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Introduction: Engaging youth in mental health research and intervention design has the potential to improve their relevance and effectiveness. Frameworks like Roger Hart's ladder of participation, Shier's pathways to participation and Lundy's voice and influence model aim to balance power between youth and adults. Hart's Ladder, specifically, is underutilized in global mental health research, presenting new opportunities to examine power dynamics across various contexts. Drawing on Hart's ladder, our study examined youth engagement in mental health research across high‐ and middle‐income countries using Internet‐based technologies, evaluating youth involvement in decision‐making and presenting research stages that illustrate these engagements. Methods: We conducted a directed content analysis of youth engagement in the study using primary data from project documents, weekly AirTable updates and discussions and interviews with youth and the research consortium. Using Hart's Ladder as a framework, we describe youth engagement along rungs throughout different research stages: cross‐cutting research process, onboarding, formative research and quantitative and qualitative study designs. Results: Youth engagement in the MindKind study fluctuated between Rung 4 ('Assign, but informed') and Rung 7 ('Youth initiated and directed') on Hart's Ladder. Engagement was minimal in the early project stages as project structures and goals were defined, with some youth feeling that their experiences were underutilized and many decisions being adult‐led. Communication challenges and structural constraints, like tight timelines and limited budget, hindered youth engagement in highest ladder rungs. Despite these obstacles, youth engagement increased, particularly in developing recruitment strategies and in shaping data governance models and the qualitative study design. Youth helped refine research tools and protocols, resulting in moderate to substantial engagement in the later research stages. Conclusion: Our findings emphasize the value of youth–adult partnerships, which offer promise in amplifying voices and nurturing skills, leadership and inclusiveness of young people. Youth engagement in project decision‐making progressed from lower to higher rungs on Hart's Ladder over time; however, this was not linear. Effective youth engagement requires dynamic strategies, transparent communication and mutual respect, shaping outcomes that authentically reflect diverse perspectives and mental health experiences. Patient or Public Contribution: There was substantial patient and public involvement in this study. This paper reports findings on youth engagement conducted with 35 young people from India, South Africa and the United Kingdom, all of whom had lived experience of mental health challenges. Youth engagement in the MindKind study was coordinated and led by three professional youth advisors (PYAs) in these contexts, who were also young people with lived experience of mental health challenges. Each of the three study sites embedded a full‐time, community‐based PYA within their study team to inform all aspects of the research project, including the development of informational materials and the facilitation of Young People's Advisory Group (YPAG) sessions referenced in this paper. Each PYA also consulted with a site‐specific YPAG that met bi‐monthly throughout the project, shaping the formation of study materials and serving as a test group in both the quantitative and qualitative studies. Youth participants in this study also contributed extensively, engaging in data collection and manuscript writing. The following youth advisory panels members (J.B., L.B., D.O.J., M.V.) and all PYAs (E.B., S.R., R.S.) in the MindKind study contributed to the writing of this manuscript and are acknowledged as co‐authors. [ABSTRACT FROM AUTHOR]

Background: Improving access to mental health data to accelerate research and improve mental health outcomes is a potentially achievable goal given the substantial data that can now be collected from mobile devices. Smartphones can provide a useful mechanism for collecting mental health data from young people, especially as their use is relatively ubiquitous in high-resource settings such as the United Kingdom and they have a high capacity to collect active and passive data. This raises the interesting opportunity to establish a large bank of mental health data from young people that could be accessed by researchers worldwide, but it is important to clarify how to ensure that this is done in an appropriate manner aligned with the values of young people., Objective: In this study, we discussed the preferences of young people in the United Kingdom regarding the governance, sharing, and use of their mental health data with the establishment of a global data bank in mind. We aimed to determine whether young people want and feel safe to share their mental health data; if so, with whom; and their preferences in doing so., Methods: Young people (N=46) were provided with 2 modules of educational material about data governance models and background in scientific research. We then conducted 2-hour web-based group sessions using a deliberative democracy methodology to reach a consensus where possible. Findings were analyzed using the framework method., Results: Young people were generally enthusiastic about contributing data to mental health research. They believed that broader availability of mental health data could be used to discover what improves or worsens mental health and develop new services to support young people. However, this enthusiasm came with many concerns and caveats, including distributed control of access to ensure appropriate use, distributed power, and data management that included diverse representation and sufficient ethical training for applicants and data managers., Conclusions: Although it is feasible to use smartphones to collect mental health data from young people in the United Kingdom, it is essential to carefully consider the parameters of such a data bank. Addressing and embedding young people's preferences, including the need for robust procedures regarding how their data are managed, stored, and accessed, will set a solid foundation for establishing any global data bank., (©Emma Grace Carey, Faith Oluwasemilore Adeyemi, Lakshmi Neelakantan, Blossom Fernandes, Mina Fazel, Tamsin Ford, The MindKind Consortium, Anne-Marie Burn. Originally published in JMIR Formative Research (https://formative.jmir.org), 23.04.2024.)