A participatory action research approach to participation with young people within mental health settings

Poor mental health is a growing issue for young people (YP) in the UK with 75% of all mental health issues occurring by age 24 (Kessler et al., 2005). YP are one of society's most oppressed groups (Sidanius & Pratto, 1999). Oppression disrupts potential for social equality, justice and wellbeing (Freire, 1973) and when already oppressed YP are faced with further oppressive structures in mental health settings their relative powerlessness is compounded (Dexter, Larkin & Newnes, 2012). Participation is a way of resisting such disempowerment and can contribute to wellbeing and recovery through empowering YP towards change (Taggart, Franks, Osborne & Collins 2013) and increasing YP's skills and competencies (Day, 2008). Services improve in quality and effectiveness when 'service-users' needs are met through 'participation' (Beresford, 1997). Despite human rights, legislation and policy drivers (Department of Health, 2005, 2015, 2017) promoting YP's meaningful participation, YP's voice is not fully heard in mental health systems (Beresford, 2002). This research recognises gaps in practice and direct research with YP around YP's participation in mental health settings. Collaborating with YoungMinds, using a Participatory Action Research (PAR) approach, YP as 'co-researchers' shared their voice through cycles of dialogue, reflection and action towards (Baum, MacDougal & Smith, 2006) transformational change on varying levels. This research is grounded in liberation practices and community psychology, utilising discursive ideas of power (Foucault,1977, 1984, 1988). Thematic analysis (Braun & Clarke, 2006) led to four main themes developed, in collaboration with coresearchers, namely 'Power over YP', 'Hearing YP's voice', 'Safe Structures' and 'Participation as Fundamental to Wellbeing'. YP discussed professionals privileging their knowledge over them as problematic in YP's voice being heard and identified action towards shaping safe, ethical and meaningful participation in mental health settings. YP positioned participation as vital to wellbeing through connecting it to transformational processes and preventing harm. A reflexive stance towards evaluating the research is considered with future implications, including how this research may be taken forward by co-researchers beyond the scope of this thesis.