As mental health research increasingly aims to generate societal impact, researchers operate at the intersection of innovation and ethical responsibility. Drawing on experiences from the cocreated NEON Young Norway Study on youth recovery narratives, this viewpoint identifies four ethical tensions that arise from the existing governance frameworks in youth digital mental health research: (1) balancing safeguarding against harm with youth participation, (2) protecting privacy without undermining authentic storytelling, (3) governing unpredictable outcomes of cocreated research, and (4) meeting ethical and legal standards while ensuring youth-friendly communication. These tensions highlight limitations in mental health research that adopts participatory and digital approaches, as this often struggles to accommodate iterative designs, narrative data, and cross-sector collaboration. We argue that responsible youth mental health research requires ethics to be understood as a dynamic, participatory practice that supports safe and equitable inclusion, rather than having a focus on risk prevention. Ethical governance, therefore, needs to evolve toward proportionate, context-sensitive approaches that can enable innovation while protecting young people’s rights, agency, and voices.
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Radically different