Understanding the interplay between young people’s mental health, sexual health and substance use experiences and their access to relevant (in)formal sources of help, support and information

Abstract

Mental health conditions typically emerge during adolescence, with young people bearing a disproportionate burden of mental ill-health compared to other age groups. This period is also marked by increased experimentation with substances such as drugs and alcohol, and the initiation of sexual and romantic experiences. The co-occurrence of poor mental health, substance use and adverse sexual and reproductive health (SRH) outcomes is well documented in young populations. However, despite the high prevalence of co- or multimorbidity, research has largely overlooked why and how these health domains are interconnected, particularly from young people’s perspectives.
This thesis sought to better understand the interplay between young people’s mental health, substance use and SRH experiences. First, a systematic review (n=27) was conducted to investigate associations between mental health and substance-use or SRH among young people in UK-based literature. Notably, a lack of research at the intersection of mental and sexual health was identified. Building on this, a qualitative interview study (n=12), using thematic and framework analyses, explored how young people perceive the links between mental and sexual health, what ‘good’ sexual health means to them and how mental and sexual health services could be improved to better meet their needs. Young people’s help, support and information-seeking behaviours, and the barriers and facilitators to accessing related services, were also explored. Lastly, a cross-sectional online survey (n=210) was used to examine associations between mental health status, loneliness and help-seeking intentions using correlational analyses, independent samples t-tests, ordinal logistic regression, and multiple linear regression. Consultations with healthcare professionals and collaborations with young people informed design, recruitment and data analysis processes in the empirical studies.
Findings indicate that young people’s mental health, substance use and SRH are deeply interconnected. Availability of high-quality, non-stigmatising health information was 3 foundational for recognising problems, seeking help and accessing appropriate care. Social relationships played a critical role in shaping how young people accessed health information and services. However, significant personal, social, and systemic barriers to mental and sexual health support persist, and many young people prefer self-reliance or informal sources of support. These findings highlight the need for integrated, youth-centred approaches to service delivery that are inclusive and responsive to young people’s lived experiences. Future clinical, research, and policy efforts should prioritise the complex factors shaping young people’s health and help-seeking practices.

Date of Award	Dec 2025
Original language	English
Awarding Institution	University of Brighton
Supervisor	Carrie Llewellyn (Supervisor), Clio Berry (Supervisor), Daniel Richardson (Supervisor) & Natalie Edelman (Supervisor)