Occupational experiences and their importance for young peoples’ mental health

Abstract

Background

Young peoples’ mental health challenges have increased in recent years to become an urgent public health issue. Research is required to gain a better understanding of how occupations influence young peoples’ everyday lives and support their mental health.

Aim

How do young people experience engaging in various occupations in their daily lives, and how do these experiences shape their mental health?

Method

Semi-structured interviews were conducted with 12 Norwegian young people aged 13–16 years. Verbatim transcriptions of the interviews were analysed using thematic analysis.

Results

Four core themes emerged: ‘doing’ for balance and stability; self-discovery through doing; intentional doing to recharge and feel free; and reflecting on the consequences of doing social media.

Conclusions

Young peoples’ occupational experiences shape their mental health in several ways: they serve as coping strategies, as a means to experience joy and accomplishment, and as a source of routines and opportunities for relaxation. We suggest that health-promoting initiatives for young people would strongly benefit from the inclusion of an occupational perspective.

Keywords:

• Engagement
• mental health promotion
• salutogenesis
• thematic analysis

Introduction

Mental health is an essential aspect of well-being, particularly in the formative years of adolescence, when young people develop physical, emotional, cognitive, and social foundations [1]. From national surveys, we know that in general young people in Norway are satisfied with their lives. However, mental health challenges [2,3] and levels of stress related to schoolwork, especially among girls, have remained persistently high over the past few years. The time young people spend on social media has also increased, while their participation in organised leisure activities has declined [3]. Such patterns imply important changes in young peoples’ everyday lives, suggesting a need to think afresh about how best to promote their mental health.

There has also been a growing focus on young peoples’ mental health in public and political circles. In 2023, the Norwegian government announced proposals to improve young people’s mental health, including initiatives to tackle the increased stress of schoolwork, combat any negative impact on mental health associated with use of social media, and promote the development of local-level leisure and cultural facilities [4].

Understanding mental health and health promotion

The understanding of mental health adopted by this paper is broadly in line with that of the World Health Organisation (WHO): that mental health involves more than simply the absence of mental disorders. Mental health is considered a state of well-being that allows an individual to cope with normal stresses in life [5]. This understanding aligns with Antonovsky’s [6] salutogenic theory, framed around the question ‘What creates health?’ Antonovsky conceptualised health as a continuum, from dis-ease (H-) to ease (H+), along which people constantly move back and forth. How a person copes with internal and external stress is also central [6]. Antonovsky’s [6] point is that health should be understood as an ongoing process rather than an outcome. On this basis, it can be argued that professionals involved in health promotion need to understand what helps people move towards the healthy end of the continuum and what makes them better able to cope with life’s many stresses [6,7].

In occupational therapy, participation in meaningful occupations is considered significant for human beings’ health, development, and change across their lifespans [8]. In this paper, the term occupation includes all the things people do in their lives, from work and behaviour to rest, and how this influence health. Occupation is seen to entail dynamic interactions between individuals and their environments [8]. There is an alignment here with salutogenic theory [6] in the sense that engaging in occupations has the potential to move people along the health continuum. Related to this, Wilcock and Hocking [8] emphasise the significance of ‘occupational balance’, which is achieved when an individual experiences satisfaction and joy in various activities without feeling overwhelmed.

The research gap

The existing literature provides plentiful evidence that preventative as well as health-promoting initiatives, at different levels and in different contexts, have positive impacts on young people [1,9–11]. Studies have mostly explored the effect of regulated interventions or programmes in specific contexts, such as schools [12] or healthcare [13], with the school context seen as offering an especially promising arena for promoting good mental health among young people [12,14–16]. Cahill and colleagues [17] evaluated the impact of interventions involving different occupations in order to shed light on the connection between children and young peoples’ engagement and positive mental health outcomes. They concluded that engagement in different occupations, along with the meanings young people attach to them, are central to their mental health and well-being [17].

Research on initiatives to support young peoples’ mental health has increased over recent years, shedding light on the efficacy of different strategies and contexts [18]. However, Rojas and colleagues [13] argue that a deeper understanding is needed of how interventions affect young peoples’ daily lives and how they can be organised to align with their needs and preferences. In similar vein, Bjerre and colleagues [9] highlight the need to examine how interventions to promote good mental health can be made more context-sensitive and/or person-centred.

We argue for a qualitative research approach to this set of issues. In our study of young peoples’ experiences of what promotes good mental health in various contexts and settings, we sought to gain insights by inviting young people themselves to explore the issues. Focusing on young people in middle schools, we addressed the following question: How do young people experience engaging in various occupations in their daily lives, and how do these experiences shape their mental health?

Material and methods

Our study forms part of an ongoing project exploring mental health promotion among Norwegian young people. The research group consisted of occupational and physical therapists with Master and PhD degrees, all females. A qualitative design drawing on Braun and Clarke’s [19] thematic analysis was used o explore the importance of occupations for young peoples’ mental health. The first author conducted 12 semi-structured interviews with young people between January and June 2021.

Sample

Our participants were middle school students with varying mental health experiences. Information about the study was posted openly on social media, where it was shared about 100 times. In order to contact young people who had experienced greater mental health challenges, we also contacted health professionals working in primary healthcare in eastern Norway and informed them about the study. In all cases, parents contacted the first author on behalf of the participants to schedule the interviews.

In total, 12 young people aged 13–16 years (four boys and eight girls) from both rural and urban areas of Norway participated in the study. All participants were unknown to the interviewer. Prior to interviews, the first author did not know whether participants had been in contact with health professionals. During the interviews, five participants spoke openly about their contact with health professionals regarding their mental health.

Ethical considerations

The Norwegian Agency for Shared Services in Education and Research (Sikt) (reference number 879123) and the Regional Committee for Medical and Health Research Ethics (REK) (project number 173007) approved the study. We gave the participants written and oral information about the study, and they and their parents jointly signed consent forms before interviews were conducted.

Conducting interviews

A semi-structured interview guide, covering themes such as life, social relationships with peers and family, and understandings of mental health, was developed and piloted prior to conducting the interviews. Questions included: ‘What contributes to your well-being on a daily basis?’ and ‘What are your thoughts on being young today?’

In the context of the ongoing COVID-19 pandemic, interviews were conducted via video chat on Teams® or Zoom. During interviews, participants were alone, often in their bedrooms. Interviews lasted 45–65 min and were audio-recorded and subsequently transcribed verbatim in Norwegian.

Data analysis

We used Braun and Clarke’s [19] six-step thematic analysis method to analyse the interview data. This involved (1) familiarising ourselves with the data, (2) generating initial codes, (3) searching for themes, (4) reviewing the themes, (5) defining and naming the themes, and (6) producing the report.

Nvivo [20] proved to be a suitable coding tool for the first three stages; it facilitated sorting and moving between different levels of data and made it easy to revisit the broader context of the coded segments when necessary. This part of the analysis was inductive in the sense that no theoretical framework underpinned the coding process; the aim was to ensure a bottom-up empirical approach that acknowledged participants’ experiences. The coding was mostly semantic in the sense that coded segments were assigned descriptive labels based on words and phrases used by the participants [19]. After coding all the transcribed interviews and reviewing the codes, the first author sorted and organised the codes that were relevant to the research question. All the authors then reviewed and discussed the themes and further organised and reorganised them into different thematic groups.

As our analysis progressed, we noticed that participants spoke frequently about the importance of occupations in their everyday lives. To further interpret the meanings they attached to occupations, we included theoretical perspectives around Antonovsky’s concept of Salutogenesis [6], and also the concept of ‘doing’ as described by Wilcock and Hocking [8] in the later stages of analysis. On this basis, we were able to gain greater insights into how occupational experiences shaped participants’ mental health. This entailed identifying a more implicit thematisation that allowed for the development of themes that were not immediately apparent in the raw data [19]. The occupational dimension of doing, described by Wilcock and Hocking [8], helped us interpret participants’ experiences of engaging in different occupations. In these final stages of analysis, we worked with flowcharts and mind maps outside of Nvivo [20], as this made it possible to visualise and structure clusters of codes and potential themes.

Results

Four core themes emerged from our analysis: (1) ‘doing’ for balance and stability; (2) self-discovery through doing; (3) intentional doing to recharge and feel free; and (4) reflecting on the consequences of doing social media.

Regardless of their individual experience of mental health challenges, all our participants agreed that occupations were important for how they felt about their everyday life. They talked about experiences intertwined with various occupational pursuits across different contexts, making distinctions between occupations and the circumstances they perceived as rewarding and challenging. They elaborated on their engagement in creative pursuits, sports, social life, social media, school work and TV watching, describing how these occupations impacted their everyday lives and their sense of purpose, accomplishment, and joy. Our four themes are elaborated below, each supported by relevant quotations from interviews.

‘Doing’ for balance and stability

Reflecting on their various occupations during and after school, participants often referred to an ordinary day as a ‘good day’. Balance and stability were important, and occupations provided structure and routines. Participants also noted that gaining expertise in different occupations affected how they felt about their everyday lives. Paul, for example, explained how his performance influenced his school day and after-school training:

A good day is just an ordinary day. Um, when I’ve been to school and had decent classes, you know, not having too difficult classes (…) Having a good day during or after training, or even not training, also makes a significant difference. (…) If I perform poorly during training, it’s not very enjoyable, and it doesn’t contribute to having a good day. If I don’t attend training, I don’t really notice any impact, but if I do attend training and perform well, then it’s definitely a good day.

Participants appreciated days without significant challenges or what many of them explicitly referred to as ‘stress’. To avoid stress, participants sought control over their schoolwork, training schedules, and other daily routines. Lack of control triggered discomfort and negative emotions, such as irritation and mood swings. Ingrid had found a way to handle this by organising and prioritising her tasks:

Um, first, it’s like I’m overwhelmed with school; there’s so much to do, and where should I start—should I do this or should I do that, what’s most important and all that. First, I try to create a small plan of priorities, what needs to be done, and what can wait a bit; that is important. Having a little plan and knowing what to work on first and what could maybe wait or be done tomorrow, and, um, [helps me] sort things out because often when there’s stress, things can get out of control, and there’s a lot that needs to happen, and I’m not quite sure how to manage it all.

When reflecting on the ways in which the ongoing COVID-19 pandemic had affected their occupations, most participants emphasised the importance of control and predictability so as to avoid feeling anxious and stressed. Some had developed new routines, added new occupations or modified previous ones, and found this to have a positive influence on their everyday lives.

Tuva spoke of how she had isolated herself in her room at the beginning of the pandemic and how this had affected her mental health. She eventually consulted a mental health professional, who helped her see how she could adapt to ‘the new normal’:

It was probably because the whole situation was so new, and you didn’t know how long it would last, so you just thought, ‘It won’t hurt to be here (in my room) for a week or so’. My eating habits changed a bit, and I quickly became irritable. I wasn’t sleeping as well. (…) I’d always heard that routines and such are important, but I never understood how crucial they are or how much can be fixed by using them.

The importance of having a routine would prove to be a recurring theme. It became clear that routine helped participants maintain a balance and feel good about their everyday lives.

Self-discovery through doing

Participants described how immersing themselves in different occupations led them to better understand themselves. By engaging in occupations, they gained insight into what brought them joy and meaning (as well as the opposite). While some described this more explicitly than others, all agreed that occupations offered them a means to both explore and express their emotions. For example, Ida found that painting could change her mood and feelings, helping her to express her emotions and feel calmer:

I usually paint based on how I feel. If I’m feeling really good, I can paint something very beautiful, but if I’m feeling really bad and having a not-so-great day, then I might paint something very sad. It depends on how I’m feeling. (…) Painting makes me calmer, and I feel as if I can express myself on a canvas. There are so many things you can paint, and it’s completely voluntary.

Helene described a similar experience where she, too, was able to express her emotions:

I’ve also painted and drawn, and at my grandparents’ Christmas workshop, I painted all the time. This year, I painted a picture with light or bright colours, and my grandma said, ‘Oh, that’s beautiful. We need to frame it. You’ve painted so much with dark colours, now you’ve changed. We need to frame this and give it to your mom’. And I just said, ‘Yeah …’ So it’s something that even my grandparents noticed. What hasn’t always been easy to talk about, I’ve used drawing and writing [to express].

Ida and Helene’s occupational experiences helped them explore, articulate and better understand their feelings. For them, painting was a way to express their emotions on a sheet of paper, enhancing both their self-awareness and their ability to communicate with those around them.

Many participants described how their engagement in social media or in organised activities such as sport and the performing arts, helped them connect with young people with similar interests. This discovery of communities of like-minded young people helped them become better acquainted with what brought them joy and fulfilment. Andreas described the impact of joining a theatre company and doing some acting:

‘It actually makes me happy, first and foremost. I find it fun and enjoyable, something that brings me joy. But it’s also, in a way, that I feel somewhat more fulfilled. Now I have expressed something, and I feel a bit more productive’.

Intentional doing to recharge and feel free

Participants highlighted the importance of physical, creative, and/or social occupations, which they said helped them relax and think about something else in situations of ‘stress’. All spoke of the many things they had to remember, do, and decide on, stating that this ‘stress’ could become overwhelming. Some of them described deliberately engaging in different occupations to temper their emotions, especially when life was challenging or stressful. Kristoffer explained it thus: ‘I think it is crucial to just disappear [into occupations] sometimes, um, because, you know, this is the world we live in, so it is nice to get away now and then’.

Others shared similar experiences. For Andreas, the concentration involved in playing the violin helped him forget challenging emotions and thoughts:

There aren’t many ways to escape my own thoughts; they’re going to come, regardless, at some point. But, well, the best way is probably to find something to focus on. Playing the violin is a very, very good way to escape from them, although it depends on the piece you’re playing. Playing a piece I know by heart and can play all the way through is probably the best way for me to get away from [my thoughts], at least for a few minutes.

Both Kristoffer and Andreas consciously engaged in satisfying occupations when facing stress and challenges. Elsewhere in their interviews, they mentioned that meaningful occupations generated positive emotions, such as joy. Helene, too, had developed strategies to cope with stress. In the following extract, she explained what she did when she had a great deal on her mind:

Getting away, being alone, drawing or writing, listening to music—I think that means a lot to me. I haven’t always been the easiest person to talk with, so I’ve done quite a bit of writing. (…) So it’s like those little things, just sitting by yourself and listening to music, singing, writing, and drawing. That’s what I think; that’s what freedom is to me. (…) I think these activities free my mind. If I have a lot on my mind, it sort of clears my head a bit and makes room for something else—something nicer—to enter my mind than what I was thinking about before.

Other participants highlighted the importance of relaxation as a way to clear their minds. They found occupations that allowed them to relax and recharge: for example, playing video games, listening to music, watching television, and knitting. All the young people saw engaging in meaningful occupations as a means to forget time and space and ‘just be’.

Reflecting on the consequences of doing social media

Regarding their engagement with social media, participants spoke with ambivalence and mixed emotions. The girls, in particular, expressed concern about body image issues and pressures relating to their appearance. It became clear that engagement with social media could result in stress as well as pleasure and joy. Anne explained it thus:

Stuff like Instagram, where you share pictures (…) I feel like it can lead to body pressure because people are supposed to look perfect all the time on social media. So, on that side, it’s not good, but you can still stay in touch through social media, so it’s kind of like, I don’t know, there are both good and bad sides to social media in a way, especially for young people. (…) People often get so caught up in social media, and like, ‘Oh, it has to be like this and that’, and people get easily distracted. Of course, you’re allowed to be on social media and look at what you find interesting, but I think it can lead to many different things, both positive and negative.

In a similar vein, Tuva highlighted the importance of knowing how to set limits to the content you are exposed to. Noting the importance of understanding how content can influence you, she stressed the need to learn how to handle it:

But not everything about social media is negative; it’s just that you have to figure out what you should look at. For example, if a person gives you really low self-esteem, you can choose not to include that person in your feed, and instead find someone who can motivate you. You have to decide what you want to see, and who you want to talk to. Stuff like that [is important].

As Anne and Tuvas’s observations underline, participants judged it vital to reflect on how to navigate social media. All participants used social media as a platform to connect with old and new friends, explore their interests, and discover kindred individual and communities. As Kristoffer explained: ‘It’s much easier to find people who are, uh, people I like, people who share common interests and such. It’s not like ‘here are the 20 people in your class, find someone to be friends with,’ it’s more like ‘here are half a billion people from around the globe.’’

However, some participants also said that being active on social media made them feel inadequate. While at times this could feel overwhelming, there was no option of not being active on social media. Some of them had, therefore, reflected on their levels of engagement on different social media platforms or developed strategies to handle it by being mindful of their engagement and the time spent on different platforms. Many participants described this as a conscious choice—something they had carefully reflected on. Maria, for example, explained how she had finally decided to stop posting pictures and updates:

‘I think initially, when I started using social media, I wanted to have that perfect, you know, portrait of my life and show that I was having fun and all that. But I found it very exhausting and irritating, so I stopped doing it very quickly’.

As this excerpt shows, the discrepancy between a seemingly perfect facade and the realities of adolescent life ‘behind the scenes’ can be hard to handle. Maria’s solution was to stop posting, which she found helpful: it made her feel better about herself, because she was less caught up in how she looked, both to herself and others.

Discussion

The aim of our study was to explore how young people experience engaging in various occupations in their daily lives, and how these experiences shape their mental health. Our findings primarily revolved around the concept of doing, as proposed by Wilcock and Hocking [8], as a means to discover how the participants’ occupational experiences intersected with their daily lives, and consequently their mental health. Participants’ diverse occupations, ranging from everyday tasks such as schoolwork to leisure activities and managing social media, underscored the complex nature of young peoples’ engagement. Furthermore, our participants described these occupations as both sources of stress and strategies for alleviating it. The most prominent finding was that occupations, which could be both challenging and rewarding, moved participants back and forth along the health continuum. Participants engaged in their occupations, consciously or unconsciously, to promote their mental health. In the following sections, we first discuss the thematic findings in the context of our theoretical framework. We then address their implications for health-promotion practice and research.

Doing, occupational balance and the health continuum

Participants recognised that daily routines provided structure to their lives; they considered days without significant obstacles to be ‘good days’. However, when faced with challenges or stress, some participants reorganised their occupations, and this enabled them to regain a sense of control and reduce discomfort and stress. This can be understood as a way to restore occupational balance, with participants adapting both the amount and variety of their occupations.

To our knowledge, occupational balance and stress have not specifically been researched in relation to young people. However, research involving other segments of the population suggest that occupational imbalance can be a predictor of stress-related disorders [21,22]. Encouraging young people to recognise the significance of maintaining occupational balance, and giving them the tools to do so, thus emerges as a way of promoting mental health.

The occupations participants engaged in also appeared to influence their sense of purpose, accomplishment, and joy. The young people spoke of how participating in creative occupations, such as painting or acting, heightened their emotional awareness, promoting self-discovery and self-expression. Exploring meaningful occupations seemed to contribute to the development of the personal resources that are crucial for coping with life challenges. These findings support [8] the argument that occupations can provide people with insight into their values and interests, fostering a clearer comprehension of their identities.

Noting the connections between occupational value, perceived meaning and subjective health, other researchers have recommended that occupational value be taken into consideration when developing interventions [23]. This line of argument corresponds with our other thematic findings, which show how young people intentionally engage in occupations that promote relaxation and a sense of freedom. Our participants said that their occupations helped them cope with challenging periods and everyday stress, allowing them to forget time and space. These occupations enabled them to better understand and express themselves, and our participants intentionally used them to cope with challenges in their daily lives. This moved them along the health continuum.

Some participants spoke of how creative occupations such as painting, acting, and writing helped them explore their emotions and feel better. While this finding aligns with previous studies, it is worth noting that prior research has tended to focus on creative occupations as organised interventions during the treatment of mental health conditions [17,24]. In contrast, the young people participating in our study pursued creative activities on their own initiative and without regard for specific outcomes. Nevertheless, it is conceivable that the same mechanisms work to promote mental health.

Our findings indicate that young people’s engagement with social media evokes mixed emotions. In some cases, exposure to certain content on social media could make participants feel inadequate. But social media use could also generate enthusiasm, inspire interest and help connect with others. Hjetland and colleagues [25] found that social media use among young people positively affected their sense of belonging and social support, while also having more negative results (such as heightened levels of stress). These findings, alongside those of other previous studies, suggest the need for more research on the impact of social media use on young people’s mental health [26–28]. While Steinbekk and colleagues [26] argue that social media use among young people is unrelated to symptoms of depression and anxiety, other scholars have found that social media can have a negative influence, particularly on body image [27]. While social media activity is not a tangible occupation, it is multifaceted and highly significant in young peoples’ everyday lives. This underlines the importance of assessing it in terms of its effects on various aspects of mental health [28].

Neither our findings nor those of previous research make it possible to state definitively whether social media use positively or negatively affects mental health. Nevertheless, a key finding of our study is young people’s readiness to reflect on the adverse consequences of their exposure to various types of social media content. Our participants demonstrated an awareness of their ability to manage a variety of content and understand its impact. They seemed to grasp how social media use could evoke mixed feelings and reactions, and acted accordingly. In line with Antonovsky’s [6] health continuum, young peoples’ awareness of, and ability to reflect on, emotional consequences can be understood as contributing to the promotion of their mental health.

Perspectives on mental health promotion research and practice

Our findings illuminate how engaging in meaningful occupations in various contexts – ranging from school and leisure time to social media - acquire significance in terms of everyday life and mental health. These findings indicate that health promotion initiatives for young people would benefit by incorporating a broader understanding of the influence and importance of occupations.

The Ottawa Charter for Health Promotion [29] states that ‘health promotion is the process of enabling people to increase control over, and to improve, their health’. We view this definition as offering a positive perspective on health, one that aligns with a salutogenic orientation. The quotation can also be interpreted as including an occupational perspective as we understand the term in this paper [8].

Research on initiatives to support young peoples’ mental health has increased over the last few years, providing insights into what works and in which contexts [18]. Nevertheless, little research has focused on the positive factors that promote health, regarded by some as more in line with the overall aims of health promotion [1]. Research on mental health has traditionally emphasised the prevention of illness and disease rather than the promotion of good mental health, quality of life, and overall well-being. Mental health has tended to be positioned alongside physical illness and disease [30], with the emphasis placed on developing and evaluating initiatives related to risk factors and disease prevention [1,30].

As previously argued in this paper, gaining more nuanced insights into young peoples’ occupational experiences can generate important new knowledge and enrich the content of health-promotion initiatives. That said, it is important to note that the specific occupational influences discussed in this paper may not be applicable to all young people. The aim of our study was to illuminate how various occupations can affect young peoples’ daily lives and how certain occupations can be experienced as challenging but also as positive coping strategies. We therefore cannot safely predict that, simply by minimising risk factors, all young people will move to the positive end of the health continuum. Professionals involved in health promotion require knowledge of both risk factors and factors that promote health. We would argue that the occupational experiences presented in this paper provide insights into both categories. Our study confirms the inseparable connection between occupations and mental health [8], shedding light on the ways in which different occupations influence how young people feel about their everyday lives.

As our results show, young people experience good mental health in a variety of different contexts. The notion that health is created outside the health/medical sector, emphasised by the Ottawa Charter [29], is widely acknowledged in both official documents [4,31] and research [1,32]. Although our findings do not specify which contexts might be best suited to the introduction of health-promotion initiatives, we know from previous research that school offers a particularly promising arena [12,14–16]. That said, more research is needed, as it is not clear which aspects of such initiatives impact young people the most. Other scholars have called for more research on the contexts of young peoples’ everyday lives [1]. We recommend that young people themselves be involved in the process of developing initiatives.

Strengths and limitations

A strength of this study is the heterogeneity of our sample: young people of both sexes drawn from different backgrounds, both urban and rural. A further strength, given the need to ensure that health-promoting initiatives reach all young people, is the fact that our participants had differing experiences of mental health challenges.

The fact that the Covid-19 pandemic was ongoing at the time of data collection may have influenced the themes brought up by both interviewer and participants. As a result of lockdowns, participants had been studying from home and leading restricted lives for extensive periods, and this had curtailed their physical as well as social activities. It is therefore conceivable that the pandemic might have led the participants to reflect on their everyday lives differently: they may have become more aware of what was important to them.

The fact that interviews were conducted online, rather than face to face, can be seen as a possible limitation. The researcher may have missed valuable nuances, including non-verbal cues, as a result of on-screen communication. However, the extent to which conducting interviews online impacts data collection remains unclear [33], and it should be noted that our participants did not appear uncomfortable or insecure during interviews.

Conclusion and clinical implications

Our findings shed light on how young peoples’ occupational experiences contribute to, and shape, their mental health. Young people engage in activities and occupations to feel better and to experience joy and accomplishment. In addition to functioning as a coping strategy, occupations also provide routines and opportunities for relaxation.

We recognise that health promotion is complex, and that there are implications for health promotion practice and research in general that we have not addressed in this paper. For example, occupation is far from being the only factor in people’s lives that contributes to their mental health. Nevertheless, we argue that an occupational perspective should form part of health promotion work, with a focus on the ways in which occupations can help move young people along the health continuum.

Our findings, along with those of previous research, suggest that occupational therapists engaged in health promotion, for example, in schools or primary health care, may have a key role to play here. By sharing their knowledge of the benefits of occupations for mental health, they can help foster collaboration across the range of contexts and arenas in which young people spend their time.

Acknowledgements

The authors would like to thank all the participants who took part in the study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The study was funded by a PhD-grant from the Oslo metropolitan University.