A systemic approach to identifying sustainable community-based interventions for improving adolescent mental health: a participatory group model building and design protocol

Abstract

Abstract Background The deteriorating mental health of children and young people in the United Kingdom poses a challenge that services and policy makers have found difficult to tackle. Kailo responds to this issue with a community-based participatory and systems-informed strategy, perceiving mental health and wellbeing as a dynamic state shaped by the interplay of broader health determinants. The initiative is active in two contrasting locales: theurban London borough of Newham and the rural district of Northern Devon in the Southwest United Kingdom. These divergent areas were intentionally selected to examine the role of local context in shaping the factors influencing young people's mental wellbeing. Kailo unfolds in three stages within each locale. These stages encompass: ‘Early Discovery’, ‘Deeper Discovery and Co-Design’, and ‘Implementation’. This document delves into the participatory group model building and design protocol occurring in the ‘Deeper Discovery and Co-Design’ stage of the project. Methods The engagements begin early in the Deeper Discovery and Co-Design phase, aiming to gain a more thorough understanding of the systemic behaviours driving the locally identified opportunity areas from Early Discovery. Participatory methods, such as group model building, are effective in building consensus on complex issues like the social determinants of adolescent mental health. This paper describes the application of group model building in two local areas to develop causal loop diagrams and pinpoint leverage points related to this issue. It also suggests a method for considering modifications to delivery within a unique project context and in alignment with participants' needs. This paper sets out to define the approach and clarify the objectives these engagements aim to fulfil. The method adapts existing Group Model Building (GMB) protocols for use in a community setting. The engagements will involve groups of local young people and existing community members. To assess the success of the session's implementation post-delivery, the study utilises existing frameworks for fidelity evaluations, which define a core and flex model. Discussion The method described enables an integration of diverse local understandings of complex processes which provides a platform for creating co-designed interventions. The strengths and limitations of the approach are discussed.