A Review of Effective Youth Engagement Strategies for Mental Health and Substance Use Interventions


      The majority of adult mental health and substance use (MH&SU) conditions emerge in adolescence. Prevention, diagnosis, and treatment programs targeting this age group have a unique opportunity to significantly impact the well-being of the future generation of adults. At the same time, youth are reluctant to seek treatment and have high rates of dropout from interventions. An emphasis on youth engagement in prevention and treatment interventions for MH&SU results in better health outcomes for those youth. This literature review was undertaken to evaluate opportunities to improve youth engagement in MH&SU programs. The intent was to determine best practices in the field that combined community-level improvement in clinical outcomes with proven strategies in engagement enhancement to inform program development at a local level. The results discuss 40 studies, reviews, and program reports demonstrating effective youth engagement. These have been grouped into six themes based on the underlying engagement mechanism: youth participation in program development, parental relationships, technology, the health clinic, school, and social marketing. A broad range of tools are discussed that intervention developers can leverage to improve youth engagement in prevention or treatment programs.


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        • Patton G.
        • Sawyer S.
        • Santelli J.
        • et al.
        Our future: A Lancet commission on adolescent health and wellbeing.
        Lancet. 2016; 387: 2423-2478
      1. Convention on the rights of the child. UNICEF, New York, NY2016 (Available at:) (Accessed November 13, 2016)
        • Kessler R.
        • Berglund P.
        • Demler O.
        • et al.
        Lifetime prevalence and age-of-onset distributions of DSM-iv disorders in the national comorbidity survey replication.
        Arch Gen Psychiatry. 2005; 62: 593
        • Urbanoski K.
        • Rush B.
        • Wild T.
        • et al.
        Use of mental health care services by Canadians with co-occurring substance dependence and mental disorders.
        Psychiatr Serv. 2007; 58: 962-969
        • James A.M.
        Principles of youth participation in mental health services.
        Med J Aust. 2007; 187: S57-S60
        • Rickwood D.
        • Deane F.
        • Wilson C.
        When and how do young people seek professional help for mental health problems.
        Med J Aust. 2007; 187: S35-S39
        • Gulliver A.
        • Griffiths K.
        • Christensen H.
        Perceived barriers and facilitators to mental health help-seeking in young people: A systematic review.
        BMC Psychiatry. 2010; 10: 113
        • Sawyer S.
        • Afifi R.
        • Bearinger L.
        • et al.
        Adolescence: A foundation for future health.
        Lancet. 2012; 379: 1630-1640
        • McConnell M.
        • Memetovic J.
        • Richardson C.
        Coping style and substance use intention and behavior patterns in a cohort of BC adolescents.
        Addict Behav. 2014; 39: 1394-1397
        • Catalano R.
        • Fagan A.
        • Gavin L.
        • et al.
        Worldwide application of prevention science in adolescent health.
        Lancet. 2012; 379: 1653-1664
      2. Maternal, newborn, child and adolescent health. World Health Organization, New York, NY2016 (Available at:) (Accessed November 13, 2016)
        • Edlund M.
        • Wang P.
        • Berglund P.
        • et al.
        Dropping out of mental health treatment: Patterns and predictors among epidemiological survey respondents in the United States and Ontario.
        Am J Psychiatry. 2002; 159 (doi:10.1176/appi.ajp.159.5.845): 845-851
        • Olfson M.
        • Mojtabai R.
        • Sampson N.
        • et al.
        Dropout from outpatient mental health care in the United States.
        Psychiatr Serv. 2009; 60
        • Richardson L.
        • Ludman E.
        • McCauley E.
        • et al.
        Collaborative care for adolescents with depression in primary care.
        JAMA. 2014; 312: 809
        • Servili C.
        An International Perspective on Youth Mental Health: The role of primary health care and collaborative care models.
        J Can Acad Child Adolesc Psychiatry. 2012; 21: 127-129
        • Garvey C.
        • Julion W.
        • Fogg L.
        • et al.
        Measuring participation in a prevention trial with parents of young children.
        Res Nurs Health. 2006; 29: 212-222
        • Garnick D.W.
        • Lee M.T.
        • O'Brien P.L.
        • et al.
        The Washington circle engagement performance measures' association with adolescent treatment outcomes.
        Drug Alcohol Depend. 2012; 124: 250-258
        • Pullmann M.
        • Ague S.
        • Johnson T.
        • et al.
        Defining engagement in adolescent substance abuse treatment.
        Am J Community Psychol. 2013; 52: 347-358
        • United Nations Department of Economic and Social Affairs
        Definition of youth.
        2013 (Available at:) (Accessed January 18, 2016)
        • Bryant J.
        • Saxton M.
        • Madden A.
        • et al.
        Consumer participation in the planning and delivery of drug treatment services: The current arrangements.
        Drug & Alcohol Revs. 2008; 27: 130-137
        • Monson K.
        • Thurley M.
        Consumer participation in a youth mental health service.
        Early Intervention in Psychiatry. 2011; 5: 381-388
        • Tobin M.
        • Chen L.
        • Leathley C.
        Consumer participation in mental health services: Who wants it and why?.
        Aust Health Rev. 2002; 25: 91
        • Steiker L.
        • Powell T.
        • Goldbach J.
        • Hopson L.
        Dissonance-based interventions for substance using alternative high school youth.
        Practice. 2011; 23: 235-252
        • Steiker L.
        Making drug and alcohol prevention relevant.
        Fam Community Health. 2008; 31: S52-S60
        • Paterson B.
        • Panessa C.
        Engagement as an ethical imperative in harm reduction involving at-risk youth.
        Int J Drug Policy. 2008; 19: 24-32
        • Stockburger J.
        • Parsa-Pajouh B.
        • de Leeuw S.
        • Greenwood M.
        Youth voices on prevention and intervention of youth substance abuse.
        Centre Excell Child Adolescents Spec needs. 2005; (Available at:) (Accessed August 15, 2014)
        • Ackard D.
        • Neumark-Sztainer D.
        • Story M.
        • Perry C.
        Parent-Child connectedness and behavioral and emotional health among adolescents.
        Am J Prev Med. 2006; 30: 59-66
        • Meyers R.
        • Miller W.
        • Smith J.
        • Tonigan J.
        A randomized trial of two methods for engaging treatment-refusing drug users through concerned significant others.
        J Consult Clin Psychol. 2002; 70: 1182-1185
        • Smokowski P.
        • Bacallao M.
        • Cotter K.
        • Evans C.
        The effects of positive and negative parenting practices on adolescent mental health outcomes in a multicultural sample of rural youth.
        Child Psychiatry Hum Dev. 2014; 46: 333-345
        • Hoagwood K.
        Family-based services in children's mental health: A research review and synthesis.
        J Child Psychol Psychiatry. 2005; 46: 690-713
        • Parent Action on Drugs
        Family-based approaches to building resiliency in children and youth.
        2012 (Available at:) (Accessed July 14, 2014)
        • Connell A.
        • Dishion T.
        • Yasui M.
        • Kavanagh K.
        An adaptive approach to family intervention: Linking engagement in family-centered intervention to reductions in adolescent problem behavior.
        J Consult Clin Psychol. 2007; 75: 568-579
        • Fosco G.
        • Frank L.
        • Stormshak E.
        • Dishon T.
        Opening the “black box”: Family check-up intervention effects on self-regulation that prevents growth in problem behavior and substance use.
        J Sch Psychol. 2013; 51: 455-468
        • Van Ryzin M.
        • Stormshak E.
        • Dishion T.
        Engaging parents in the family check-up in middle School: Longitudinal effects on family conflict and problem behavior through the high school transition.
        J Adolesc Health. 2012; 50: 627-633
        • Weist M.
        • Youngstrom E.
        • Stephan S.
        • et al.
        Challenges and ideas from a research program on high-quality, evidence-based practice in school mental health.
        J Clin Child Adolesc Psychol. 2013; 43: 244-255
      3. Steeves V. Young Canadians in a wired world. Phase III: Experts or amateurs? Gauging young Canadians' digital literacy skills: MediaSmarts. 2014. Available at: Accessed August 1, 2014.

        • Fergie G.
        • Hunt K.
        • Hilton S.
        What young people want from health-related online resources: A focus group study.
        J Youth Stud. 2013; 16: 579-596
        • Korda H.
        • Itani Z.
        Harnessing social media for health promotion and behavior change.
        Health Promotion Pract. 2011; 14: 15-23
        • Davies E.
        • Morriss R.
        • Glazebrook C.
        Computer-delivered and web-based interventions to improve depression, anxiety, and psychological well-being of university students: A systematic review and meta-analysis.
        J Med Internet Res. 2014; 16: e130
        • Boydell K.
        • Hodgins M.
        • Pignatiello A.
        • et al.
        Using technology to deliver mental health services to children and youth: A scoping review.
        J Can Acad Child Adolesc Psychiatry. 2014; 23: 87-99
        • Loucas C.
        • Pennent M.
        • Whittington C.
        • et al.
        G130 e-therapies for mental health problems in children and young people: A systematic review and focus group investigation.
        Arch Dis Child. 2014; 99: A58
        • Stephens-Reicher J.
        • Metcalf A.
        • Blanchard M.
        • et al.
        Reaching the hard-to-reach: How information communication technologies can reach young people at greater risk of mental health difficulties.
        Australas Psychiatry. 2011; 19: S58-S61
        • Ellis L.
        • Collin P.
        • Hurley P.
        • et al.
        Young men's attitudes and behaviour in relation to mental health and technology: Implications for the development of online mental health services.
        BMC Psychiatry. 2013; 13: 119
        • Makela K.
        • Paavola T.
        • Stenman M.
        Development of short message services application for patient-provider communication in clinical psychiatry.
        Telemed e-Health. 2010; 16: 827-829
        • Gulliver A.
        • Griffiths K.
        • Christensen H.
        • et al.
        Internet-based interventions to promote mental health help-seeking in elite athletes: An exploratory randomized controlled trial.
        J Med Internet Res. 2012; 14: e69
        • Norman C.
        • Skinner H.
        Engaging youth in e-health promotion: Lessons learned from a decade of teen net research.
        Adolesc Med State Art Rev. 2007; 18: 357-369
        • Rundle-Thiele S.
        • Russell-Bennett R.
        • Leo C.
        • Dietrich T.
        Moderating teen drinking. Combining social marketing and education.
        Health Educ. 2013; 113: 392-406
        • McGrath P.
        • Lingley-Pottie P.
        • Thurston C.
        • et al.
        Telephone-based mental health interventions for child disruptive behavior or anxiety disorders: Randomized trials and overall analysis.
        J Am Acad Child Adolesc Psychiatry. 2011; 50: 1162-1172
        • Norman C.
        • Yip A.
        eHealth promotion and social innovation with youth: Using social and visual media to engage diverse communities.
        Stud Health Technol Inform. 2012; 172: 54-70
        • Anderson J.
        • Lowen C.
        Connecting youth with mental health services: Systematic review.
        Can Fam Physician. 2010; 56: 778-784
        • Anderson J.
        • Lowen C.
        Developing a youth friendly family practice.
        Can Fam Physician. 2010; 56 (e283–5): 737-738
        • Ambresin A.
        • Bennett K.
        • Patton G.
        • et al.
        Assessment of youth-friendly health care: A systematic review of indicators drawn from young people's perspectives.
        J Adolesc Health. 2013; 52: 670-681
        • Kim H.
        • Tracy E.
        • Biegel D.
        • et al.
        The effects of organizational culture on mental health engagement of transition youth.
        J Behav Health Serv Res. 2015; 42: 466-485
        • Faulkner N.
        • McCambridge J.
        • Slym R.
        • Rollnick S.
        It ain't what you do, it's the way that you do it: A qualitative study of advice for young cannabis users.
        Drug Alcohol Rev. 2009; 28: 129-134
        • Murnaghan D.
        • Morrison W.
        • Laurence C.
        • Bell B.
        Investigating mental fitness and school connectedness in Prince Edward Island and New Brunswick, Canada.
        J Sch Health. 2014; 84: 444-450
        • Resnick M.
        • Bearman P.S.
        • Blum R.W.
        • et al.
        Protecting adolescents from harm. Findings from the national longitudinal study on adolescent health.
        JAMA. 1997; 278: 823-832
        • McNeely C.
        • Falci C.
        School connectedness and the transition into and out of health-risk behavior among adolescents: A comparison of social belonging and teacher support.
        J Sch Health. 2004; 74: 284-292
        • Bond L.
        • Butler H.
        • Thomas L.
        • et al.
        Social and school connectedness in early secondary school as predictors of late teenage substance use, mental health, and academic outcomes.
        J Adolesc Health. 2007; 40: 357.e9-357.e18
        • Fletcher A.
        • Bonell C.
        • Hargreaves J.
        School effects on young People's drug use: A systematic review of intervention and observational studies.
        J Adolesc Health. 2008; 42: 209-220
        • Husky M.
        • Kaplan A.
        • McGuire L.
        • et al.
        Identifying adolescents at risk through voluntary school-based mental health screening.
        J Adolesc. 2011; 34: 505-511
        • Stead M.
        • Gordon R.
        • Angus K.
        • McDermott L.
        A systematic review of social marketing effectiveness.
        Health Educ. 2007; 107: 126-191
        • Andreasen A.
        Social marketing: Its definition and domain.
        J Public Policy Marketing. 1994; 13: 108-114
        • Thompson E.
        • Heley F.
        • Oster-Aaland L.
        • et al.
        The impact of a student-driven social marketing campaign on college student alcohol-related beliefs and behaviors.
        Social Marketing Q. 2013; 19: 52-64
        • Kirkwood A.
        • Stamm B.
        A social marketing approach to challenging stigma.
        Prof Psychol Res Pr. 2006; 37: 472-476
        • Scheier L.
        • Grenard J.
        Influence of a nationwide social marketing campaign on adolescent drug use.
        J Health Commun. 2010; 15: 240-271
        • Longshore D.
        • Ghosh-Dastidar B.
        • Ellickson P.
        National youth anti-drug media campaign and school-based drug prevention: Evidence for a synergistic effect in ALERT Plus.
        Addict Behav. 2006; 31: 496-508