Better together: Supporting youth with mental health needs by utilizing the social network

Abstract

The purpose of this dissertation was to advance our knowledge on the effectiveness of youth interventions that utilize the social network. To this end, we had three aims: 1) to provide insight into the effectiveness of youth care programs that utilize the social network; 2) to zoom in on the effectiveness of one program specifically, which is developed for youth with mental health needs in multi-problem families (i.e., InConnection); and 3) to better understand the links between pandemic-related stress, informal and formal support and mental health in multi-problem families. 1. How effective are interventions that activate the informal network? An overview study with different intervention types showed that youth interventions which activate the informal network are not more effective than interventions in which the network is not engaged. However, under certain circumstances, interventions that activate the social network were more effective. For example, interventions in which youth decide for themselves who to engage from their informal network, interventions in which only one person is involved, and interventions for youth with mental problems, did have significant effects. 2. How effective is InConnection for youth from multi-problem families? InConnection is an outpatient, systemic treatment for multi-problem families, in which a multidisciplinary team of professionals collaborates with an informal mentor according to the youth-initiated mentoring (YIM) approach. Interviews showed that almost all participants were positive about the collaboration with a YIM. The match between the needs of youth and parents and what mentors thought they could offer turned out to be good in most cases. The effectiveness study showed that InConnection showed some positive effects compared to treatment as usual, namely a decrease in the emotional and behavioral problems of youth and an increase in positive parenting behavior from the parents' perspective. No differences in effectiveness were found for the other outcome measures, including youth well-being and resilience. 3. Does support protect against mental health problems in youth and parents from multi-problem families during the Covid-19 pandemic? Due to the measures taken during the Covid-19 pandemic, youth and their parents had fewer opportunities to receive support from their network, while the risk of mental health problems increased, especially among vulnerable groups. Results showed that the pandemic was experienced as stressful by some youth from multi-problem families. Youth who experienced pandemic-related stress had a higher risk of mental health problems, especially if they reported receiving little or no formal support (therapist support). Parents were minimally affected by pandemic-related stress, suggesting strength and flexibility. Youth and parents who experienced support from their informal and/or formal networks during the pandemic had fewer problems, thus showing the importance of providing help and support to people with mental health problems during stressful situations such as a pandemic. These findings illustrate that despite the complex challenges that vulnerable youth (such as youth with mental health problems and youth from multi-problem families) experience, interventions with characteristics of YIM in general and InConnection specifically are as good or even better than other interventions in supporting youth and reducing their problems.