Mind the Gaps: Involving Diverse Young People in Mental Health Research

Why are some young people still missing from mental health research and what can we do to change that?

Hi, I’m Rachel Perowne, a PhD researcher and I’m passionate about making youth mental health research more inclusive. I believe that the best way to achieve this is to involve young people in a meaningful way in the research process. Together with my supervisors and colleagues, including three young co-researchers, I recently published a systematic review exploring the barriers and facilitators to involving under-represented children and young people (aged 8–25) in mental health research. This blog is my reflection on what we found, why it matters and how we can do better.

Why this matters

When young people are involved in mental health research, this make the research more successful, relevant and impactful. But despite growing interest in participatory approaches, certain groups, such as those from ethnic minorities, lower-income households, migrant backgrounds or with disabilities are still under-represented. This gap matters because we risk continuing to exclude certain groups and past inequalities being repeated, making research less relevant to those who have historically been left out and who are often disproportionately affected by mental health issues.

What we did

We conducted an extensive search of the literature (over 13,000 papers) and found 27 studies from seven countries which contained relevant information about why certain under-represented groups might be less likely to be involved in research. We applied the Behaviour Change Wheel (BCW) – a tool which helped us understand what helps or hinders involvement and identify actions to overcome the barriers.

Figure by Michie and Colleagues (2014)

We also worked closely with a group of young co-researchers who shaped the review from start to finish. They were involved in many stages of the systematic review process including reviewing the research question, identifying terms to include in the search, carrying out their own searches and reviews of potentially suitable papers and extracting relevant data.  Their insights were invaluable and three of them co-authored the paper.

Barriers to involvement

As the illustration below shows, most barriers reduced opportunity, things like:

• Digital exclusion: Not everyone has access to stable internet or devices.

• Language: Materials often weren’t accessible or available in young people’s preferred languages.

• Time and competing priorities: Especially for those in vulnerable or precarious situations, such as having caring responsibilities.

• Bureaucratic hurdles: Ethics processes which can make it harder to involve younger age groups.

• Mistrust of researchers: Particularly among Indigenous and racially minoritised youth who may have had negative previous experiences.

Some barriers were more subtle and connected with relationships or identities. For example, unbalanced power dynamics in mixed adult–youth groups, or male identity and stigma, which made some young men feel that mental health research wasn’t for them.

Facilitators to involvement

The good news? Many barriers had a flip side, that we can learn from. These “facilitators” included:

• Flexible and creative engagement: Offering a range of methods for involvement such as WhatsApp, visual methods and co-design workshops to make contributing easier and convenient for more young people.

• Accessible communication: Using plain language, interpreters and culturally or age relevant materials.

• Relationship-building: Taking time to build trust and mutual respect with the aim of increasing young people’s confidence to contribute and feeling of safety.

• Supportive adults: Allies who champion young people’s voices rather than speaking for them.

• Shared experiences: Organising activities and groups so that young people are with others who they feel understood by and comfortable with.

• Building in fair rewards and incentives: that young people will value such as payment in line with national guidance.

Figure by Rachel Perowne and colleagues (2025)

Strategies for change

We identified practical strategies that align with the BCW’s intervention functions of enablement and environmental restructuring. These include:

• Tailoring communication to young people’s needs – for example, videos or easy read versions of materials.

• Creating safe, inclusive spaces for engagement, which can be as simple as providing refreshments at meetings or more thoughtfully, offering support options and self-care tools

• Providing flexible involvement options, such as adapting timings of meetings to meet young people’s schedules e.g., holding meetings in the evenings or at weekends or going to meet young people where they are.

• Recruiting beyond traditional networks: through local community groups or places where young people not in work or school might be.

• Investing time to build trust and relationships – for example, by providing induction sessions and icebreakers, placing young people in position of responsibility such as co-facilitating meetings.

What does all this mean?

Overall while involving young people in mental health research is widely recognised as valuable, the review found that many young people still face barriers, especially those from under-represented groups.  Importantly, we found that different groups face different challenges. For example, refugee youth may need more language support, young carers may struggle with time constraints and young men may feel mental health research isn’t for them. If we don’t think carefully about these differences and address them by taking targeted approaches, research risks continuing to be shaped only by those who have previously been consistently included, making it less relevant and less effective for those who are most affected by mental health inequalities.

What’s next?

We still have work to do. We need more research that centres the voices of under-represented young people and make efforts to understand and include those who haven’t been involved before.

The review also highlights that there is room for improvement in how researchers report the involvement of young people. When reporting is vague or inconsistent, we lose valuable opportunities to learn from each other and to build on the good work already being done to involve young people in appropriate and meaningful ways. Better reporting can help create a culture of transparency and continuous improvement in youth involvement practices. There are tools which researchers can use to do this. The GRIPP2 checklist, for example, is a simple checklist which guides researchers to think about what to report and how, with the aim of improving our knowledge base. You can find the checklist here.

Final thoughts

This is a call to action: inclusive involvement isn’t a matter of lip service. It requires thoughtful, flexible and supportive approaches. It also shows the value of using theory, like the Behaviour Change Wheel, to guide how we design involvement strategies. Most importantly, it reminds us that young peoples lived experience, insights and ideas are essential for shaping better mental health research.

My thanks to everyone who contributed to this review – including Professor Leslie Gutman, Dr Sarah Rowe, Gabrielle Grey, Pamela Thomas, Azin Lajevardi, Ella Parry, Luke Bingham and the other young people in our Young Researchers’ Oversight Group as well as Lucy Condon (Public and Patient Involvement Facilitator).