The Need
Each year, the global youth mental health crisis grows more apparent and devastating. Worldwide, mental health and substance use disorders are the leading cause of disability in children and youth, and suicide is a leading cause of death among people aged 10–24. Fourteen percent of youth ages 10–19 experience mental health issues, which can have lasting effects on functioning and well-being into adulthood. In addition to the profound costs to wellbeing and quality of life, the economic cost is also staggering: up to $16 trillion between 2010 and 2030.
Yet critical gaps persist in our ability to address this crisis. Eighty-five percent of children worldwide live in low- and middle-income countries where youth mental health concerns are often overlooked. The resulting lack of quality data prevents further understanding and improved resources. And even in high-income countries, youth face significant barriers to accessing mental health treatment. Reports point to shortages of mental health professionals, long waitlists, and systems that many young people cannot or won't engage with.
The scope of youth mental health concerns and the limited resources currently available demand that we direct collective efforts toward developing innovative, age-appropriate, and culturally sustaining solutions.
Arts and Culture as Community-Based Assets
One such solution involves engagement in the arts: tapping into and building upon existing local resources and cultural practices in order to bolster youth mental health.
Research shows that social determinants of health — the community and contextual factors that shape our ability to be healthy — have greater influence on health than clinical care alone. These include safety, access to education and employment, resources and opportunities, and physical and psychological wellbeing.
In recent years, as we learn more about the health benefits of arts, culture, and nature, access to these resources is also often considered a social determinant of health. Studies indicate that arts-based experiences can generate positive outcomes for youth populations, improving quality of life and promoting connection, reducing anxiety and depression, and generating an enhanced sense of community, self-expression, and cultural identity — which are protective factors against mental ill health.
What Makes Arts-Based Approaches Promising
Several factors make arts- and culture-based strategies particularly valuable for supporting youth mental health globally:
- Accessibility and scalability Unlike clinical interventions requiring specialized mental health professionals, of which there are shortages in many regions, arts-based approaches can build on existing community resources and cultural practices. Every community has arts and cultural assets; often, these can be integrated into efforts to support youth wellbeing.
- Cultural responsiveness Arts-based practices can honor and amplify existing cultural traditions rather than imposing external frameworks. This is particularly vital for communities that have been underserved by conventional mental health systems.
- Low-barrier engagement Young people can benefit from creative activities without needing to identify as having mental health challenges or disclose personal struggles. This removes barriers that prevent many youth from seeking help, while also offering preventive, health-boosting benefits to youth who aren't experiencing mental health concerns.
- Developmental appropriateness Creative expression aligns with how young people naturally explore identity, process experiences, and connect with peers.
- Community and "upstream" change Arts-based strategies can move beyond individual benefits to raise mental health awareness, address stigma, generate new social connections, and foster dialogue around difficult issues. Creative arts have also been shown to inform and shift policies and resources; they can even improve youth mental health data by expanding the ways in which researchers, healthcare providers, educators, and others learn about youth and their experiences.
Emerging evidence suggests that the strongest outcomes arise out of co-created programs (i.e., youth co-leading the work from ideation through evaluation), trauma-informed approaches, culturally-attuned opportunities, and iterative adaptation of programs based on evaluation and "what works."
Of course, it's worth noting what these important approaches are not. They're not a replacement for clinical care, and they don't require facilitators to become therapists. They're also not magic bullets; as I've shared in work about "arts on prescription," the beneficial outcomes associated with arts engagement are not inevitable results of it.
What This Means for OST/CYD Leaders
So what does this mean for professionals in extended learning and creative youth development?
It means you're not "adjacent" to the youth mental health conversation; you're positioned within a promising landscape for community-based support. You likely know this well; mental health benefits already inform and motivate many practitioners' work. From here, the research supports further recognition, exploration, and support.
Arts-based OST programs have long promoted protective factors that matter for mental health: belonging, identity formation, peer connection, emotional expression, meaning-making, and skill-building. In addition, because OST contexts can be lower-barrier than clinical systems, they can reach youth who might never access formal services. They can also help connect young people with the clinical and community resources they might need: becoming a hub for additional services. In short, the opportunity for greater growth and impact is clear.
To make the most of this opportunity, youth-serving organizations can focus on four high-impact moves:
1. Move from "Serving Youth" to Co-Creating with Youth
A key reason arts-based strategies are able to offer mental health benefits is that they're so often culturally relevant and developmentally aligned. That said, relevance isn't something adults can decide on youths' behalf. As many CYD programs know, the strongest youth programs are built with young people; not for them.
This means engaging youth as leaders rather than mere participants, collaborating with them to:
- shape program goals (including what "health" or "wellbeing" mean to them)
- design activities and spaces
- decide what outcomes matter
- co-design evaluation
- interpret evaluation results
- help evolve the program over time
This intentional co-leadership is both ethical and practical; co-creation increases engagement, sustainability, and real-world impact.
2. Be Explicit About What You're Offering, and What You're Not
Arts-based strategies can support youth mental health, but they're not a substitute for clinical care. Many young people need access to licensed mental health providers, and arts programs shouldn't be framed as a replacement.
That said, OST programs don't need to apologize for being "non-clinical." Preventive and community-rooted supports are essential precisely because they're part of building lives and communities in which humans connect and thrive. In addition, since clinical care can be inaccessible, stigmatized, overburdened, or culturally misaligned, these spaces are essential supports and collaborators in whole-person care.
Your lane isn't direct "treatment;" it's protective factors, upstream support, and connections to further care. And that lane matters.
A helpful framing for many programs is: "We're strengthening the conditions that support mental health — connection, agency, identity, belonging, coping, meaning, and knowledge about health — and we're doing it through culturally grounded creative practice."
3. Track Outcomes That Matter (Without Over-Medicalizing Your Work)
Evaluation is critical for increasing understanding and integration of OST programs within the broader ecosystem of youth mental health supports. Common evaluation pitfalls include measuring only what's easy to quantify (e.g., attendance, satisfaction), or using clinical outcomes that may not fit the context (e.g., symptom change). Instead, programs should focus on outcomes they influence that also align with mental health and wellbeing, such as:
- social connection and belonging
- confidence/self-concept
- emotional literacy and coping
- reduced stigma
- hope and future orientation
- sense of meaning and agency
When starting out, partnering with evaluators or research teams can support you in identifying and articulating your likely current outcomes, recognizing outcomes you may not have considered, and determining apt evaluation methods. Notably, there are many creative and participatory evaluation approaches that can reflect arts programs' ethos and goals.
Remember that even simple, modest approaches count. The aim isn't to turn youth programs into research labs; it's to bolster transparency and credibility, increase accountability for the impacts we seek to have, and build evidence about our work — which can help translate program impacts for funders, partners, and many others.
4. Build Partnerships That Strengthen the Ecosystem
One of the most powerful moves OST and CYD leaders can make — along with their communities and funders — is to avoid trying to hold the weight of youth mental health in isolation. The path forward isn't forged with a single opportunity, but with what I've called a "fabric of community care." Each program is linked to many others, creating referral pathways and crisis protocols — and ensuring that youth who need additional support can find it.
In short, arts-based youth programs provide the most effective support when they're woven into broader systems through partnerships with:
- schools and district staff
- health systems and pediatric practices
- social service organizations
- libraries, parks departments, cultural institutions
- public health departments
- faith-based organizations
- other anchor institutions and cultural organizations
This is where "creative youth development" becomes not only a program model, but a strategy for community health infrastructure: connecting youth to multiple supports and improving access through trusted relationships and culturally relevant engagement.
This is where "creative youth development" becomes not only a program model, but a strategy for community health infrastructure.