UC San Diego

To address the youth mental health crisis, youth must be engaged in improvement efforts. However, there is limited research on how youth come to participate in this work and what conditions enable and constrain their efforts. In this yearlong case study, I examined a high school student-led mental health advocacy committee situated in a large urban U.S. district. Interviews (N=31), documents, and field notes were analyzed using a five-cycle inductive and deductive coding process, guided by social cognitive theory and the critical youth empowerment framework.The first research question asked what shapes students’ pathways into mental health advocacy. Findings reveal seven elements that form the preliminary Proximity-Based Model of Youth Mental Health Advocacy Development: a prosocial orientation, experience related to mental health concerns, empathic concern, disillusionment and frustration with inadequate systems, moral conviction and urgency, self-efficacy, and opportunity.The second research question examined student advocates’ perceptions of school-based mental health supports. Advocates recognized care among school staff while identifying gaps across tiers of support. They described universal initiatives as often surface-level and disconnected from student needs, and they identified various barriers to help-seeking, including overstretched counselors, stigma, and limited awareness of resources or how to navigate them.The third research question investigated the conditions that enable and constrain student mental health advocacy within a school district. Strong peer relationships, youth-centered leadership, and strategic flexibility characterized the committee’s work, and six external supporter roles were essential for converting advocates’ goals into systems change. Yet findings reveal what happens when youth voice is valued by a district but not formally embedded in decision-making, highlighting the need for structures that position young people as partners in mental health solution-setting. By centering student advocates’ perspectives, this dissertation contributes to scholarship on youth development, mental health promotion, and education systems change.