Conceptualising and operationalising 'patient and public involvement' (PPI) and 'responsible research and innovation' (RRI) in youth mental health research: a scoping review.

BACKGROUND

Meaningful youth involvement has gained attention in mental health research, especially in collaborative approaches such as Patient and Public Involvement (PPI) and Responsible Research and Innovation (RRI). While both aim to support inclusive research, there is limited clarity on how they are conceptualised and used in projects together with young people. This scoping review examines how PPI and RRI approaches are defined and implemented in mental health research involving young people as collaborators rather than solely as research participants.

METHODS

The included studies were empirical, peer-reviewed articles published in English that involved young people (aged 10-25 years) as collaborators in shaping mental health-related research, interventions, or products beyond their contributions as study participants, and used PPI, RRI, or related collaborative approaches. Reference to terms such as "participatory research" alone was not treated as evidence of involvement; eligibility required young people to have a reported collaborative role. Eight bibliographic databases (Scopus, Web of Science, MEDLINE, PsycINFO, CINAHL, ASSIA, PsycARTICLES, and IBSS) were searched on 21 February 2024. Following the JBI methodology and PRISMA-ScR guidelines, records were screened. Data were then charted from the included papers to capture study characteristics, definitions and applications of PPI and RRI, and the modes and reported forms or roles of youth involvement.

RESULTS

Thirty-two papers were included, most were published from 2022 onwards, originated from high-income English-speaking countries, and defined and applied PPI more frequently than RRI. However, both approaches lacked operational clarity. Key terms such as co-production, co-design, and participatory research were widely but inconsistently used, often without clear definitions or sufficient information to establish whether young people were involved as partners rather than solely as research participants. Explicit discussions related to power or intersectional barriers to youth involvement were rare. Some studies reported involving large numbers of young people, including up to 339 youths, raising questions about feasibility and depth of involvement.

CONCLUSIONS

This review highlights promising trends in extending youth involvement in mental health research, but also reveals important conceptual and ethical limitations. The findings emphasise the need for clearer definitions, explicit distinctions between meaningful youth involvement and being researched as a study's participant, more inclusive research practices, and stronger commitments to equity. Expanding future research is crucial for advancing responsible and collaborative approaches in youth mental health.