International Youth Mental Health Conference

Workshop: Stopping Young People from Falling Through the Cracks: Applying a Missing Middle Lens Across All Contexts.

At the 2022 International Youth Mental Health Conference in Copenhagen, InspireCorp’s founder, Jihad Bnimoussa, co-led a collaborative expert workshop that delved into the global challenge of the “Missing Middle”—the group of young people who are too unwell for primary services yet not ill enough for tertiary care, and who therefore fall through systemic gaps in mental health support.

This highly interactive session, co-facilitated with leading researchers and clinicians Jai Shah (McGill University), Jana Menssink (Orygen), and Ian Hickie (University of Sydney), as well as a panel of young people with lived experience of Mental Health, explored how to define and operationalize a missing middle lens across contexts, cultures, and systems. Grounded in lived experience perspectives and collaborative inquiry, participants reflected on critical questions:

1. Who exactly are the young people in the missing middle? Who are the invisible groups of young people with unmet needs?
2. How can systems and services be redesigned to meet their needs?
3. What does prevention and continuity of care look like in under-resourced settings?

Drawing on a Delphi study conducted in Australia by Jana Menssink, the team shared international findings on how systemic barriers—service inflexibility, inadequate duration and quality of care, and social disadvantage—compound to exclude these youth from effective support. The workshop then invited participants to co-create operational definitions and propose solution pathways adaptable to diverse cultural and service contexts.

“If we want to stop young people from falling through the cracks, we have to start by naming the cracks — and redesigning the system, not the person.”

Attendees worked in breakout groups to draft and test one-line definitions of the “Missing Middle,” considering both clinical and social determinants. The result was a spirited collective effort to move from theory to action, emphasizing that the solution requires cross-sectoral collaboration, flexibility, and youth partnership.

This workshop exemplified InspireCorp’s commitment to prevention-focused, systems-level mental health innovation, amplifying young voices and building bridges between research, policy, and practice worldwide.