The DREAM Project: Diversity, Research, and Engagement for Adolescent Mental Health

The number of children and adolescents from migrant backgrounds is increasing in the UK. These individuals may be at increased risk of poor mental health outcomes such as depression, anxiety, and post-traumatic stress disorder (PTSD). This may be because they have experienced stressful or traumatic events before, during, and following migration. For example, children may have experienced violence, conflict, or natural disasters in their countries of origin. They may have had long journeys to the UK, or experienced stressful situations such as refugee camps or detention centres, dangerous transit routes, or poor living conditions before arriving in the UK. Children and adolescents from migrant backgrounds in the UK may also experience stressors here such as poverty, violence, stigma or discrimination, violence, or social isolation.

There has been limited research on ways to protect the mental health of these children and adolescents, or how to prevent poor mental health outcomes. There is also little understanding of how to best connect with these groups to support their engagement in research or health services, or to ensure that interventions are appropriate, effective, and sustainable. Creative and arts-based approaches such as drawing, painting, theatre, music, and dance have been used to both connect and engage with youth from diverse backgrounds in a meaningful way, and to promote mental health and resilience.

The aim of this project is to collaborate with children and adolescence from migrant backgrounds to strengthen what we know about the mental health needs of these youth, and how to promote and protect their mental health. The project will have three interlinked parts in which we will: 1) Develop a research group with collaborators from a range of disciplines and sectors such as research, health services, and community organisations, and the creation of a youth group through which we will collaborate with children and adolescents to develop an art-based intervention; 2) Gather evidence on the mental health needs of children and adolescents from migrant backgrounds and their conceptualisations of stressors, resilience, and barriers to engagement with research and health services through a survey, and a photovoice project using photography to explore their experiences; and 3) Develop, test, and evaluate an art-based intervention in collaboration with the youth group. The findings will be shared with researchers, and the wider community, and will strengthen our understandings of the mental health needs of children and adolescents from diverse backgrounds, and inform future research and interventions.

The number of children and adolescents from migrant backgrounds is increasing in the UK, with evidence that they may be at increased risk of poor mental health outcomes due to exposure to psychosocial stressors before, during, and following migration. There is limited evidence on protective or preventive interventions to promote mental health and well-being in migrant children and adolescents, and a lack of community engagement or participatory research to support effective implementation. However, creative and arts-based approaches have been used to both facilitate meaningful engagement and to promote mental health and resilience. The aim of this project is to utilise participatory research and engagement to strengthen evidence on the mental health needs of children and adolescents from migrant backgrounds, and approaches to promoting their mental health and well-being. The specific objectives across three interlinked work packages are to: 1) Establish a sustainable foundation for community engagement and participatory research through a multidisciplinary research network, and youth consortium; 2) Investigate mental health needs, and conceptualisations of risk factors, resilience, and barriers to engagement among children and adolescents with migrant backgrounds through a mixed-methods survey and photovoice project; and 3) Develop, pilot, and evaluate a co-produced arts-based mental health promotion intervention through collaboration with the youth consortium and research network.

Children and adolescents from migrant backgrounds have been shown to experience significant barriers to accessing health and social services and engaging in research, which may be exacerbated by increasingly restrictive immigration and healthcare policies. As a result, these communities are consistently underrepresented and excluded from both health research and health services.

The research will have important benefits both for children and adolescents from migrant backgrounds, and the organisations and services working with them. The participatory emphasis of the research will support engagement, knowledge exchange, awareness raising, inclusion, and capacity building among children and adolescents. The youth consortium who will be engaged in co-producing the interventions, will receive training on research methods, mental health promotion, and arts-based approaches, contributing to capacity building in these areas, in addition to promoting inclusion and the development of social networks.

The research participants will also directly benefit from the research through participation in the arts-based intervention, which will be focused on promoting mental health among children and adolescents, directly benefitting the participants and informing strategies to improve mental health and prevent poor psychological outcomes in wider communities of children and adolescents from diverse backgrounds. The participants may also benefit from the opportunity to engage with other youth, as well as local support organisations through the intervention, strengthening their social networks and resources.

Finally, the project will have important benefits for other sectors, as it will strengthen multidisciplinary and cross-sectoral links through the research network, and inform changes in policy and practice, supporting these organisations to address the social and mental health needs of the communities with whom they work.