Conference Agenda

Recent evidence has suggested that adolescent girls are experiencing increasing rates of low mood and anxiety. There is little clarity on the cause of this increase, and no understanding of adolescent girls’ own perspectives on these issues, with most explanations put forward by researchers. We present here on analysis from a co-produced qualitative study, where we undertook online focus groups with 32 adolescent girls to explore their perspectives on, and explanations for, growing rates of low mood and anxiety in their population. We have constructed six key themes through reflexive thematic analysis: a) current mental health context and discourses, b) how girls and women “should” look and behave; c) educational pressure; d) peer relationship difficulties, e) social media and insecurity, and f) there is no easy answer. In this presentation we explore these themes and the pressure and complexity that they capture, and reflect on the methods and process of this research and the possibilities and challenges it carries for directing ongoing research in this area.

In the UK, one in four girls aged 17 to 19 have a probable mental disorder. Yet there is a lack of research focusing on the self-management of young people’s mental health, particularly those whose difficulties are below clinical thresholds. In this study, an innovative interdisciplinary approach was piloted to access the real-time stressors and self-management strategies of adolescent girls.

Fifteen girls, aged 16-17 and not receiving professional mental health support, were invited to record video diaries (on their phones) of their daily lives for four weeks. Video diary data was analysed, and interview questions formulated around the key themes. Interviews were conducted and analysed using Interpretative Phenomenological Analysis. Finally, participants were invited to make films that drew on their video diaries.

Six themes were formulated: (i) Tick Tock: The Constant Threat of Time; (ii) Me Versus School; (iii) 'Why am I like this?' Struggling for Agency over spiralling emotions; (iv) Being there no matter what; (v) Uplifting power of everyday rituals and routines and (vi) My Superpower.

Video diaries provided access to the day-to-day lives of participants, enabling interviews to be focused on what mattered to them. This approach is well-positioned to capture daily experiences, particularly among hard-to-reach groups.

Aim

To offer a fine-grained analysis of adolescent suicides classified as “unexpected”, in order to arrive at lessons for suicide prevention.

Methods and Materials

Qualitative interviews were held with the parents, peers, and teachers of 35 adolescent suicide cases (17 boys, mean age= 17 years). We performed a thematic analysis regarding the aforementioned factors and identified three categories of youth suicides, “unexpected suicides” being one of the categories.

Results

Seven adolescent male and two female suicides could be categorized as “unexpected” i.e., cases without clear signals, who had not received mental health care. In hindsight, for almost all 9 young people informants could point at “normal” adolescent issues. i.e., loneliness or depressed mood- based on their diaries or school notebook studied after their death. Others had been anxious about growing up and what the future would bring, and for others school stress or insecurity in social relationships had played a role. Referral to death had sometimes been made by these 9 youth, albeit in covert ways.

Discussion and Conclusion

Suicide prevention for adolescence requires a social network approach where schools, peers, teachers and general practitioners, together with parents share responsibility for the care of young people.

Seeking refined understanding of recovery during formation in is relevant, as life-disrupting mental suffering diagnosed with psychosis generally appears at an early age. However, most meta-studies overlook what it means to recover during the period of youth. Examined through a theoretical lens of youth belonging, this qualitative meta-ethnography synthesizes empirical studies' interpretations of young people´s recovery during psychosis. Based on a systematic literature review, eleven empirical studies were included, generating four overarching themes: 1) Feeling unable to live up to expectations of progress in youth 2) Feeling lost and left behind, 3) Recovering through belonging with other young people, 4) Navigating identity positions of growth or disability. While young people suffer from isolation, recovery is conceptualized as "getting on with life like other young persons" which implies belonging to and synchronizing life rhythms with age peers. Primarily socializing with adults may imply feeling stuck in a child´s position, while belonging to age peers enables positioning oneself as a young person. A synthesizing line of argument suggested relational complexities in pathways to recovery in youth. These complexities of navigating social relationships while striving for recognition and avoiding undesired identity positions can challenge young people´s processes of breaking out of social isolation.