What Should Personalised Mental Health Support Involve? Views of Young People with Lived Experience and Professionals from Eight Countries.

Research demonstrates that young people value mental health support that is tailored to their needs and preferences, rather than a "one size fits all" offer, which is often not equitably accessible (National Children's Bureau, 2021). Understanding young people's lived experiences across different sociocultural contexts is important. The aim of this research was to conduct an international qualitative study on the views of young people with lived experience and professionals, on proposed aspects of personalised support for anxiety and/or depression. Participatory action focus groups were conducted with N = 120 young people with lived experience of anxiety and/or depression (14-24 years) and with N = 63 professionals in Brazil, India, Kenya, Pakistan, Portugal, South Africa, Turkey, and the United Kingdom. Data were analysed using the rigorous and accelerated data reduction (RADaR) technique. Overall, although some country-specific differences were found in terms of what aspects of support young people found to be most important, individual preferences were considered stronger, furthering the view that support should be personalised to the needs of the individual young person. Young people experiencing anxiety and/or depression should be able to choose for themselves which aspects of support they would prefer in their own care and support plans, with families and mental health professionals providing guidance where appropriate, rather than removing the young person from the decision-making process altogether. It should also be ensured that the aspects of personalised support can be understood by young people and professionals from different contexts, including marginalised and minoritised groups and communities.

Youth-led co-production of mental health promotion in Pakistan: intergenerational influences.

Youth with mental health needs face barriers in seeking and accessing help, especially in resource-constrained settings in Majority World Countries. Community engagement is thus important for mental health promotion, particularly in addressing stigma. Engagement can be enhanced by involving peer educators and by relating to intergenerational experiences in the sociocultural context of the community. The aim of this study was to explore how intergenerational experiences and perspectives can inform the co-production of youth-led mental health promotion in a Majority World Country, Pakistan. We recruited 11 families (one grandmother, mother and granddaughter in each family) as advisers from two disadvantaged areas of Karachi, and 14 peer educators. Training for peer educators included seminars, experiential activities, three participatory workshops with family advisers and supervision. A sub-sample of family advisers and peer educators attended four focus groups, and peer educators completed reflective diaries following each activity. Data were integrated and subjected to thematic codebook analysis. The three themes related to enabling and hindering factors towards co-production of mental health promotion, incorporation of intergenerational resilience and cascading knowledge to communities. The findings highlighted potential benefits of youth-led mental health promotion that contextualizes intergenerational experiences for those communities. Peer educator roles should be supported by training, and mental health promotion should be integrated within local service systems.

International youth mental health case study of peer researchers' experiences.

BACKGROUND: The involvement of young people as peer researchers, especially with lived experience, is increasingly considered important in youth mental health research. Yet, there is variation in the understanding of the role, and limited evidence on its implementation across different research systems. This case study focusses on the barriers and enablers of implementing peer researcher roles within and across majority world countries contexts. METHODS: Based on an international youth mental health project involving different levels of peer researchers and participants from eight countries, peer researchers and a co-ordinating career researcher reflect on lessons regarding enabling and challenging factors. These reflections are captured and integrated by a systematic insight analysis process. RESULTS: Building on existing international networks, it was feasible to actively involve peer researchers with lived experience in a multi-country mental health study, who in turn recruited and engaged young participants. Identified challenges include the terminology and definition of the role, cultural differences in mental health concepts, and consistency across countries and sites. DISCUSSION: Peer researchers' role could be strengthened and mainstreamed in the future through ongoing international networks, training, sufficient planning, and active influence throughout the research process. TRIAL REGISTRATION: Not applicable.

The involvement of young people with lived experience as collaborators (peer researchers) in mental health research has become more prominent in recent years. Yet, there is variation in the understanding of this role and how to involve young people. There is also limited evidence on how this role can be applied across different research systems, especially in majority world countries. We share our experience from a youth mental health project involving peer researchers in eight countries. Peer researchers and the co-ordinating career researcher reflected on lessons regarding enabling and challenging factors. Their reflections highlighted that, overall, it is feasible to successfully involve young people with lived experience in international mental health research. Several challenges were also identified, including terminology, definition of roles, cultural differences in understanding mental health, and consistency across participating countries and sites. According to peer researchers' reflections, these challenges can be overcome through the establishment of ongoing international networks, training and support, sufficient planning and peer researchers getting involved at all the stages of the research. Lessons from this case study can be of interest to the international research community in strengthening the involvement of young people in mental health research.