Developing an animation-based mental health measure for children and young people.

Background: There is a need to increase the accessibility, inclusivity, and representation of mental health measures for young people, particularly for those who may struggle with traditional text-based formats due to literacy, language, or cognitive barriers. We aimed to develop an animation-based mental health measure for young people. Methods: This study involved a community-based participatory action research (CBPAR) process, including 10 four-hour in-person workshops with young co-researchers and two rounds of 90-min focus groups with different stakeholders. We also conducted think-aloud interviews with 31 young people to explore comprehension, engagement, and usability of the measure. Findings: The resulting tool, Animi, assesses seven symptoms of depression and anxiety through animated characters. Each scenario is depicted by an animated character (Animi) that indicates whether the symptom is present or absent. Users respond by selecting the animation that most closely matches their experience, using either a multiple-choice or Likert-scale format. In the think-aloud interviews, young people reported they generally understood the animations as intended and described the measure as engaging and easy to use. Feedback identified areas for improvement, like clarifying the instructions and further developing accessibility features (e.g., subtitles, customisation options). Participants also highlighted the tool’s potential relevance for younger children, neurodivergent youth, and those with additional needs. Conclusion: Animi represents a promising and innovative approach to mental health measurement that prioritises accessibility and co-production. Future research will revise the instrument based on feedback from the think-aloud interviews, evaluate its psychometric properties, and explore its use across clinical and educational settings. We hope this research can be used by others seeking to increase the accessibility, inclusivity, and representativeness of mental health measures for young people.