There is a growing body of evidence which supports the  importance of Right Here’s work and the need for radical change to how youth mental health is addressed.

This paper provides four case studies giving a flavour of the approaches that the Right Here programme has adopted to addressing the mental health needs of 16 –  25 year olds, a unique combination of youth participation and co-design, prevention, early intervention, resilience-building and anti-stigma activity.


The need for Right Here

A growing body of evidence is emerging  which supports the importance of Right Here’s work. Rates of mental ill-health among young people are concerning1 and it is now understood that adolescence and early adulthood is the peak age of onset for mental ill-health and the period when there  is a need for initial care2. Promoting good mental health and preventing mental health problems in young people is therefore an issue of considerable significance for UK society both in terms of public health and social wellbeing.

Some young people are particularly vulnerable to mental ill health. These include young people exposed to socio-economic factors such as poverty, social exclusion, and unemployment3 Individuals who are subject to social and gender inequalities or  who experience injustice or discrimination are also at higher risk of developing mental health problems4.

Young people experience a range of barriers to mental health support. Transitions between child and adult services tend to be poorly co-ordinated and there is a lack of age-appropriate mental health services to support this particular group5. Adult mental health services are often not designed or delivered in ways that young people wish to engage with, and the fear of being  stigmatised for having a mental health problem is also a major factor in young people’s decisions not to access help from mainstream, traditional services 6.

These barriers can mean that young people’s mental health needs can go unsupported. However, it has been suggested that the effective treatment of mental health problems in young people may result in the prevention of many adult cases of mental ill health7. There is a good case to be made therefore that young people should have ready access to mental health support, both to support their mental health in the  present and to prevent the development of future mental health problems in adult life.

Approaches to supporting young peoples’ mental health underpinning Right Here

To better address the mental health needs of young people and prevent the continuation of mental health problems into adult life, the literature points to a number of approaches and interventions which are at the heart of Right Here’s approach. These include: prevention, early intervention, resilience building, youth participation, and anti-stigma activity. In some cases Right Here has also adopted gender specific approaches to  encourage higher service take up.

Prevention and early intervention

The World Health Organisation (WHO) has made a strong case for the implementation of evidence based programmes to prevent the development of mental health problems across all age groups; to reduce risk factors, strengthen protective factors and decrease psychiatric symptoms as well as directly prevent the onset of some mental health problems. Examples of effective interventions  HO recommend for young people at risk of developing mental health problems include: group education in positive thinking, challenging negative thinking styles and improving problem-solving skills and mental health literacy programmes to encourage early  help-seeking8


Resilience (the ability to cope well when something bad happens) has been shown to act as a protective factor against the development of mental health problems in young people9 identify three key facilitators: activities that promote wellbeing, building social capital and developing psychological coping strategies10. The authors suggest that wellbeing is best promoted through the delivery of “upstream” interventions which seek to remove barriers to support and enable people to take part  in positive activities, such as being active, learning or giving to others. Social connectedness can be encouraged through peer support groups, social prescribing programmes and community based arts activities. Psychological coping strategies can be instilled through the provision of psychological therapies and education courses11.

Youth participation

There are a considerable variety of ways in which young people can actively participate within mental health services and organisations, including: participation in consultation processes, membership of advisory boards, informing the design of services, being involved in staff recruitment and training, service promotion and evaluating  the impact of services12. Participation has been shown to have a positive impact on the mental health and wellbeing of the young people participating13. However it has also been acknowledged by organisations such as the Carnegie Trust and the National Children’s Bureau that considerably more action is still required to increase young people’s participation within services: both in terms of breadth (the amount of young people involved) and depth (the meaningfulness of their involvement)14 15

Challenging stigma and discrimination

Evidence suggests that young people hold more stigmatising attitudes towards mental ill-health than the general population and are also more likely to be the recipients of stigmatising attitudes if they have a mental health problem16. Stigma can act as a barrier to help seeking17 and reduces self confidence and esteem18. In order to address stigma, providing young people with information about mental health issues has been shown to improve attitudes to mental health problems and help seeking behaviour19.

Gender-specific approaches

Gender plays a role in terms of the vulnerability of young people to mental health problems such as depression, self harm and suicide20. Evidence also suggests that young men and women present different help seeking behaviours, with girls and young women having higher levels of mental health literacy than males21. For these reasons WHO recommends a gender sensitive approach to mental health interventions for young people22. Case study selection and methodology This report presents four case studies from across the Right Here initiative, focusing on one specific activity from each of the four project areas. The case studies have been chosen to demonstrate the range of different approaches developed under the Right Here banner, with a particular emphasis on activities which incorporate the following components:

  • Awareness raising to increase young people’s understanding of mental health and wellbeing (in the wider community)
  • Therapeutic activities targeted at young people most at risk of developing mental health problems
  • Participation activities involving young people in developing and delivering Right Here activities
  • Physical and creative activities.

Evidence for the case studies was gathered from existing Right Here evaluation data and supplemented by one to one and group interviews with project staff and young people involved in the activities described.


  • 1 About one in six young adults aged 16 – 24 will have a common mental health disorder (anxiety or depression). See National Centre for Social Research (2009) Adult Psychiatric Morbidity Survey, 2007: Results of a household survey. Leeds: NHS Information Centre for Health and Social Care
  • 2 Poor mental health is closely related to many other health and social concerns for young people, including educational achievements, employment, relationships and substance use[3. Kessler RC, Amminger GP, Aguilar‐Gaxiola S, Alonso J, Lee S and Ustun TB (2007) Age of onset of mental disorders: A review of recent literature, Curr Opin Psychiatry. 2007 July; 20(4): 359–364
  • 3 Patel V, Flisher AJ Hetrick S, McGorry P (2007) Mental health of young people: a global public-health challenge. Lancet, 369:1302-13
  • 4 WHO (2012) Risks to Mental Health: An Overview of Vulnerabilities and Risk Factors. World Health Organisation
  • 5 Sainsbury S & Goldman R (2011) Mental health service transitions for young people. London: Social Care Institute for Excellence
  • 6 Gulliver A, Griffiths KM & Christensen H (2010) Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review, BMC Psychiatry 2010, 10:113
  • 7 Kim-Cohen J, Caspi A, Moffitt TE, Harrington HL, Milne BJ, Poulton R (2003) Prior Juvenile Diagnoses in Adults With Mental Disorder: Developmental Follow-Back of a Prospective-Longitudinal Cohort. Arch Gen Psychiatry. 2003;60(7):709-717
  • 8 WHO (2004) Prevention of Mental Disorders: Effective Interventions and Policy Options: Summary Report. Geneva: World Health Organisation
  • 9 Garcia I (2008) Right Here Literature Review: Young people aged 16 to 25: The promotion of mental health and wellbeing and the early intervention in mental health problems. Paul Hamlyn Foundation / Mental Health Foundation In order to promote the building of resilience, Mind and the Mental Health Foundation
  • 10 Mind & Mental Health Foundation (2013) Building Resilient Communities: Making every contact count for public mental health. Mind & Mental Health Foundation
  • 11 Mind & Mental Health Foundation (2013) Building Resilient Communities: Making every contact count for public mental health. Mind
    & Mental Health Foundation
  • 12 Mental Health Foundation (2007a) Listen up!: Person-centred approaches to help young people experiencing mental health and emotional problems: London: MHF
  • 13 Vasiliou-Theodore, C. and Penketh, K. (2008) ‘Listen Up! Young people’s participation in service design and delivery’, in Jackson, C., Hill, K. and Lavis, P. (eds.), Child and adolescent mental health today: A handbook. Brighton: Pavilion Publishing Ltd.  and on the quality of the services involved, in terms of their accessibility and responsiveness to the needs of young people[15. Wright, P., Turner, C., Clay, D. and Mills, H. (2006) The Participation of Children and Young People in Developing Social Care. Participation and practice guide 06
  • 14 Carnegie UK Trust (2007) Empowering young people: the final report of the Carnegie young people initiative. Fife Carnegie UK Trust
  • 15 Burke T (2010) Anyone listening? Evidence of Children and Young Peoples’ Participation in England. Office of the Children’s Commissioner. London: National Children’s Bureau
  • 16 Young Minds (2010) Stigma – A Review of the Evidence. London: Young Minds
  • 17 Gulliver A, Griffiths KM & Christensen H (2010) Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review, BMC Psychiatry 2010, 10:113
  • 18 Corrigan P (2004) How Stigma Interferes with Mental Health Care. American Psychologist, 59 (7) 614-625
  • 19 Young Minds (2010) Stigma – A Review of the Evidence. London: Young Minds
  • 20 World Health Organisation (2011) Evidence for gender responsive actions to promote mental health: young peoples’ health as a whole society response. Copenhagen: WHO
  • 21 MacLean A, Hunt K and Sweeting H (2013) Symptoms of Mental Health Problems: Childrens’ and Adolescents’ Understandings and Implications for Gender Differences in Help Seeking. Children and Society, 27, 161-173
  • 22 World Health Organisation (2011) Evidence for gender responsive actions to promote mental health: young peoples’ health as a whole society response. Copenhagen: WHO