Quarterlife Crisis in the UK and India: Perceived Standards and Unfulfilled Expectations

The term “quarterlife crisis” is associated with difficulties transitioning to adulthood that are accompanied by feelings of panic, loss, and uncertainty. However, we argue that this experience could vary largely depending on the sociocultural context and requires delving into nuances to understand and appreciate the lived experiences of the young population transitioning in different contexts. The aim of this study is to explore young people’s experiences of quarterlife crises triggered from interactions with the social environment, taking into consideration both British and Indian contexts. Our participants are 22-30 years of age from the UK (n=16) and India (n=8) who self-define as having experienced difficulties “finding one’s place in the world.” Data were generated through photo-elicitation and timeline interviewing and analysed with Interpretative Phenomenological Analysis. We focus here on one of the themes derived from this project: “perceived standards and unfulfilled expectations,” which involves the sub-themes of playing catch up, feeling responsible, and living up to social expectations. We consider our findings in light of Robinson and Smith’s (2010) theory of early adult crisis. Our study adds detail and subtlety with respect to ways in which young people experience threats to their self-worth as a central feature of quarterlife crisis within individualist and collectivist cultures

Co-design and evaluation of a youth-informed organisational tool to enhance trauma-informed practices in the UK public sector: a study protoco

Introduction A trauma-informed approach (TIA) means working with awareness that people’s histories of trauma may shape the way they engage with services, organisations or institutions. Young people with adverse childhood experiences may be at risk of retraumatisation by organisational practices in schools and universities and by employers and health agencies when they seek support. There are limited evidence-based resources to help people working in the public sector to work with adolescents in trauma-informed ways and the needs of adolescents have not been central in resource development. This study contributes to public sector capacity to work in trauma-informed ways with adolescents by codesigning and evaluating the implementation of a youth-informed organisational resource. Methods and analysis This is an Accelerated Experience-based Co-design (AEBCD) Study followed by pre–post evaluation. Public sector organisations or services, and adolescents connected with them, will collaboratively reflect on lived experience data assembled through creative arts practice, alongside data from epidemiological national data sets. These will present knowledge about the impact of adverse childhood experiences on adolescents’ mental health (stage 1). Collaboratively, priorities (touch points) for organisational responses will be identified (stage 2), and a low-burden resource will be codesigned (stage 3) and offered for implementation (stage 4) and evaluation (stage 5) in diverse settings. The study will provide insights into what adolescents and public sector organisations in the UK want from a TIA resource, the experience of services/organisations in implementing this and recommendations for resource development and implementation. Ethics and dissemination The UK National Health Service Health Research Authority approved this study (23/WM/0105). Learning will be shared across study participants in a workshop at the end of the study. Knowledge products will include a website detailing the created resource and a youth-created film documenting the study process, the elements of the codesigned resource and experiences of implementation. Dissemination will target academic, healthcare, education, social care, third sector and local government settings via knowledge exchange events, social media, accessible briefings, conference presentations and publications

The effectiveness of anti-stigma interventions for reducing mental health stigma in young people: A systematic review and meta-analysis

Experiencing mental health stigma during adolescence can exacerbate mental health conditions, reduce quality of life and inhibit young people’s help-seeking for their mental health needs. For young people, education and contact have most often been viewed as suitable approaches for stigma reduction. However, evidence on the effectiveness of these anti-stigma interventions has not been consistent. This systematic review evaluated the effectiveness of interventions to reduce mental health stigma among youth aged 10–19 years. The review followed Cochrane and PRISMA guidelines. Eight databases were searched: PubMed, PsycINFO, MEDLINE, Web of Science, Scopus, EMBASE, British Education Index and CNKI. Hand searching from included studies was also conducted. Randomised controlled trials and experimental designs that included randomised allocation to interventions and control groups were included in the review. Narrative synthesis was employed to analyse the results. A meta-analysis was conducted to determine the effectiveness of included interventions. Twenty-two studies were included in the review. Eight studies reported positive effects, 11 studies found mixed effects and 3 studies reported no effect on indicators of mental health stigma among youth. Seven of the effective studies were education-based. Eleven studies were suitable for meta-analysis, and the multivariate meta-analytic model indicated a small, significant effect at post-intervention (d = .21, p < .001), but not at follow-up (d = .069, p = .347). Interventions to reduce stigma associated with mental health conditions showed small, short-term effects in young people. Education-based interventions showed relatively more significant effects than other types of interventions

Qualitative assessment of evidence-informed adolescent mental health policymaking in India: insights from project SAMA

Background: The importance of evidence-informed health policymaking is widely recognized. However, many low- and middle-income countries lack evidence-informed mental health policies due to insufficient data, stigma or lack of resources. Various policies address adolescent mental health in India, but published knowledge on their evidence-informed nature is limited. In this paper, we report results of our analysis of the role of evidence in adolescent mental health policymaking in India. Methods: This paper reports findings from the document analysis of key policy documentation (n = 10) and in-depth interviews with policy actors including policymakers, researchers, practitioners and intermediaries (n = 13). Framework analysis was used, informed by the components of a conceptual framework adapted from the literature: actors, policy and evidence processes, nature of evidence itself and contextual influences. Results: Results show that adolescent mental health policies in India were generally evidence-informed, with more key evidence becoming generally available from 2010 onwards. Both formal and informal evidence informed mental health policies, particularly agenda-setting and policy development. Mental health policymaking in India is deemed important yet relatively neglected due to competing policy priorities and structural barriers such as stigma. Use of evidence in mental health policymaking reflected differing values, interests, relative powers and ideologies of policy actors. Involvement of government officials in evidence generation often resulted in successful evidence uptake in policy decisions. Policy actors often favoured formal and quantitative evidence, with a tendency to accept global evidence that aligns with personal values. Conclusions: There is a need to ensure a balanced and complementary combination of formal and informal evidence for policy decisions. Evidence generation, dissemination and use for policy processes should recognize evidence preferences by key stakeholders, while prioritizing locally available evidence where possible. To help this, a balanced involvement of policy actors can ensure complementary perspectives in evidence production and policy agendas. This continued generation and promotion of evidence can also help reduce societal stigma around mental health and promote mental health as a key policy priority

“This doesn’t feel like living”: How the COVID-19 Pandemic Affected the Mental Health of Vulnerable University Students in the United Kingdom

Introduction: Concerns about student mental health have been rising globally. The COVID-19 pandemic triggered unprecedented disruption in higher education as universities were forced to close and adapt their education delivery. Understanding the impact of this on vulnerable students can inform higher education’s response to future similar events. Aims: To understand the lived experience of first year university students studying in the United Kingdom, who had a history of poor mental health and lived on a low income, we examined the inter-relatedness between mental health, financial strain, remote learning and engagement, and well-being. Methods: At the start of their first year of study, whilst the UK was in periods of lockdown, we conducted in-depth semi-structured interviews with 20 diverse first-year university students. We analyzed data using interpretative phenomenological analysis. Results: The pandemic’s impact on student mental health, engagement and learning remained pervasive and serious. Key themes conveyed how isolation triggered past mental health difficulties and a perception that the universities – and government – had forgotten about them. Students also experienced greater difficulty in navigating the liminal threshold between being a child and an adult, and having the additional worry of financial instability left students with fewer coping resources. Conclusions: To mitigate the impact of future pandemic responses, constant and effective communication is needed between faculty and students to safeguard against isolation and low motivation. Vulnerable students need guidance in coping skills to manage mental health risks when they are away from family and familiar support network

Photo-elicitation and time-lining to enhance the research interview: Exploring the quarterlife crisis of young adults in India and the UK

The aim of this article is to convey our experience of using photo-elicitation along with time-lining to enhance the research interview. We reflect on a study on the ‘quarterlife crisis’ in India and the UK. Participants were aged 22-30 years and self-defined as having experienced difficulties ‘finding their place in the world.’ There were 16 British (8 women, 8 men) and 8 Indian participants (4 women; 4 men). First, we consider how photo-elicitation proved highly compatible with our method of analysis – interpretative phenomenological analysis – through affording a deep connection with participant experience. Second, we explore how participants engaged with photo-elicitation and time-lining, providing examples of image content (events and feelings), image form (literal and symbolic), and creative use of timelines. Third, we reflect on how photo-elicitation and time-lining appeared to enhance participant agency, and to have a therapeutic value for participants, as well as providing particularly rich material for analysis

Typologies and Features of Play in Mobile Games for Mental Wellbeing

Background: The smartphone market is saturated with apps and games purporting to promote mental wellness. There has been a significant number of studies assessing the impact of these digital interventions. Motivation. The majority of review papers solely focussed on the impact of strict rules and award systems of the apps. There is comparatively little attention paid to other game techniques designed to encourage creativity, a lusory attitude, and playful experiences. Results. This gap is addressed in this paper in a consideration and analysis of a purposive selection of six mobile games marketed for wellbeing, our focus is on both external and internal motivations that these games offer. Our specific interest is how these games balance rule-based play with creativity. We find that ludic play is a highly-structured, rule-bound, goal-oriented play, in contrast to paedic play which a freeform, imaginative, and expressive. We argue that while ludic play is purposed towards the promotion of habit formation and generates feelings of accomplishment, it nonetheless relies heavily on extrinsic motivation to incentivise engagement. By contrast, paidic play, specifically role-playing, improvisation, and the imaginative co-creation of fictional game worlds, can be used effectively in these games to facilitate self-regulation, self-distancing, and therefore provides intrinsically-motivated engagement. In the context of games for mental wellbeing, ludic play challenges players to complete therapeutic exercises, while paidic play offers a welcoming refuge from real world pressures and the opportunity to try on alternate selves. Conclusion: Our intention is not to value paidic play over ludic play, but to consider how these two play modalities can complement and counterbalance each other to generate more effective engagement

Safeguarding adolescent mental health in India (SAMA): study protocol for codesign and feasibility study of a school systems intervention targeting adolescent anxiety and depression in India.

INTRODUCTION: Symptoms of anxiety and depression in Indian adolescents are common. Schools can be opportune sites for delivery of mental health interventions. India, however, is without a evidence-based and integrated whole-school mental health approach. This article describes the study design for the safeguarding adolescent mental health in India (SAMA) project. The aim of SAMA is to codesign and feasibility test a suite of multicomponent interventions for mental health across the intersecting systems of adolescents, schools, families and their local communities in India. METHODS AND ANALYSIS: Our project will codesign and feasibility test four interventions to run in parallel in eight schools (three assigned to waitlist) in Bengaluru and Kolar in Karnataka, India. The primary aim is to reduce the prevalence of adolescent anxiety and depression. Codesign of interventions will build on existing evidence and resources. Interventions for adolescents at school will be universal, incorporating curriculum and social components. Interventions for parents and teachers will target mental health literacy, and also for teachers, training in positive behaviour practices. Intervention in the school community will target school climate to improve student mental health literacy and care. Intervention for the wider community will be via adolescent-led films and social media. We will generate intervention cost estimates, test outcome measures and identify pathways to increase policy action on the evidence. ETHICS AND DISSEMINATION: Ethical approval has been granted by the National Institute of Mental Health Neurosciences Research Ethics Committee (NIMHANS/26th IEC (Behv Sc Div/2020/2021)) and the University of Leeds School of Psychology Research Ethics Committee (PSYC-221). Certain data will be available on a data sharing site. Findings will be disseminated via peer-reviewed journals and conferences

Practitioner Review: effectiveness and mechanisms of change in participatory arts-based programmes for promoting youth mental health and well-being – a systematic review

Background: Participatory arts-based (PAB) programmes refer to a diverse range of community programmes involving active engagement in the creation process that appear helpful to several aspects of children's and young people's (CYP) mental health and well-being. This mixed-methods systematic review synthesises evidence relating to the effectiveness and mechanisms of change in PAB programmes for youth. Method: Studies were identified following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach. Eleven electronic databases were searched for studies of PAB programmes conducted with CYP (aged 4–25 years), which reported mental health and well-being effectiveness outcomes and/or mechanisms of change. A mixed-methods appraisal tool assessed study quality. A narrative synthesis was conducted of effectiveness and challenges in capturing this. Findings relating to reported mechanisms of change were integrated via a metasummary. Results: Twenty-two studies were included. Evidence of effectiveness from quantitative studies was limited by methodological issues. The metasummary identified mechanisms of change resonant with those proposed in talking therapies. Additionally, PAB programmes appear beneficial to CYP by fostering a therapeutic space characterised by subverting restrictive social rules, communitas that is not perceived as coercive, and inviting play and embodied understanding. Conclusions: There is good evidence that there are therapeutic processes in PAB programmes. There is a need for more transdisciplinary work to increase understanding of context–mechanism–outcome pathways, including the role played by different art stimuli and practices. Going forward, transdisciplinary teams are needed to quantify short- and long-term mental health and well-being outcomes and to investigate optimal programme durations in relation to population and need. Such teams would also be best placed to work on resolving inter-disciplinary methodological tensions

StammerApp:Designing a Mobile Application to Support Self-Reflection and Goal Setting for People Who Stammer

Stammering is a speech disorder affecting approximately 1% of the worldwide population. It can have associated impacts on daily life, such as loss of confidence in social situations and increased anxiety levels (particularly when speaking to strangers). Work exploring the development of digital tools to support people who stammer (PwS) is emerging. However, there is a paucity of research engaging PwS in the design process, with participation being facilitated mainly in testing phases. In this paper, we describe the user-centered design, development and evaluation of StammerApp, a mobile application to support PwS. We contribute insights into the challenges and barriers that PwS experience day-to-day and reflect on the complexities of designing with this diverse group. Finally, we present a set of design recommendations for the development of tools to support PwS in their everyday interactions, and provide an example of how these might be envisioned through the StammerApp prototype