This report summarises what we’ve learned about the evidence for 'active ingredients' of effective interventions for youth anxiety and depression.
There are many approaches that make a difference in preventing, treating, and managing anxiety and depression in young people (14-24) worldwide. However, what we know about what works, for whom, in what contexts, and why is limited. Little consensus exists in the field of mental health on what makes an approach effective. We want to change this.
Since 2020 we have been commissioning research teams from across the world to review the evidence for different approaches that are deemed to help prevent, treat, and manage anxiety and depression in 14–24 year olds.
We refer to approaches that make a difference as ‘active ingredients’. These active ingredients are the building blocks of what is most likely to make a difference in preventing or addressing youth anxiety and depression. They are varied and connected, spanning biological, cognitive, relational, and societal approaches.
For example, we know that boosting social connection can help those experiencing depression. However, we lack evidence as to the best way to increase social connection and how this may vary for different people in different cultural contexts. We are also only beginning to understand why social connection exerts its positive effects (e.g. via effects on thought processes, or via changes at the neurobiological level). Understanding these factors will help us to develop better ways to prevent or intervene in depression.
So far, we’ve funded research into more than 40 active ingredients which we’ve grouped into six themes. Although they do not represent an exhaustive list of all possible active ingredients, the commissioned reviews give us a birds’ eye view of the state of the science.
A summary report of this research is available to download.
This research represents the start of a journey to consider how well each approach works.
Members of the mental health science community need to work together to understand how these approaches interact and what combinations work best, for whom, in what contexts, and why. We hope these reviews will inspire researchers to develop potential proposals for well-powered studies to tease out the mechanisms underpinning effective approaches so that we can develop more personalised interventions for young people.
This work is the first step towards finding the next generation of mental health treatments and approaches.
Active ingredients: aspects of an intervention that make the difference
Behaviours and activities
- Behavioural activation: increasing engagement with positive activities
- Collaborative goal setting and tracking
- Engagement with the arts
- Exposure: facing one’s fears in a planned manner
- Physical activity: more bodily movement
- Problem solving
- Relaxation techniques: better stress response via relaxation
- Remote measurement technologies: use of remote technologies to monitor changes in biology, behaviour, and environment relevant to the problems
- Self-disclosure: sharing information with others about personal experiences and characteristics
Beliefs and knowledge
- Agency: developing a sense of agency through social action
- Cultural connection: connection with one’s own culture
- Mental health literacy
- Sense of mattering
- Sense of purpose
- Self-evaluation: improved view of self
- Spiritual and religious beliefs
- Circadian rhythms: better sleep-wake cycles
- Gut microbiome: improving gut microbiome function
- Hippocampal neurogenesis: growth of new neurons in the hippocampal region of the brain
- Omega-3 supplements
- Reduced levels of inflammation in the body
- Selective serotonin reuptake inhibitors: use of antidepressants
Cognitive and attentional skills
- Affective awareness: knowing how one feels
- Decentering: better able to shift perspective
- Emotional controllability: beliefs about the extent to which emotions are controllable
- Emotional granularity: improved ability to characterise emotional experiences
- Emotion regulation: improved management of emotions
- Grief reduction: use of strategies to target feelings of grief
- Helpful attentional and interpretational thinking patterns
- Hopefulness: learning to be more hopeful
- Mental imagery: helpful use of emotional mental imagery
- Perfectionism reduction
- Repetitive negative thinking reduction
- Communication in families
- Digital quality social connection
- Family support
- Loneliness reduction
- Neighbourhood cohesion: increased neighbourhood social connection
- Peer support: support from a peer who has experienced anxiety and/or depression
- School connectedness: sense of connection to school life
- Social inclusion: improved inclusion for those who are minoritized on the basis of their identity (e.g., sexual and gender)
- Social relationships: facilitating improvements in social relationships
- Working alliance: a functional and collaborative relationship with a helper
- Economic transfers: increased financial resources via cash transfers
- Urban access to green space