Optimistic Minds: An innovative approach to evidence-based decision making in youth mental health through the performance of a State of the Youth

An introduction to this Emerging Minds funded project by the lead researcher, Dr James Duggan, Manchester Met University

We funded Dr James Duggan from Manchester Met University to work with Dr Sonia Bussu (MMU), Dr Sarah Parry (MMU), Katy Rubin and young people from Youth Focus North West and 42nd Street to develop Optimistic Minds, a project seeking to include young people in decision making in youth mental health. 


There are persuasive reasons and a series of commitments to include young people in decisions about mental health services, which must include processes of evidence-based decision making. Despite good intentions, the inclusion of young people is uneven and there are recurrent concerns that participation is tokenistic, adult- or service-led and not followed through in terms of improved delivery or feedback to young people. There are of course admirable exceptions but these demonstrate the importance of developing a broader series of productive arrangements that are sustained.  


Optimistic Minds is exploring a speculative State of the Youth approach to youth mental health – that is, a state run by and for young people, with the support of adults working with and for them. 

We are working with the Greater Manchester Youth Combined Authority (GMYCA): a democratic, legitimate and ongoing youth assembly. Significantly, rather than including young people in existing services and systems, we are using arts-based and co-produced approaches (e.g. legislative theatre) to reimagine a new way of nurturing, caring and supporting young people.

A common criticism of any youth-focused work that seeks to work beyond public services or usual forms of support is that we consigning young people and their families to self-help, the failure of which is often definitional of needing mental health support. It is through the idea of the State of the Youth, the legislative theatre practice, and the engagement in evidence-based decision making that we hope to identify and then iteratively expand and clarify new infrastructures for positive mental health. 


We are aware of the limitations of imaginative and speculative work, in that it might prove to be provocative and interesting but too disconnected from the ‘real’ world. We are working to ensure that the State of the Youth project delivers defined outcomes: 

1. Inform the process to develop Greater Manchester Living Well Community Mental Health Framework

2. Develop an innovative approach and culture of evidence-based decision making for young people in Greater Manchester and specifically in the GMYCA 

3. Develop a legislative theatre play and perform it four times with diverse audiences to co-produce recommendations for youth mental health policy 

Key Messages

Following the end of the project, James Duggan shared the key messages behind the research findings.

Legislative theatre is a process that supports young people to make a play about their lived experience of mental health issues and services. The play we made helped a diverse group of 16-25 year olds to explore and act out their lived experience of mental health and navigating a complex system that too often denies them the empathy and the support they need. The play was performed in front of a number of audiences, including professionals and decision makers, and together these young people were able to develop solid policy recommendations and ensure buy-in and support from the policymakers in the room around a set of actions.       

The research challenged much of the existing approaches to mental health support. Despite having evidence to suggest they are useful, the young people we sceptical about receiving advice about breathing techniques, exercise and mindfulness. The young people were also critical of approaches that individualised and/or over-medicalised mental health.  

The young people wanted mental health support that placed an emphasis on: trust-based relationships; bringing mental-health experience into mental health training; peer-driven mentoring, education, and support delivered by individuals who, because of their own experience, are qualified to support peers currently experiencing similar difficulties; the co-production of care and settings of care with young people and their community (e.g., schools, colleges, family and friends). 

The research identified a number of factors relating to the location, time and accessibility of good mental health provision in youth-friendly services clinics including after school clinic hours, peer support, and connection to the clinical staff. Receptionists and client-facing roles were seen as incredibly important. 

Further Reading

Policy report – as part of the legislative theatre performance, the policy report was developed presenting the themes the audience wanted to work on.
Link: https://optimisticminds317353588.wordpress.com/resources/

Blog: Loneliness Connects us
Link: https://www.lonelinessconnectsus.org/blog

Drawings: Reimagining young people’s agency in decision-making on mental health
Link: https://optimisticminds317353588.wordpress.com

Short films: 
Link: https://optimisticminds317353588.wordpress.com/gallery/


For more information about this project please visit the project website or Twitter using the buttons below, or contact the project lead James Duggan by emailing j.duggan@mmu.ac.uk.