Title: “Hopeful” interventions to reduce mental ill-health and improve social outcomes for young women who are not in education, employment or training (NEET): Stakeholder engagement and co-design in disadvantaged coastal communities
Funder: Department of Health and Social Care

Abstract: About 10% of 16-24-year-olds in the UK are not in employment, education or training (NEET). They have worse mental health and fewer life chances than young people who are studying, in paid work or volunteering. There are more NEET young women than NEET young men and NEET young women are more likely to be bullied, harassed, socially isolated, and to experience domestic abuse._x000D_ _x000D_ There is little direct evidence about how to improve mental health and life in general for young women who are NEET. In other research, young people with mental health problems have benefited from programmes that increase hopefulness. “Hopefulness” is a particular way of thinking that helps people to identify and achieve their goals. NEET young people are known to struggle with hopefulness. This means that NEET young people may go on to experience better mental health and life outcomes if we can help them to identify meaningful goals, make plans to achieve those goals, and become more motivated for change._x000D_ _x000D_ We will plan a short, hopeful and goal-focused programme based on supportive discussions and activities. It will be delivered by trained people from local communities, in safe and familiar spaces. A low-cost programme like this could have positive impacts on the mental health and life chances of NEET young women across many different settings._x000D_ _x000D_ Our project aims to: (1) understand how the mental health and social conditions of NEET young women affect their needs and preferences for a hope-focused programme; (2) decide how, where, and by whom the programme should be delivered; and (3) describe how the programme might positively affect the lives of NEET young women on a large-scale._x000D_ _x000D_ We will do the research in two seaside towns with large NEET populations: Hastings in East Sussex and Margate in Kent. For aim 1, we will carry out approximately 40 in-depth interviews that explore the views of NEET young women, their family members, and people working in services and community organisations that currently support NEET young women. For aim 2, we will run two youth workshops in which we show and discuss other programmes that increase hopefulness (which we have reviewed in a previous project). We will ask young people which approaches they think will be most useful and relevant to NEET young women. For aim 3, we will run a workshop with local services and community organisations. We will ask them how a new hope-focused programme could reach and improve outcomes for large numbers of NEET young women in the short- and longer-term._x000D_ _x000D_ Information from young people will be collected by trained peer researchers. They will use their lived experience and local knowledge to help interviewees speak openly about their needs and preferences. Other team members have backgrounds in psychology, public health, and patient and public involvement. This varied expertise will help us to develop a programme that meets the multiple and complex needs of NEET young women. _x000D_ _x000D_ At the end of the project, we will have created the materials needed to deliver a hopeful programme for NEET young women. We will seek more funding to test the programme. We will share our results with other researchers, professional agencies and community organisations in order to generate interest for this future research.

Lay abstract: BACKGROUND: Young people who are not in employment, education or training (NEET) constitute 10% of 16-24-year-olds. NEET young women outnumber males and suffer from worse mental health and social outcomes. The evidence on effective interventions is scarce and promising approaches need to be adapted from wider populations. A number of studies show that interventions focused on hopefulness (which NEET young women notably lack) can significantly improve mental health in a variety of youth populations. Hopefulness can be defined as a mindset comprising self-agency (motivation and self-belief) and pathways (identifying goals and plans). Research suggests that hope-focused interventions can be deployed across a range of community settings and may therefore reach a wider audience than specialist mental health care. _x000D_ _x000D_ AIMS: We will select from and adapt brief hope-focused interventions so that they can be delivered by non-specialists. We will also tailor these intervention elements to fit the life contexts and needs of NEET young women living in seaside towns of Hastings and Margate, where high levels of social deprivation compound the detrimental effects of gender inequalities. _x000D_ _x000D_ METHODS: We will use a person-based intervention development approach with a phased qualitative research design. Phase 1 will capture local needs and intervention priorities in up to 40 formative stakeholder interviews, including NEET young women, family members, statutory agencies and community organisations. Phase 2 will refine hope-focused interventions based on lived experience insights from young people in two co-design workshops (approximately n=6 each). Phase 3 will formulate a theory of change and preconditions for scaling up in a workshop with statutory and community stakeholders (approximately n=12). _x000D_ _x000D_ ANTICIPATED IMPACT AND DISSEMINATION: The research will produce: (i) an intervention manual that describes delivery agents, settings, formats, procedures, outcome measures and quality assurance methods; (ii) a theory of change delineating how intervention components bring about short- and long-term outcomes; and (iii) a network of statutory agencies and community organisations committed to supporting future collaborative research._x000D_ _x000D_ After 6 months, we will seek funding to pilot and then test the effectiveness and cost-effectiveness of the intervention. The intervention will have the potential to reach a large number of NEET young women at relatively low cost. We envisage that it could become a routine activity in many settings where trusted adults or peers may be able to intervene relatively rapidly to engender a more hopeful mindset that facilitates personally meaningful goals in the short-term, and can reduce mental ill-health and promote social re-engagement in the longer-term. We will disseminate the findings through the NIHR Applied Health Collaboration in Kent, Surrey and Sussex, with target audiences including local authorities, community organisations, NEET young women, family members, and the general public in the research sites and more widely. _x000D_ _x000D_ TEAM: The project will be delivered by an interdisciplinary team with backgrounds in clinical and social psychology, public health medicine, and patient and public involvement (PPI). Our PPI lead will supervise a pair of peer researchers (young women with relevant lived experiences) who will facilitate interviews and workshops with the intention of improving rapport and generating richer data.

Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: MENTAL HEALTH