Editorial Perspective: Using the levers to improve the mental health transitions of 15–25 year olds – learning from the evidence across the whole of health, social care and beyond

Abstract

How can we utilise the four key findings from the Scoping Review by Adu et al. (2022) as levers for change? The end to be kept in sight is to shift the dial to where, at any one point in time, far more 15-25 year olds are mentally healthy, or are at least coping, and far fewer are struggling or unwell. Any strategy development is impacted on by the major global levers for change: demographics (population health); technology and innovation; the political, economic, social and environmental context; and current service models and patient/health workforce expectations. Health care in any country, whatever the funding mechanism, whether high or low income, is set within finite funding packages. Policymakers have many competing priorities within, and beyond health and social care. Globally, TAY exists in an increasingly digital world, facing the reality of climate change and rapidly changing geopolitics. Their lives are now hit by the impact of pandemic and cost of living crisis.We live in a world of strap lines such as 'No Health without Mental Health' and 'Nothing About Us Without Us'. We are undoubtedly all in this together but the reality of life circumstances for growing numbers of young people living at the margins, who have experienced cumulative trauma, is stark. From the first spark of life, and throughout our lives, our mental and physical health is profoundly affected by the places we live, the people with whom we spend time and interact, and the communities to which we, and 15-25 year olds, belong, or from whom they have become detached. Using systems thinking as a lever to help us deliver effective pathways of careSystems thinking is a way of making sense of the complexity of the world by looking at it in terms of wholes and relationships rather than splitting it down into its parts. It has been used as a way of exploring and developing action in complex contexts (Meadows, 2017). TAY fits well with Systems Thinking:1 The matter is undoubtedly important.2 The problem is chronic not a one-off event.3 The problem has a known history.4 Progress has been made but is limited.TAY is often described as a complex issue, which, all too easily, can convert to a 'Too difficult to tackle' mindset. The benefits of Systems Thinking applied to TAY is its potential to help all players make sense of complexity at mental health transitions, understanding transition as wholes and relationships, rather than splitting it down into parts, as is done at present. This aligns closely with the ask of users and carers to be supported and live WELL beyond their diagnosis:1 To be seen, heard and understood, in the context of the impact of their mental health problems on all aspects of their lives and in their unique social context.