feel, and what would it enable them to do? Their responses were captured in this image:
Through the discussions young people identified five priority areas that would have the biggest positive impact on their mental health; these priorities are presented in our Mentally Healthy Society Report.
TRIUMPH followed up on this report by providing funding to research projects addressing one or more of the report’s five priorities to help the project researchers undertake co-production with young people. You can read about the fantastic projects here, how they used the funding and key outputs young people contributed to:
The Young Women’s Movement were able to use these vouchers to engage with thirty young women and people of marginalised genders to explore their experiences of accessing healthcare. You can read more about the project in their blog below. You can also read their project report here.
The Status of Young Women in Scotland: Experiences of Accessing Healthcare
We are the Young Women’s Movement- Scotland’s national organisation for young women’s feminist leadership and collective action against gender inequality. We are for all self-identifying young women and girls. We value the power, and recognise the necessity, of working both intersectionally and intergenerationally to achieve change. Young women, girls and non-binary people who recognise themselves within this movement are at the heart of everything that we do by participating, co-designing and leading.
Financial support from the TRIUMPH network enabled us to engage with thirty young women and people of marginalised genders* over four group discussions to explore their experiences of accessing healthcare as part of our annual research project, the Status of Young Women in Scotland (SYWS).
We hosted group discussions around accessing healthcare with young people aged 16-30; who were disabled or have long-term health conditions; who live rurally; who were from ethnic minorities; and those whose weight impacts their access to healthcare. These groups explored barriers to accessing healthcare, how negative experiences can impact future access, what makes a good healthcare experience and what needs to change for all young women and people of marginalised genders to better access healthcare in Scotland. These discussions built on our national survey that gathered nearly 900 responses.
Recent work from our colleagues at Close the Gap and Engender shows that young women are anxious about being able to access good quality healthcare in the future. Despite this, there are major gaps in research and policy about young women’s experiences of accessing healthcare, we are actively addressing that with this project.
TRIUMPH’s Mentally Healthy Society report shone a light on the need for systemic change to see young people thrive and access the support that they need and deserve. Our group discussions echoed the priorities identified in this report, especially inclusive access to services for all and equity between deprived and affluent areas.
Initial analysis of our survey shows young women in Scotland are far less likely to access support for their mental health than their physical health. As we explored this more in group discussions, a lack of services, waiting times and dismissal from healthcare practitioners are the main barriers that stop young women from accessing the mental health support they need.
Engaging with health services was challenging for young women, who felt like talking to a GP about their mental health was ‘pointless’ because they understood how long they would have to wait to get referrals. Some shared how difficult it was to get an appointment in the first place. Some reported that the medical centre in their local area was not open for new registrations, or that calling early in the morning was not an option for them due to work or caring responsibilities.
“I had to wait something like seven months to get therapy from CAMHS, and because of this my condition worsened significantly. When I eventually got therapy, it was useless, and I was signed off after a few months because I turned 18. Now I’ve been left alone with no support.” (group discussion participant)
Sentiments like this were echoed by other young women, who had remained on waiting lists for long periods of time, only to be referred to a service that did not meet their needs.
Young women frequently reported feeling like their mental health concerns were dismissed by healthcare professionals. Equally, young women described experiences of presenting with physical symptoms, and health care professionals would suggest poor mental health was the cause, but without offering tangible next steps for either. Young women are left feeling like they have not been taken seriously, and they have no pathway to healing.
It is clear from this initial analysis that young women are not accessing the care they need and deserve and that systemic changes are required. This research has been supported by the Women’s Health Plan team at the Scottish Government, as well as our working group comprised of healthcare professionals, third sector professionals and young people.
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*Young women, and young people of other marginalised genders including trans or non-binary people, and gender-fluid/non-conforming individuals who wish to be included in this research.
This is a PhD project by Esther Putzgruber at King’s College London. Below is a short summary of the project by Esther, followed by a blog written by a Peer Researcher on the project. Esther has also provided a video summary of the project which you can watch.
This project aims to examine patterns of mental health help-seeking, and barriers to mental health support among Black young people, before and during/after the COVID-19 pandemic. However, in order to find solutions that can contribute to the removal of the racial disparities that do exist, research is needed to identify and better understand the barriers and facilitators of mental health help-seeking and service use for Black young people. As co-production is at the core of this project, I’d like to thank the TRIUMPH Network for their contribution in providing funding that is being used as a token of appreciation given to young people for taking part in discussions and workshops throughout this project. It is only through working with Black young people throughout this project, that we can generate research that is culturally relevant, inclusive, and directly connected to lived experiences. Young people have been frequently excluded from decision-making processes in schools, despite the knowledge of their own needs. This contribution from the TRIUMPH Network will work towards greater representation in decision-making in school and in research, whilst also improving equity in addressing the experiences directly affecting Black young people.
So far, young people have come together in workshop discussions about current research on racial inequalities in mental health help-seeking and have offered their insights and opinions, as heard in the project video. In this blog, Jonas, one of our young peer researchers on this project and at King’s College London, reflects on his thoughts and opinions surrounding the barriers to mental health help-seeking in school as a Black young person. He also offers his opinions on the need for more inclusive interventions in school.
This project aims to examine patterns of mental health help-seeking, and barriers to mental health support among Black young people, before and during/after the COVID-19 pandemic. However, in order to find solutions that can contribute to the removal of the racial disparities that do exist, research is needed to identify and better understand the barriers and facilitators of mental health help-seeking and service use for Black young people. As co-production is at the core of this project, I’d like to thank the TRIUMPH Network for their contribution in providing funding that is being used as a token of appreciation given to young people for taking part in discussions and workshops throughout this project. It is only through working with Black young people throughout this project, that we can generate research that is culturally relevant, inclusive, and directly connected to lived experiences. Young people have been frequently excluded from decision-making processes in schools, despite the knowledge of their own needs. This contribution from the TRIUMPH Network will work towards greater representation in decision-making in school and in research, whilst also improving equity in addressing the experiences directly affecting Black young people.
So far, young people have come together in workshop discussions about current research on racial inequalities in mental health help-seeking and have offered their insights and opinions, as heard in the project video. In this blog, Jonas, one of our young peer researchers on this project and at King’s College London, reflects on his thoughts and opinions surrounding the barriers to mental health help-seeking in school as a Black young person. He also offers his opinions on the need for more inclusive interventions in school.
Seeking mental health support in schools as a Black young person- Written by Jonas Kitisu, Young Person Community Champion at KCL
The increasing presence of mental health support services in schools in recent years, for me, has been a hopeful indicator that young people may be more willing and open to address the mental health challenges they face- with the knowledge that they will be supported adequately. Many young people seek support in schools through counselling, which, I think, has been essential for tackling mental health problems early. However, there are several barriers that exist which stop many young people using the support they can receive, particularly for young Black people.
As a Black young person, I feel that we generally may have a more difficult time dealing with mental health challenges and seeking support due to both social disadvantages and community stigma surrounding mental health. It has been found that Black children are 10 times more likely to be referred to Children and Young People’s Mental Health Services via social services, rather than through their GP, compared to white British children (Kapadia, et al., 2022). Research also suggests that individuals from Black communities are at higher risk of developing a mental health problem in adulthood and yet still, are less likely to receive support for their mental health (NHS Digital, 2016). To me, these statistics highlight how important it is for Black young people to receive effective support for their mental health during adolescence.
While some schools have implemented support for young people, I feel that services in school are generally not tailored to suit or adequately supply services that can fully support Black young people. There is a significant lack of Black professionals (counsellors, therapists) especially in schools- which can be problematic for Black young people when seeking support. In my own experience of receiving mental health support through my school, I found that the lack of diversity in mental health professionals affected me quite significantly. A survey in 2021 conducted by Mind found that 70% of children surveyed who experienced racism in school said that the experience had an impact on their wellbeing. This is an experience I can relate to, and I believe that having a Black counsellor who understood my cultural and racial experiences would’ve been more effective in providing solutions for the mental health challenges I was facing.
Many young Black people are taking the steps to combat the stigmas within the community surrounding mental health- and seeking the necessary support. However, if schools fail to implement inclusive interventions that can be tailored to Black students, then this may continue to discourage Black students from seeking support.
References:
Kapadia, D., Zhang, J., Salway, S., Nazroo, J., Booth, A., Villarroel-Williams, N., Becares, L. & Esmail, A. (2022) Ethnic Inequalities in Healthcare: A Rapid Evidence Review – NHS Race and Health Observatory. [Online] Available at: https://www.nhsrho.org/wp-content/uploads/2022/02/RHO-Rapid-Review-Final-Report_v.7.pdf [Accessed 23 March 2023].
Mind (2021) Not Making the Grade. [Online] Available at: https://www.mind.org.uk/media/8852/not-making-the-grade.pdf [Accessed 23 March 2023]
NHS Digital. (2016) Mental Health and Wellbeing in England, Adult Psychiatric Morbidity Survey 2014 England. [Online] Available at: https://webarchive.nationalarchives.gov.uk/ukgwa/20180328140249/http:/digital.nhs.uk/catalogue/PUB21748 [Accessed 23 March 2023].
The Centre for Mental Health’s Young Changemakers programme is undertaking research into inequalities within the mental health system for young people from racialised communities. With TRIUMPH support they were able to fund the work of peer-researchers on this project to conduct a scoping review and fieldwork.
Associated research projects
- Children as Innovators – Harnessing the creative expertise of children to address practical and psycho-social challenges of COVID-19 Pandemic (University College Dublin)
- Involving children in Child Rights Impact Assessment and Child Rights Impact Evaluation (Children’s Parliament, Scotland)
- Making Children’s Rights Real through Implementation of the UNCRC (University of Edinburgh)
- COVID-19 School Infection Study (LSHTM)
- Co-RAY Project (University of Oxford
- Achieving Resilience during Covid-19 (University of Oxford)
- Feeling Well, Feeling Cared For (University of Edinburgh, Who Cares? Scotland)
- Relationships in Good Hands Trial (University of Glasgow)
- MoodHwb (Cardiff University)
- Care-experienced children and young people’s interventions to improve mental health and wellbeing outcomes (Cardiff University)
- Net4Health (University of Glasgow)
- Digital youth work for LGBTQ+ young people (Lancaster University, Midlothian Young)
- People’s Advice Service (University of Glasgow)
- ESRC Loneliness and Mental Health in Adolescent and Young Adult Populations (University of Glasgow)
- Participation of children and youth in mental health policymaking: A scoping review (McGill University)
- BRIDGE Project (University of Glasgow)
- Sleep, circadian rhythms and mental health in schools (University of Glasgow)
Research Publications
