Developing the theoretical basis for a targeted familyinvolved intervention, to reduce co-occurring alcohol use and mental health problems in young people aged 12 to 17.

Abstract

Background: There is a high prevalence rate of co-occurring alcohol use and mental health problems in young people. This is associated with adverse outcomes and poses a substantial public health concern. Despite the key influence of family life, there is a lack of family interventions developed and evaluated specifically for young people with cooccurring alcohol use and mental health problems. Aim: This thesis addresses this gap by developing the theoretical basis for a targeted family intervention to reduce co-occurring alcohol use and mental health problems in young people aged 12 to 17 years. Method: Formative exploratory work was carried out by systematically reviewing the effectiveness of existing family interventions and carrying out qualitative interviews with young people and caregivers to explore their experiences of these co-occurring difficulties. Findings were then integrated to form the basis of initial intervention strategies. These were then further developed within co-design workshops with young people, caregivers and professionals to develop the theoretical basis for a prototype intervention. Results: Targeting family functioning is insufficient, with family interventions found to be ineffective. Rather, galvanising familial support alongside enhancing young people’s coping mechanisms emerged as key. This involves building their resources, including knowledge and skills. The relationship between alcohol use and mental health are embedded within, and interact with, young people’s social context. Consequently, a holistic approach should be taken within an intervention, targeting these interacting socio-ecological factors. Conclusion: This doctoral work contributes to the existing evidence base with a contextualised understanding of young people and caregivers needs to support young people with co-occurring alcohol use and mental health problems within the UK. It provides the theoretical basis for an intervention, building familial support and young people’s own coping mechanisms, tailored to how alcohol use and mental health problems specifically link for that young person.