Anxiety and depression in young people: finding the next generation of treatments and approaches

We’ve convened researchers across the mental health science community to identify and review the 'active ingredients' of effective interventions for youth anxiety and depression.  

By 'active ingredients' we mean those aspects of an intervention that drive clinical effect, are conceptually well defined, and link to specific hypothesised mechanisms of action. In other words, those aspects most likely to make a difference in preventing, treating or managing mental health difficulties.  

These ingredients will be different for different people and could span biological, cognitive, relational and societal approaches. For example, they could include practicing relaxation techniques, taking antidepressants or having access to more financial resources. 

1. What the evidence tells us

Anxiety and depression are holding millions of people back in life. However, we still know very little about underlying mechanisms of how current mental health treatments work (Holmes et al., 2018) or why they do not work for everyone (Cuijpers, 2017). And there has been no improvement in outcomes over the past 50 years. 
 
The mental health science community is fragmented, with different disciplines taking different approaches and not enough interdisciplinary learning. Researchers lack a common language for describing problems, interventions and outcomes (Allsopp et al., 2019, Krause et al., 2018). 
 
There is even less learning from other areas of academia, including the humanities, law, economics, mathematics and philosophy, where potentially relevant research is taking place (Siegle et al., 2018)

2. Our approach 

We’re bringing the mental health science community together to forge a common research agenda around active ingredients. We’re focusing on those most likely to help the most young people in the most contexts, globally. In the process, we’re working to establish a common language – based on a common set of metrics – that all researchers, across disciplines, can use.  

In 2020, we launched our first project to build a foundational set of active ingredients, funding 30 teams from across the world to review the existing evidence.  

We then commissioned two research teams to explore what had been learned and what was missing, with young people with lived experience of anxiety and depression, researchers, clinicians and other stakeholders from across the world. The qualitative insights from that research have helped us to refine our work by bringing to the fore new voices and ideas from across the mental health science community. 

In 2021, we funded another 21 research teams to review an additional set of active ingredients. See all the researchers we've funded so far. 

3. Our values

We want to help build a more diverse and inclusive mental health science community, underpinned by a shared focus on finding new solutions. 

Through our work, we aim to:  

• encourage collaboration – mental health science is inherently interdisciplinary. By bringing researchers from different disciplines to collaborate on the same issue, we hope to break down existing siloes and weave knowledge together. 
• improve inclusivity and global representation – we’re funding researchers from all over the world and making a concerted effort to involve those in low- and middle-income contexts, to help make mental health science more diverse and inclusive.   
• involve people with lived experience – mental health research has had little input from people with lived experience of mental health problems. This is why we’re asking all the research teams we fund to seek input from young people with lived experience and include their insights in their work.    
• be transparent – we’re at the start of a journey and know that we can only make progress by acknowledging existing limitations in the field and working together to resolve them. We are keen to learn in public, alongside and as part of the mental health science community, to stop young people being held back by mental health problems. 

Researchers we’ve funded

So far, we’ve funded more than 50 research teams to review the evidence for active ingredients, and two teams to explore what others think of our approach.

Our lived experience advisors 

We’re working closely with our lived experience advisors to make sure that we invest our money and efforts in the types of support that are most important to young people.

The advisors help us decide on who to commission and they support our funded researchers to involve young people with lived experience in their research. They are: 

• Dhriti Sarkar, India
• Dion Agnuza, Indonesia
• Kamini Hari, United Kingdom
• Margaret Odhiambo, Kenya
• Natasha Swingler, Australia
• Tania Pandia, Indonesia

In October 2021 we published a report summarising the findings from the 30 teams we commissioned in 2020 to review the evidence for 27 active ingredients. Later this year, we will be publishing a second report with the findings from the teams commissioned in 2021.

We’ve also teamed up with the Mental Elf to share what we’ve learned so far via blogs, podcasts, and videos.

You can read publications by members of our mental health team and some of our funded teams below.

If you have any questions or comments about this work, email activeingredients@wellcome.org