This blog is part of the Children, young people and families newsletter
Blog authors: Will Mason, Steph Scott, Hannah Fairbrother, G.J. Melendez Torres, and Michelle Tester-Jones
In the past five years, young people’s mental health has declined nationally (NHS, 2023). Particular population groups, however, are disproportionately affected by poor mental health. Children living in adverse circumstances – like household poverty or high levels of family stress – have poorer mental health outcomes than their peers. There are also clear racial disparities in mental health. People from minority ethnic groups have poorer access to, experiences of and outcomes from mental health services (NCCMH, 2023). Recent evidence shows that young people in the North of England have poorer mental health outcomes, compared with those in the rest of the country (Pickett et al., 2021).
Men report being less likely to discuss their mental health than women. They are also less likely to seek mental health support, due to concerns about help-seeking behaviour and acceptance from peers. Suicide rates are consistently higher for men than women (around three quarters of all suicides in England and Wales) and are consistently highest in the North of England. Still, little is known about how young men manage their mental health and go about seeking social support (McKenzie et al., 2018).
Mental healthcare reform and the role for community services
NHS services are struggling to cope with rising demand (APPG, 2024). Doctors providing mental healthcare in England report significant barriers to the delivery of adequate mental health provision (BMA, 2024: 2). The challenges of funding, insufficient workforce and unsustainable infrastructure are compounded by problems ‘upstream’ associated with limited progress on the wider social determinants of mental health, like poverty, poor housing and discrimination (APPG, 2024; BMA, 2024).
Several calls have been made for mental healthcare reform. In 2022, the World Health Organization (WHO) called for a major reorganisation of mental health services, promoting a multisectoral approach that ‘shifts the locus of care’ from medical interventions, towards more preventative and community-based provisions. In May 2024, the ‘Beyond Pills’ All-Party Parliamentary Group (APPG) endorsed this priority, recommending radical changes to the national mental health system, tipping the balance towards more holistic, person-centred approaches.
Both the WHO and the APPG acknowledge that community-based, non-medical and peer-led projects will be an important part of successful mental health reform.
Social and informal support delivered by community providers (e.g., community workers, peers) complement formal services and help ensure enabling environments for people with mental health conditions (WHO, 2022: xix)
Community services can also promote mental health, by improving wellbeing in the settings where people live, work, and thrive.
Our SPHR study: Young men, mental health and community services
The WHO and the APPG have both recognised that more research is needed to understand and build upon successful examples of non-medical, community and peer led projects that promote mental health and generate positive outcomes for people within their own social environments.
Our collaborative study of Young men, mental health and community services responds to these priorities in two ways:
- A realist evidence review assessing how, for whom and in what ways non-medical, community-based projects impact the mental health and wellbeing of disadvantaged young men. This review will assess the scale and the quality of existing evidence, alongside outlining the mechanisms by which these projects generate their outcomes.
- Two collaborative case studies of non-medical, community-based projects in the North of England. Our case studies – designed and conducted with community researchers – will enable comparative analysis of how disadvantaged young men aged 16–25: (1) understand mental health, (2) engage with community services and (3) manage the everyday challenges associated with their social environments.
Combined, these pieces of work seek to make a significant contribution to the priorities for mental health reform, outlined by the WHO and echoed by the APPG.
Why this study, now?
Our research extends over a decade of active collaboration between the research team and communities in the case study sites. Our objectives and questions are informed by the priorities of those delivering community services, and the young people who access them.
Our work also compliments the priorities of the Integrated Care Boards in the case study regions, each of whom are committed to developing services according to the insights of children, young people and families with the greatest need.
Nicola Ennis (Director of the South Yorkshire Children and Young People’s Alliance) highlights:
There is a very real synergy with the SPHR ‘Young men, mental health and community services’ study and the work of the Child Health Equity Collaborative, led by South Yorkshire Children and Young People’s Alliance.
To make sure any service provision meets the needs of those who are most disadvantaged in our society, we need to start by listening to their experiences of health and care services. Their insights create the foundations for any service offer.
In South Yorkshire, there feels like there are the beginnings of a wider movement with specific organisations taking action, developing services that make most sense to those who need to use them.
The Child Health Equity Collaborative is currently piloting an intervention, aimed at children aged 9 and 10 years old, that focuses on improving children’s mental health and wellbeing, building their confidence and agency and supporting children to both attend and learn well in school.
The Young men, mental health and community services project will complement this work, adding to the growing evidence base for community services that promote the mental health and wellbeing of children, young people and families in their own environments.
Find out more
For more information about the study contact Dr Will Mason: w.j.mason@sheffield.ac.uk
