Teenagers in England are navigating school mental health support under consent and confidentiality rules that may be pushing them away from asking for help. This project investigates whether policies requiring parental permission or communication create barriers for young adolescents, who are often more comfortable turning to peers than adults during this developmental stage. The research maps current school policies, examines how they affect students’ sense of agency and their decisions to seek help, and explores the attitudes of young people, parents, and school staff. If successful, the project will produce co-designed digital resources—short videos—that strengthen adolescents’ ability to make informed choices about their own mental health care. These resources could shift how schools handle consent and confidentiality, making support more accessible without undermining ethical safeguards. The work also aims to influence policy alignment across schools and health services, potentially changing a system that quietly governs millions of young people’s access to help during a critical period.
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Research questions: Do consent and confidentiality policies and practices influence mental health help-seeking in secondary schools? What are the challenges and attitudes of young people, parents/carers and school professionals? How can we address challenges and promote ethical decision-making through co-designed, accessible resources? Background: The early adolescent years are crucial for addressing mental health challenges, but many adolescents face difficulties in seeking help. Interventions within school settings, crucial platforms for reaching out, often have stringent parental consent or communication requirements, which potentially create barriers to help-seeking during a period when adolescents are strongly peer-oriented. Aims and objectives: This project investigates adolescent mental health help-seeking, through aspects of consent and confidentiality, in secondary schools in England. Working closely with adolescents, parents/carers and health/education professionals the project maps school policies, challenges and attitudes, and co-creates accessible digital guidance to address needs, assessing its acceptability nationally among the three stakeholder groups. Methods and timelines: This is an interdisciplinary project combining policy mapping, large-scale statistical modelling, qualitative methods, co-design, and digital surveying. The project engages an advisory group of adolescents, parents/careers and professionals, youth co-researchers, audiovisual partners, digital influencers and policymakers. Four work packages are linked conceptually and temporally over 5 years: WP1. Policy mapping and mechanisms (years 1-2): We will map current consent and confidentiality policies and practices in secondary schools in England (N=185 schools). Using large-scale survey data (OxWell) we will investigate connections among these policies, self-reported agency and help-seeking choices in a sample of 26,453 adolescents. WP2 Challenges and attitudes (years 2-3): Interviews will be conducted with parents (n=20) and school professionals relevant to student wellbeing (n=20), and focus groups will be held with a diverse, inclusive sample of secondary school adolescents (aged 11-16 years; n=50), to understand challenges, needs and attitudes surrounding adolescent consent and confidentiality in the context of school mental health support. WP3. Co-design (years 3-4): With a team of public contributors (n=6), videographers and digital influencers, we will co-design and user-test accessible digital guidance (short videos) addressing challenges and training needs of adolescents, school professionals and parents/careers in relation to consent and confidentiality. These will be engaging resources designed to strengthen adolescent agency, improve literacy and support ethical decision-making. WP4. Acceptability testing and dissemination (years 4-5): Acceptability and usefulness of the digital guidance will be assessed from an England-wide sample of adolescents, parents/carers, and school and community professionals (N=1,100) via an online survey. We will then disseminate the digital guidance widely via a co-produced campaign. Dissemination: Social media influencers with audiences of adolescents, parents/careers and school/health professionals will lead public engagement, through stories, polls and live-streaming sessions. Workshops will support policy alignment and impact. Findings will also be shared with via school assemblies, academic papers, conferences and a micro-documentary. Impact: This project is centred on genuine partnership among different stakeholders to address complex ethical concerns and major barriers to help-seeking. Through in-depth collaborative research and innovation, the project will enhance adolescents' ability to access support in schools, protecting their mental health during a critical stage of human development.
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