PLOS Mental Health ‘Young Voices’ Part 1: Speaking Through Content.

A key element of our mission at PLOS Mental Health is to ensure that we are not just providing a platform for young people, but that we are meaningfully engaging with their perspectives and knowledge in order to help steer change. Although there are many factors that determine a person’s mental health experiences, we know that age plays a huge role. Bringing different generations into the same space is not an opportunity to explore who is right and who is wrong, but an opportunity to identify what we can all learn from each other. In this limited ‘Young Voices’ blog series from PLOS Mental Health, we will be highlighting some of the ways in which we are working with young people and Early Career Researchers (ECRs) in order to ensure that they too play a role in driving progress. Over the next few months, we will be proudly highlighting the following:

1) Journal content: We will be running through articles that we have published that are authored by young people or addresses the needs of young people specifically.

2) Community Engagement: We will be reflecting on some of the work that the journal is doing to engage with young people across the globe. 

3) Spotlighting ECRs: We will be getting to know more about some of our authors and editors who represent young people in different communities and regions.

Young Voices: Speaking through journal content

Not every aspect of youth mental health is going to be dissimilar to mental health in older people. There are many overlapping factors and experiences. However, there are also enough differences to warrant different approaches to support…

Substance use among students

Substance use is certainly not an age-specific behavior. Anyone, of any age, gender, race, or any other sociodemographic identity, can experience an unhealthy relationship with substances. But the circumstances leading to substance misuse, and therefore the interventions that are needed, are going to be different, even if subtly, across generations. We therefore need to understand as much as we can about how substance use has an impact on young people and not assume that what applies to older generations, also applies to younger generations. 

In July of this year, we published a study led by University of Texas, which explored the impact of substance misuse on academic performance among over 700 young people between the ages of 8 and 20 years. The authors also simultaneously examined the impact that social anxiety had on functioning at school and this played a role in the impact that substance use had. The authors found that in youth without problematic substance use, having social anxiety was associated with similar levels of impairment in school functioning compared to youth with problematic substance use alone. Furthermore, having social anxiety appeared to not significantly worsen the impact of substance use on school performance. So whilst one may have assumed that social anxiety is a key contributor to substance misuse, this appeared to not be the case among the young people in this study, which has important implications for interventions and risk detection. 

Understanding how substance use may have an impact on young people is only half of the battle. Whilst in an ideal world, we would be able to tackle all potential causes of substance misuse, in reality, this is far from possible and many are affected by problematic substance use. In recent years, the use of electronic cigarettes have been used as a replacement for combustible tobacco products but we do not yet fully understand how these particular substances have an impact on mental health. When PLOS Mental Health first launched, we published a study from West Virginia University, which used data from the 2021–2023 National Youth Tobacco Survey to explore mental health outcomes among over 60,000 adolescents who used electronic cigarettes, combustible tobacco products, or both. The study highlighted a significant association between tobacco use and poor mental health among adolescents, with dual users appearing to have the highest odds of mental health struggles and all users, regardless of nature of use, having greater levels of psychological distress compared to non-users. This study shines a light on an important relationship between tobacco use and mental health in young people, however further work will be needed to differentiate between cause and consequence, which will directly impact any potential interventions or prevention approaches. 

Body confidence into adulthood

Individuals of all ages, genders and socioeconomic backgrounds can struggle with body confidence. Regardless of what a particular community or society dictates as ‘ideal’ many will struggle with comparing their body to how they think it should be. Being able to achieve a healthy relationship with one’s body starts in childhood and the impact of low body confidence often ramps up into young adulthood.  In 2025, we published a study from University of Toronto, which explored the association between muscle-building supplement use and muscle dysmorphia symptomatology among Canadian adolescents and young adults using data from the Canadian Study of Adolescent Health Behaviors (which included responses from 2,731 people). The study probed the impact of the use of six different supplements and found that the use of all of them was associated with a greater muscle dysmorphia symptomatology, highlighting the importance of exploring the impact of muscle supplements on mental health further. Again, more work is needed to differentiate between causation, correlation, and consequence, but the relationship appears to be a significant one that requires a greater understanding in order to protect younger generations. 

Understanding the online world

The online world is something that older people did not grow up with – some grew up prior to the internet becoming so accessible and dominant, some grew up at a time that it was just emerging and so connecting with people online was not commonplace. We also know that the online world provides us with mixed blessings. In some ways, it is a gift – helping people to connect easily with others and to equip themselves with knowledge (provided the source is reliable). In other ways, we know it is a curse. People are exposed to so many dangers and sources of false information. In a Systematic Review from Aga Khan University that PLOS Mental Health published at the end of 2024, the impact of cyberbullying – a phenomenon that only arrived with the online world – was explored. The authors specifically reviewed the impact of cyberbullying on university students with 32 studies involving over 29,000 people being included. The authors consequently call for a zero tolerance policy against cyberbullying in institutions of higher education given the severe yet avoidable mental health distress that cyberbullying causes. 

Even if a person’s experience online is seemingly innocuous, the increased screen time that feels like another avoidable aspect of the world at present will itself have an impact on mental health – whether direct or indirect. For instance, at the end of 2025, we published a study from Koirala Institute of Health Sciences, Nepal, which investigated the impact of screen time and sleep quality among 259 secondary school children. As expected, the authors found that young students who had higher levels of screen time (when used for entertainment purposes) also had poorer sleep quality and poorer mental health. Whilst the study does not necessarily provide concrete implications, in particular due to its cross-sectional design, it further reiterates the importance of carefully considering how we can support young people who are pressured to engage with the online world so that they can gain the benefits of having information at their fingertips without it also having a detrimental impact on their well-being. 

Support young people with neurodivergent conditions

Although we have come a long way in understanding neurodivergence – both the hurdles and gifts that it can present, we have a long way to go. Young people who are neurodivergent can struggle to form relationships, which has a long-lasting impact into their adulthood. Among the first papers that we published, a study from University of Gothenburg highlighted how important friendships and peer support are for young people who have a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD). The authors conducted in-depth interviews with young people with ADHD between the ages of 15 and 17 years and found that healthy friendships were especially important for people of this age whilst navigating their diagnosis and developing their sense of identity. The study participants described some of the hurdles that people with ADHD can face when it comes to maintaining friendships. For instance, they expressed struggles with impulsivity and the need for planning in order to function. This insight helps many, whether health professionals, friends, or guardians, to understand some of the hurdles faced by young people with ADHD when trying to maintain helpful friendships, and also helps them to cultivate a supportive environment that empowers all.

Involving young people in service evaluation

Using studies such as those mentioned above is necessary to ensure that we develop a better understanding of the needs of young people, which will help us to develop more effective interventions. But this is not where the input of young people should end. Once we do develop or implement interventions for young people, it is vital that young people are also the ones to help evaluate them. A recent study from University of Sterling, UK, does just that by conducting interviews with young people who had been referred to Child and Adolescent Mental Health Services for support with suicidality. The results indicate that services are falling short and urgently need to be revisited accordingly. The issues, according to the findings of this study go beyond resource limitations. The young participants described how they do not feel seen or heard and the model of care that is offered to them rarely meets their needs. The participants expressed a need for more flexible support and approaches that afforded them the time and space they need to explore the underlying and contextual issues contributing to their suicidal thoughts and behaviors. This study adds to growing evidence that we cannot continue to implement interventions without seeking input from the very people that the interventions are trying to help.

Providing a space for young authors

Understanding the needs of young people is not just about engaging with them as study participants. Whilst young people as participants is necessary and valuable, there is a limitation to how meaningful their engagement can be. They are not always able to shape the questions that are asked or the interpretations that are made. That is why it is also important to give young people their own voice and space to talk about what affects them the most. As a journal, we can do that very easily. For instance, we published an Opinion at the end of 2025, which was written by young authors across the globe on the dangers of disinformation online. In particular, the authors provided a response to claims that Tylenol use during pregnancy can result in autism, and they did so through the lens of young people with lived experience of mental health struggles and neurodivergence. As stated in the opening paragraph:

This claim [use of Tylenol during pregnancy causes Autism] embodies the scapegoat archetype, where society seeks someone to blame for what it doesn’t understand. Instead of embracing neurodiversity as a natural part of human variation, people direct their fears toward pregnant individuals and medical interventions. These claims reopen wounds for every neurodivergent person who’s ever been told that they shouldn’t exist

Disinformation spreads especially quickly in a digital world. The authors provide some important strategies by which people can combat the spread of disinformation and therefore stigma. Such strategies include the promotion of media literacy, collective ‘un-learning’, and centering lived experiences. When young people are being so heavily impacted by the world that they are growing up in, we must listen to their needs and to their calls for change. Older generations cannot guess on behalf of younger generations. We must all work together to drive progress and repair damage. Journals play a crucial role in this, should they choose to do so. 

We look forward to continuing this blog series over the next few months. Our dedication to meaningfully engaging with young people will continue. Not only do they bring an alternative perspective, but they are the future of mental health. Now is the time for them to shape where the field goes.