Understanding how interventions for youth depression and anxiety work
This report identifies what we do and don’t know about how interventions for youth anxiety and depression work. It also includes recommendations for future research to fill the gaps and better inform policy and funding decisions.
Report at a glance
This report was commissioned by Wellcome and authored by Ms Tarisai Bere, Dr Christian Kieling, Dr Katherine Young and Dr Anna McLaughlin in consultation with lived experience advisory groups. The views and opinions expressed in this report are solely those of the authors and do not necessarily reflect the official policy or position of Wellcome.
- Strategic programme:
- What's inside:
- This report shares synthesised evidence on the mechanisms of youth mental health interventions, examines the gaps and opportunities for research and shares insights from young people with lived experience of mental health problems.
- Who this is for:
- Mental health researchers, funders and policymakers
- Creative commons:
Summary
Anxiety and depression are two of the biggest health challenges among young people globally. Despite the availability of evidence-based interventions, many do not experience lasting improvement, and recurring illness is common. This report synthesises global evidence to understand how interventions work, for whom and why.
Looking at psychological, pharmacological, digital, lifestyle, social and creative interventions, the report highlights the way in which these interventions reduce symptoms. It identifies four major challenges:
- Weak mechanistic evidence: Most studies evaluate whole interventions withoutexplaining the processes behind how things happen, for example by isolating active ingredients or testing causal pathways.
- Limited prevention research: Few studies look at the factors at play before symptoms emerge.
- Lack of diversity: Evidence is concentrated in high-income countries, with little focus on how interventions can be adapted for low- and middle-income countries.
- Minimal lived experience integration: Young people’s perspectives are rarely included in setting out what they value in how interventions should work and be measured.
The report concludes that a shift toward mechanistic, hypothesis-driven research that is youth-centred, culturally relevant and designed to test how interventions work is needed. The key recommendations include:
- designing studies to test mechanisms explicitly
- advancing prevention research
- investing in lifestyle, social and creative interventions
- embedding lived experience in research design
These insights aim to guide future funding and policy work, ensuring interventions are effective, scalable and meaningful to young people.
Key findings
1. Mechanistic evidence is weak and underdeveloped
Most interventions don't have clear evidence of how they work. Few studies test mediation, dosage effects, or temporal sequencing, limiting understanding of active ingredients.
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Conclusion
The report concludes that to improve youth mental health outcomes, research must move beyond symptom reduction to understand how interventions work. This means testing mechanisms, tailoring interventions to diverse contexts and embedding lived experience.
The report makes 5 key recommendations.
Recommendations for policy and research
- Fund studies that test mechanisms using theory-driven designs.
- Prioritise prevention research targeting risk factors.
- Invest in culturally adapted interventions for low and middle-income countries.
- Embed lived experience in all stages of research.
- Support underexplored areas like lifestyle, social, and creative interventions.
Quotes
“Young people consistently emphasised the importance of trust, collaboration and therapeutic alliance.”
“Interventions are most effective when tailored, culturally relevant, and grounded in trust.”
“Creative and spiritual practices were widely endorsed but seen as under-researched.”
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Contact us
Wellcome's mental health team
For more information on this report please contact the mental health team. Please put "Youth interventions report" in the subject line.
