Co-producing good mental health with young people

Good mental health begins in childhood, but it’s clear that many young people aren’t getting the help and support they need to stay mentally healthy.

With 50% of mental health problems established by age 14, it’s crucial that the foundations of good mental health are laid early. That means giving young people the skills and knowledge they need to support themselves – and each other – now and in the future.

School plays a central role in promoting and protecting the health and wellbeing of young people, and this includes mental health education and support. However, mental health doesn’t form part of the PHSE curriculum, meaning that it’s up to individual schools to decide what to teach about mental health, how and when.

Increasingly, it is being recognised that many public services can be more relevant, effective and even affordable, when they are designed in partnership with the people who use them. The NHS Five Year Forward View highlights the need to "engage with communities and citizens in new ways, involving them directly in decisions about the future of health and care services."

What is co-design and co-production?

Co-design and co-production is an approach which aims to ensure the service meets the needs of all stakeholders by involving them in the design and production process.

There are examples outside the healthcare sector, too, of professionals and service users working together to co-design services that meet their needs, from nursery schools to housing associations and restorative justice initiatives.

There are a number of reasons why co-produced education programmes work for young people. When information is designed and delivered by other young people, pupils are more likely to feel that the message applies to them. Advocates for Youth, a pro-youth organisation in the USA, highlight that:

"Research suggests that people are more likely to hear and personalise messages, and thus to change their attitudes and behaviours, if they believe the messenger is similar to them and faces the same concerns and pressures."

Studies have also shown a range of benefits for young people involved in the design and delivery of health education initiatives, as well as those receiving the information; they develop their self confidence and leadership skills whilst increasing their own knowledge of the issue at hand. 

By involving young people in designing and delivering health education, we can improve the chance that they will make healthy choices, and ensure that we are truly addressing the concerns and worries that they have in their own lives.

How we're using co-production

The Mental Health Foundation’s Peer Education Project is a schools-based, peer-delivered curriculum of lessons based on the principle of co-design, which we developed in partnership with Cernis and Highgate School.

The five-lesson syllabus covers basic mental health awareness and introduces young people to ways to stay mentally healthy. Crucially, the content of these lessons was co-produced with young people themselves.

This was a two-stage process, led by Yvonne Anderson of Cernis. Using insights from a consultation with Year 7 students, we developed the core content of the five interactive sessions of the Peer Education Project. We then tested and refined these sessions through a series of workshops with Year 12 students, who went on to deliver the sessions to Year 7 pupils at their school.

This is co-production in more ways than one, however. The project also requires the peer educators to work closely with teachers and younger pupils to deliver lessons that work for everyone. There are benefits on all sides; as well as teaching younger students vital information about their own mental wellbeing, peer educators are developing their own skills in teaching, co-operative working, and hopefully building their self esteem, too.

The first pilot year of the project showed some encouraging results: by the end of the project, 33% more Year 7 students reported that they are 'able to talk openly with others' about their mental health.

The co-production process isn’t finished, though. We’re excited to be expanding the project for the second part of the pilot, which will see the Peer Education Project delivered in 10 schools, with more than 1,000 Year 7 students receiving the curriculum. The feedback from students, peer educators and staff in this second round of schools will help us make sure that the toolkit of lessons works in different types of schools, for as many students as possible. 

Further intensive co-design workshops later in the year will see the whole project adapted for students with learning disabilities, who will work closely with mainstream school peers to help younger students maintain good mental health and ensure they know how to seek help if they need it.

The evidence shows that we need to act earlier to teach young people about mental health. If we're serious about doing this, we need to maximise the potential of our interventions - this means involving young people throughout the process.

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