A new methodology linking interactional and experiential approaches, and involving young people as co-analysts of mental health encounters.

Imagine that you are a researcher working on youth mental health. You know that adolescence and early adulthood are a critical period for intervention to prevent mental health problems continuing into adulthood. You want to understand why a substantial number of young people don't engage with, or don't benefit from, mental health interventions and services.

You might want to use 'qualitative' methods, because they are often better suited to capturing meaning, context and complexity. If you were curious about how interactions with services can sometimes go wrong for young people, this would be a good approach. You could record what happens when young people do meet with professionals. You could analyse those conversations using an 'interactional' method. This focuses on how a particular social interaction unfolds - who says what, and where does that lead? But you would be lacking important contextual information about the meetings you recorded. For example, you wouldn't know how these events fitted into the broader story of the young person's attempts to get help, or how the young person felt about the event that you had just observed.

You could interview the young person instead, to find out about this context, and how they were feeling about their attempts to get help - what was it like for them? You could analyse these interviews using a 'phenomenological' method. This focuses on how people make sense of their experiences. But then you wouldn't be able to be very precise about what professionals should do differently, because you hadn't observed it.

There are two important and new features to the methodology which we propose to develop in this project. The first of those features is that we will combine these the approaches above, in order to show how a more powerful and insightful analysis of young people's experiences can be developed when we examine both what happens to young people when they seek help, and what they think and feel about that, in the context of their mental health needs. This may seem obvious, but these two methods are rarely - if ever - combined, and there is no methodological framework available for researchers to help them to think about how to combine them. We will do this, and then show how it can be done by others.

The second feature of our proposed new methodology is equally important. If you were a researcher preparing a new project, we hope that you would also be thinking about how to involve young people in planning, conducting, evaluating and sharing that project. You would find that there is plentiful guidance available about the general principles underlying this kind of collaboration. But there is no guidance (and there are very few published examples) which would help you to involve young people in analysing and interpreting data. This is the stage where researchers decide what they have found, and what it means, so it is very important.

We have found in our previous work, talking with young people about video data, that with appropriate preparation and support, young people will contribute very important analytic insights. We have shown already that the principles of this co-analysis are acceptable to young people, feasible for researchers, and produce valuable research. We want to expand on this and develop it, to meet the needs of the youth mental health research community.

By bringing other data sources (interviews) into the process, and showing how young people can engage with more than one form of analysis (phenomenological and interactional), we will develop a methodology that other researchers can use, in order that they can also co-analyse data with young people, and benefit from young people's expertise. These methodological developments will be transformative for the field of youth mental health research, enabling qualitative researchers to capture a much fuller picture of young people's experiences, and to work much more equitably alongside young people.

It is crucial to understand young people's subjective experiences of mental healthcare. Existing methods tend to oversimplify and decontextualise these experiences. Methodological innovation is needed to provide a more systemic view.

The ethical and epistemic benefits of co-producing research with young people are now evident. Any new methodology thus must incorporate strategies for conceptualising and implementing the active involvement of young people in research. While significant progress has been made for many aspects of the research process, the field of youth mental health lacks a methodology for involving young people in data analysis and interpretation.

Our proposal connects these two problems by suggesting that different forms of expertise can be understood in terms of the different perspectives they provide. Bringing more than one perspective supports more comprehensive analysis. We will work with young experts-by-experience, in the context of an interdisciplinary approach. An independent youth-led evaluation will examine the pilot work which we have completed so far, to identify barriers and facilitators to successful co-analysis. We will then follow a prototype-refinement process to carry out a full application of our proposed methodology. This will examine young people's encounters with professionals about their mental health. We will conduct co-analysis with young people (aged 15-24), examining two innovative data types (image-based interviews and video-recorded clinical interactions), and employing two established qualitative methods (Interpretative Phenomenological Analysis and Conversation Analysis) in a novel complementary design. We will document our process, strategies, and resources. We will work with young people and other stakeholders to develop materials to allow the wider research community to plan, fund, implement, conceptualise, evaluate and adapt our methodology for other crucial topics in the field of adolescent mental health.