“When you’re a young person, your identity is so malleable… It’s very easy for a label to become enmeshed with your sense of identity”. Agency and mental health are intrinsically related. Most mental health problems appear before the age of 25, at a time when people are still developing their sense of agency. The sense of agency is that feeling that you can shape your own life through actions and decisions. When young people seek help from mental health professionals, they put their trust in these professionals. Practitioners need to be mindful of how their words may support or obstruct a young person’s sense of agency. In this Lecture, Rose McCabe, Lisa Bortolotti and Michele Lim, will analyse a series of recorded encounters between young people and mental healthcare practitioners in emergency services. They will analyse in which ways the communication validates the young person’s experience, whether it legitimized their choice to seek help, if it refrained from objectifying the young person, if it affirmed their capacity to contribute to positive change and if it involved them in the decision-making process. This is the eighth lecture in the London Lecture Series 2023/24, which this year is on the subject of Madness and Mental Health. Watch the whole series here: https://www.youtube.com/playlist?list=PLqK-cZS_wviD4i_zvM3cXuRZNgy_FWk6a About the speakers Rose McCabe is Professor of Clinical Communication at City, University of London and co-Director of the Centre for Mental Health Research at City (https://www.city.ac.uk/about/people/academics/rose- mccabe). Her research focuses on understanding patient experience, professional-patient communication, the therapeutic relationship and developing interventions to improve communication, therapeutic relationships and outcomes of mental healthcare. Central to this work is involving people with lived experience in designing and evaluating new approaches to care. Key concepts of interest include agency, coercion, epistemic injustice, trust and engagement. She works across a range of issues (psychosis, self-harm, depression, dementia) and treatment settings (inpatient and community mental health care, emergency departments, primary care). She also works with community organisations and schools to improve mental health and wellbeing. Lisa Bortolotti is Professor of Philosophy at the University of Birmingham specialising in the philosophy of the cognitive sciences, with a focus on belief, rationality, mental health, and agency. She is the editor in chief of the journal Philosophical Psychology and her most recent book is Why Delusions Matter (Bloomsbury 2023), accessible to a wide audience. Lisa is involved in several collaborative projects exploring youth mental health and is creating and gathering teaching resources on misinformation and conspiracy theories at The Philosophy Garden (http://www.thephilosophygarden.com). Michele Lim is a trainee clinical psychologist currently undertaking a Doctorate in Clinical Psychology. Prior to this, she completed an MSc in Psychological Research (University of Oxford) and a BSc in Psychology with Education (UCL). In her clinical work, Michele has worked with children, young people and adults with various emotional and psychological difficulties including trauma, anxiety, depression and eating disorders. As a researcher, she has spoken and presented at international conferences, and holds publications in journals including Neuron and Nature Human Behaviour. Alongside her clinical and academic work, she is passionate about widening public engagement with the field of psychology. She has collaborated with various organisations via co- production on multiple research projects — ranging from improving young people’s sense of agency in mental healthcare to feasibility trials for psychological interventions. Lecture - 00:00 Q&A – 49:18