Youth are an important population for prevention and early intervention efforts, as many adult mental health and substance use disorders emerge during the adolescent years. Strategies to engage youth are key to successful prevention and intervention efforts.
A new review by Canadian researchers, Dunne, Bishop, Avery and Darcy (2017), published in the Journal of Adolescent Health, analyzed youth engagement strategies used during mental health and substance use interventions. The researchers reviewed 40 studies and reports published between 2004 and 2014 that described engagement strategies used with youth aged 11 to 29 years to improve mental health and substance use outcomes. Their analyses led to six overarching themes for youth engagement:
1) Youth empowerment through participation in program development
• Examples: filling out feedback surveys, becoming peer support workers, participating in program design, implementation and evaluation, sitting on boards or committees
• Possible outcomes: development of coping and professional skills, improved relationships with clinicians, greater recovery focus, decrease in substance use
2) Engagement through parental relations
• Examples: strengthening parent-child relationship, increasing positive parental behaviours, supporting parents to advocate for their child’s care, family interventions
• Possible outcomes: engagement in treatment, reduced risky behaviours, reduced substance use
3) Engagement through technology
• Examples: computer-, texting- and Internet-based interventions (easy access, low costs, confidentiality and anonymity)
• Possible outcomes: reduced symptoms for depression, anxiety, stress, post-traumatic stress, first episode psychosis and eating disorders; engages traditionally hard to reach youth (e.g., adolescent males, marginalized youth, youth not attending school or living in remote areas)
4) Engagement through medical or mental health clinic
• Examples: housing clinics within schools, increasing accessibility of location, communication and spaces geared towards youth, flexibility, diverse services, continuity of care, privacy, including family in treatment
• Possible outcomes: increased seeking of help
5) Engagement through school
• Examples: increasing student connectedness with school and teachers, screening at schools to help identify at-risk youth
• Possible outcomes: lower use of substances, lower emotional distress and suicide-related thoughts or attempts
6) Engagement through social marketing
• Examples: social media campaigns (most effective when included as part of an integrated intervention strategy)
• Possible outcomes: reduced stigma, less substance use, changed beliefs about alcohol, increased skills in reducing alcohol-related harms
The main conclusion from this review was that there is no single method of engagement that is most effective, and successful mental health and substance use interventions likely involve a combination of strategies that is shaped by local needs, goals and resources. Ideally, youth should be involved in the design and implementation of interventions and programs should address any barriers to participation. For more information, please see the review article.
Dunne, T., Bishop, L., Avery, S. & Darcy, S. (2017). A review of effective youth engagement strategies for mental health and substance use interventions. Journal of Adolescent Health, 60(5), 487–512.