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Background: Youth mental health is a major health concern in almost every country. Mental health accounts for about 13% of the global burden of disease in the 10-to-19-year age group. Still there are significant gaps between the mental health needs of young people and the quality and accessibility of available services. Collaboration between health and social service actors is a recognized way of reducing gaps in quality and access. Yet there is little scientific evidence on how these collaborations are applied, or on the challenges of cross-boundary collaboration in the youth mental health space. This study aims to explore how collaboration is understood and practiced by professionals working in the Swedish youth mental health system.

Methods: We conducted 42 interviews (November 2020 to March 2022) with health and social care professionalsand managers in the youth mental health system in Sweden. Interviews explored participants’ experience andunderstanding of the purpose, realization, and challenges of collaboration. Data were analysed under an emergentstudy design using reflexive thematic analysis.

Results: The analysis produced three themes. The first shows that collaboration is considered as essential andimportant, and that it serves diverse purposes and holds multiple meanings in relation to professionals’ roles andresponsibilities. The second addresses the different layers of collaboration, in relation to activities, relationships, andtarget levels, and the third captures the challenges and criticisms in collaborating across the youth mental healthlandscape, but also in growing possibilities for future development.

Conclusion: We conclude that collaboration serves multiple purposes and takes many shapes in the Swedish youth mental health system. Despite the many challenges, participants saw potential in further building collaboration. Interestingly our participants also raised concerns about too much collaboration. There was scepticism about collaboration directing attention away from young people to the professionals, thereby risking the trust and confidentiality of their young clients. Collaboration is not a panacea and will not compensate for an under-resourced youth mental health system.

Purpose: The aim of this study was to explore how health care providers at youth clinics (YCs) in Sweden engage with, focus on, and navigate across the mental health youth space, while upholding the core bedrock principle of "youth-centeredness".

Methods: Qualitative interviews were conducted with 21 health care professionals working in three YCs located in three different regions of Sweden. Data were analysed using reflexive thematic analysis informed by the work of Braun and Clarke.

Results: The three themes were: 1) "youth mission-at the core of the YCs" work and challenged by a stronger involvement in mental ill health'; 2) "YCs" unique and complementary role in the youth mental health system: a holistic perspective, team work, and a focus on normalization', and 3) "Caught between a rock and a hard place: to treat at a care level that is not optimal for the young users" needs or to refer within an unreliable system'.

Conclusion: This study reflects the individuality and key features of YCs, their widening roles within the mental health sphere, and the challenges faced in maintaining and expanding the characteristic "youth-centred" approach while expanding their work with mental health

Denna kunskapsöversikt har för avsikt att kartlägga befintlig kunskap omhur fritid och fritidsaktiviteter kan bidra med friskfaktorer för ungas psykiskahälsa. Översikten har ett tydligt ungdoms- och rättighetsperspektiv för attlyfta ungas egna upplevelser av fritid och om fritiden sker på lika villkor. 

This article analyses how youth subject positions of the ‘racialized other’ are produced, and how these positions interconnect with the concept of belonging to the rural community. We do this by analysing 15 group discussions with 63 young people living in rural areas in northern Sweden taking a discursive psychology approach, and focusing on how discourses produce certain subject positions of ‘the racialized other’. Drawing on the concepts of the politics of belonging and the ‘stranger’, we argue that discourses on belonging to the (rural) community create boundaries that exclude ‘other’ youth, as well as resistance and contestation. The subject positions that such discourses produce represent racialized youth in stereotypical ways and imply a promise of belonging for certain ‘others’ based on their fulfilment of particular norms. However, such a depoliticized promise of belonging that places the responsibility for becoming integrated on the ‘others’ was also challenged. Firstly, in relation to criticisms of the welfare system, and secondly, in relation to racism as an unwelcome threat in rural communities.

There is a lack of research on young trans people's everyday leisure. This article analyses how leisure, defined within a broad spatial context beyond sport and physical activity, is perceived and experienced by trans youth in relation to their mental health and wellbeing. We draw upon theoretical concepts of cisnormativity and spatiality to our analysis of sixteen interviews with young trans people (16-25 years old) in Sweden. Three themes emerged. The first refers to how both queer- and non-queer-specific leisure spaces connect people with similar (and different) experiences regarding queer and trans identities and shows how these identities can shift in importance. The second highlights how creative spaces (e.g., theatre, cosplay) can offer opportunities to carve out a leisured space to explore different gender identity/ies and expressions that are often crucial and life changing. The final theme illustrates how leisure is avoided, postponed, waited for, and reclaimed by trans youth. Excluding mechanisms such as transphobia, cisnormativity, and the lack of access to gender-confirming care can hinder young people's leisure participation. Our analysis illustrates the complex connections between leisure and mental health among young people with trans experiences. Leisure can be a source of discomfort and distress but also of belongingness and affirmation of one's identity. Finding and accessing strengthening leisure spaces demands emotional investment, engagement, and navigation.

Objective: There has been a lack of systematic and theoretically underpinned evaluations, internationally and in Sweden, of local multi-component initiatives delivered outside public employment services and formal education systems to young people who are not in employment, education or training (‘NEETs’). To bridge this knowledge gap, the objective of this study was to present findings from the theory gleaning phase of a realist evaluation aimed at assessing how Swedish community-based initiatives may work to (re)engage vulnerable ‘NEET’ young people in education or employment, under what conditions and why.

Results: Based on insights gleaned and synthesised from various sources, three candidate programme theories were elicited drawing attention to the importance of community-based initiatives in Sweden adopting a ‘caring approach’, a ‘capability approach’ and a ‘collaborative approach’ to (re)engage ‘NEET’ young people in education or employment. While limited to the initial phase of theory gleaning, the study provides valuable insights into the potential functioning of (re)engagement initiatives directed towards vulnerable ‘NEETs’ in addition to increasing the transparency of a highly iterative research project.

The relationship with place has been recognized as a significant dimension of rural youth leisure, both through the discursive constructions of place, but also as affective and embodied dimensions. This study captures these processes by applying the concept of place-making as a set of recurrent discursive processes, analyzing how girls in Northern Sweden engage in place-making alongside, beyond, and in contrast to dominant discourses on leisure, rurality and wellbeing. The study draws on data from photo-elicited focus groups with girls from two sports organizations. The discursive psychology analysis resulted in three interpretative repertoires. The first repertoire describes the sharp contrast between discourses of the ‘rural dull’ and how stressful the participants constructed their own places of leisure. The second illustrates the gendered discourses around what is considered to be productive and respectable leisure. The third shows how the participants are made responsible for the survival of their leisure. Through place-making, the participants shape places of leisure, affecting both themselves and their rural community. They engage in, conform to, and challenge place-making within discourses of responsibility and precariousness, creating space for their own initiatives, which are simultaneously shaped by the material conditions under which these practices take place.

Background: The reasons why young people are increasingly suffering frommental health problems, and the opportunities to turn this development aroundare globally debated. Stressors such as education, relationships, futuretrajectories of housing and employment all constitute important factors affectingyoung people’s mental health, leading to stress and achievement pressureespecially among girls and young women. The need to reduce individualization ofyoung people’s health problems, and instead encourage spaces for collectivesupport, action, and change has been called for in previous studies. Leisureparticipation has the potential to be such a collective space where young peopletogether can respond to stressors experienced in their daily life. Apart fromstudies on individual behavior change, leisure participation has been anoverlooked arena within public health and within research on young people’smental health and stress in particular. The complexity of youth leisure, especiallyin relation to gender and spatiality, calls for further investigation, exploring thesocial places of leisure that young people create themselves.

Aim: The aim of this thesis is to understand how places of youth leisure areperceived and collectively constructed as social factors of youth mental health,and to analyze the strategies developed within these places to handle and respondto the everyday stressors experienced by young people.

Conceptual framework: The analysis builds on four conceptual sections: (i)The stress process model explores stressors as situated in a wider social context,where social factors shape both the stressors that affect mental health, theresources to handle those stressors as well as the mental health outcomes. (ii) Thesocial practice theory highlights how social practices within places of leisure canbe identified as resources in relation to responses to stressors. (iii) The thirdsection of the framework takes on the relationship between stress, leisure, andpost-feminist perspectives on gender and successful femininity. The final section(iv) outlines leisure as a spatial (re)construction; emphasizing rural space andplace in relation to gender, stress, and precarity.

Methods: This thesis builds on two sub-studies, generating three papers. SubstudyI is based on data from individual interviews with eight adult leaders fromdifferent leisure organizations (paper 1), and sub-study II (paper 2 and 3) is basedon an ethnographic multiple-case study with 16 girls (age 14-21) from two leisureorganizations. The setting for both sub-studies is rural northern Sweden. Thematerial from the ethnographic study was collected through participatoryobservations and focus group discussions using photo elicitation. For the first andsecond paper, thematic analysis was used as an analytical strategy, while a4discursive psychology approach (interpretative repertoires) was used for the thirdand final paper.

Results: The first part of the results concerns how girls and adult leadersperceived and experienced daily stressors within the context of youth leisure.Such stressors were represented by the high demands girls face in relation toachievement pressure and time management, school, gender norms andexpectations, but also in relation to their leisure engagement. The second partexplores how the girls and adult leaders developed and negotiated strategies torespond to stressors, within the context of leisure. Responses were constructedthrough daily social practices within the context of leisure e.g. through sharingexperiences of stress with each other, based on a sense of belonging and trust. Inthe final part, rurality holds a central position in how place and space werediscursively constructed by the participants, in relation to leisure, gender, andstressors. Here, one of the main results in the third part was the complexity ofhow the participants’ constructed leisure as a place of wellbeing. In order to buildand maintain a space that enabled responses to stressors, the girls constantlyneeded to invest time, engagement, achievements, and emotions. In addition,places of leisure needed to be constructed in certain ways to be perceived asbeneficial and ‘positive’, for example as a place marked by respectability and selfdevelopment.This illustrates the precarity of youth leisure where educational andlabor-market opportunities have changed how young people now understand freetime as something that should be ‘productive and meaningful’. The metaphor of‘carving out spaces’ speaks for the effort the girls had to make in order to createand sustain such places; not only in relation to a successful femininity, but alsoin relation to the rural community and the survival of rural places of leisure.

Conclusions: This study contributes to a better understanding of youth leisure,and how to build sustainable and inclusive places of leisure from a gender andrural perspective. Places of leisure and civic engagement are perceived asimportant social factors of youth mental health, and needs to be taken intoconsiderations when young people’s stress and mental health are discussed.Places of youth leisure are spaces where responses to everyday stressors can becollectively developed. At the same time, youth leisure is also precarious,demanding, and contributes to the reproduction of gendered discourses onrespectability and responsibility, both in relation to a successful femininity, butalso in making it work for the rural collective.

Bakgrund: Orsakerna till att unga rapporterar allt sämre psykisk hälsa och vilka åtgärder som kan vända detta diskuteras på både global och nationell nivå. I Sverige visar undersökningar att fler unga rapporterar att de känner sig stressade, i synnerhet tjejer. Tjejer rapporterar också högre grad av ångest och fler psykosomatiska besvär relaterade till stress och prestationskrav än killar. Stressfaktorer relaterade till skola, framtida möjligheter på bostads – och arbetsmarknaden och sociala relationer utgör viktiga faktorer som påverkar ungdomars psykiska hälsa, vilka kan resultera i stress och prestationskrav. Jag ser ett behov av att minska den rådande individualiseringen av psykisk ohälsa bland unga, och istället främja miljöer och mötesplatser för kollektivt stöd och möjlighet till förändring. Ungdomars fritidsarenor kan vara en sådan kollektiv plats där unga tillsammans kan hantera de stressfaktorer som de upplever i sin vardag och utveckla kollektiva strategier för att möta dessa. Utöver studier om fritid kopplat till ungas beteendeförändringar på individnivå har ungdomars fritid varit en förbisedd arena inom folkhälsan och i relation till ungdomars psykiska hälsa och stress. Ungas fritid är en komplex arena som i större utsträckning behöver undersökas i relation till psykisk hälsa bland unga, särskilt i förhållande till genus och ungdomars egna platsskapande inom ramen för sin fritid. Syftet med studien är att fördjupa kunskapen om hur platser för ungas fritid kan utgöra en social faktor för ungdomars psykiska hälsa och vilka erfarenheter och strategier som ungdomar och vuxna ledare utvecklar inom fritidsverksamheter för att hantera och svara mot de dagliga stressfaktorer som unga människor upplever.

Metod: Ungas och vuxna ledares tankar och erfarenheter om behov och strategier för att hantera stress i vardagen är viktiga kunskapskällor. Avhandlingen bygger på två delstudier. Delstudie I är baserad på material från åtta intervjuer med vuxna ledare inom fritidsverksamhet för ungdomar (artikel 1). Delstudie II (artikel 2 och 3) bygger på en etnografisk fallstudie med 16 tjejer (ålder 14-21) från två idrottsföreningar i två olika landsbygdskommuner i norra Sverige. För denna delstudie samlade jag in material genom att göra deltagande observationer och fokusgrupper med hjälp av foto-elicitering. I den första och andra artikeln genomfördes analysen med hjälp av tematisk analys. Den tredje artikeln bygger på diskursanalys (discursive psychology) med särskilt fokus på olikatolkningsrepertoarer.

Resultat: De vuxna ledarnas och tjejernas erfarenheter visar hur höga krav i förhållande till skolprestationer, tidsplanering och könade normer utgjorde stressfaktorer som påverkade ungas psykiska hälsa, men även krav och 6 förväntningar kopplade till ungas fritidsengagemang. Den andra delen av studien visar hur tjejerna och ledarna utvecklade och förhandlade fram strategier för att kunna hantera de dagliga stressfaktorer som unga upplever. Dessa strategier skapades genom dagliga rutiner och sociala praktiker inom fritidsverksamheterna, till exempel genom att dela erfarenheter av stress och ansvar med varandra. Gemenskap och tillit var centralt i dessa processer. Denna gemenskap beskrevs dock också som sårbar eftersom den kunde vara kopplad till tjejernas prestationer på fritiden, exempelvis i form idrottsresultat. Den tredje delen av studien tar sin utgångspunkt i den diskursiva konstruktionen av plats och rum i rurala områden, särskilt i relation till fritid, kön, stress och psykisk hälsa. Ett av de viktigaste resultaten var komplexiteten i tjejernas platsskapande och konstruktioner av fritid som en plats för välbefinnande. Paradoxalt nog utgjorde tjejernas fritidsengagemang både en viktig social plats för att dela individuella erfarenheter av psykisk ohälsa och stress, men var samtidigt också en källa till ökad stress och prestationskrav. Platsskapandet krävde mycket av tjejerna i form av tid, resurser, prestationer, ansvar, engagemang och känslor, vilket också gjorde att de kände sig ännu mer stressade och pressade. För att deras fritid skulle upplevas som positiv behövde den även konstrueras utifrån diskurser om respektabilitet och personlig utveckling. Detta illustrerar hur det prekära i ungas utbildning- och arbetsmarknad också återfinns i hur unga förstår och upplever sin fritid. Fritiden är nu något som bör vara produktivt och självutvecklande. Tjejerna var alltså konstant involverade i ett platsskapande, inte bara i relation till könade normer kring framgångsrik femininitet utan också i relation till ungdomars fritid på landsbygden och föreningslivets överlevnad.

Slutsatser och implikationer: Denna studie bidrar till en bättre förståelse för ungdomars fritid och hur man bygger hållbara och inkluderande fritidsplatser ur ett genus- och landsbygdsperspektiv. Platser för fritid och delaktighet i civilsamhället uppfattas som viktiga sociala faktorer för ungdomars psykiska hälsa. Föreningar och andra platser för ungas fritid kan utgöra platser där kollektiva strategier för att hantera dagliga stressfaktorer kan utvecklas. Samtidigt är ungas fritid och föreningsengagemang krävande och bidrar till att reproducera könade normer kring respektabilitet och ansvarstagande. Fritid utgör en prekär arena där tjejer återigen ska ta ansvar, vara framgångsrika och duktiga, både i förhållande till en ambitiös femininitet men också i relation till landsbygden och i solidaritet med det rurala samhället och föreningslivet.

The aim of this qualitative study was 2-fold: to explore, in the context of young people’s civic engagement in Sweden, (i) how adult leaders perceive social factors of youth mental health and (ii) how adult leaders handle such social factors within their organizations. Interviews were conducted with leaders engaged in various civic organizations that provide leisure activities for young people. Using thematic analysis, three themes were constructed. Firstly, the social landscape of youth mental health described how adult leaders perceived the social factors of youth mental health within the context of civic engagement. Secondly, the organizational structures developed by adult leaders illustrated the organizing forms that leaders created for young people’s civic engagement. Thirdly, adult leaders’ strategies for addressing the social factors of youth mental health reflected the strategies developed to handle e.g. stress and achievement pressure. The adult leaders recognized the importance of their organizations and their huge potential to have a positive impact on youth mental health. However, some participants also saw limitations in terms of their own resources and competence. They found themselves having to address the complex issue of social factors of youth mental health regardless of whether they felt competent and prepared to do this or not. Our findings contribute to the existing knowledge on youth and community development via the role of adult leaders in promoting young people’s mental health by highlighting the organizational structures and leadership strategies developed by them.

While sexual consent has been a hot topic during recent years in the Swedish context, there is a lack of empirical studies on the issue. The aims of this study were to analyse how adults in Sweden experience and make sense of sexual (non)consent in sexual encounters, and to contribute to a conceptual discussion of sexual consent, especially in relation to a Foucauldian understanding of power and subjectivity.

The analysis is based on 31 interviews with adults living in Sweden. Participants describe consenting to sex due to being exposed to interpersonal forms of power, ranging from violence and clear violations of consent to nagging and being subjected to pressure from others. But they also feel pressure and give consent to sex based on self-regulation and disciplinary forms of power, connected to normative ideals about "the good relationship", monogamy and heterosexuality, men and women, and age. Our Foucauldian analytical lens allowed us to explore and challenge understandings of autonomous, rational subjects who communicate consent on the basis of authentic feelings. It also provided an analytical strategy for analysing and understanding the complex power relations that matter in the negotiation of sexual consent.