For Surgo Health, understanding youth mental health and well-being is not a one-time research exercise. The work keeps changing because young people’s lives keep changing, from the pressures they face and the relationships they build to the role technology plays in all of it.
Surgo Health is a Public Benefit Corporation working to close some of the biggest gaps in health equity, using data science and applied AI to understand who is most affected, where they are, and why. The Youth Mental Health Tracker reflects that mission applied specifically to youth as it is a nationally representative, equity focused surveillance system built to make mental health and wellbeing for advocates, researchers, educators, policymakers, and all individuals working to help youth thrive.
“What makes this partnership work is a shared commitment to getting youth voices heard safely, in a way that is both effective and empowering for the young people involved. Our research depends entirely on youth experiences and narratives, and partnering with In Tandem gives us access to thoughtful young people who are willing to share those experiences in a way that can genuinely benefit them and the field.”- Shums Alikhan, Senior Manager, Surgo Health
That is why Surgo Health has continued building the Youth Mental Health Tracker (YMHT) with the support of In Tandem Youth Partners. Now in its third year, the project is updated annually and shaped by evolving research priorities around young people’s health and well-being.
The collaboration began with a Youth Advisory Board model. Over time, it grew to include flexible, iterative user testing sessions including a series of interactive, incremental feedback activities that allowed Surgo Health to bring young people into the work as specific research questions and product needs emerged.
As the desired impact shifted from ongoing advisory, to specific, incremental, iterative product feedback, so did the structure of our engagement today. Instead of waiting for a single formal research milestone, the team could learn, adjust, and test again, keeping youth perspectives close to the decisions being made.
“Sustaining this partnership matters because our work is not a one time snapshot. We are trying to understand youth mental health and well-being longitudinally, as a continual pulse on what matters to young people right now. That means we need a research agenda that youth can shape directly, whether that is confirming an issue we have already identified, pushing back on one, or raising something new entirely through focus groups, async surveys, or in person sessions. A sustained partnership is what lets their experiences, not just our assumptions, drive where the research goes next.”- Christina Mehranbod, Senior Research Scientist, Surgo Health
Derin is an AI conversational interviewer delivered through a web browser. It asks open-ended questions and follows up based on what a participant says, creating a more conversational experience than a traditional survey. Surgo Health plans to utilize Derin with partner organizations that need an easy way to understand topics affecting teen mental health and well-being. Their promise is significant: a research format that can capture more descriptive, open-ended youth perspectives at scale.
But before expanding its use, Surgo Health needed to understand the experience from a teen’s point of view. Did the tone feel age-appropriate? Did follow-up questions feel responsive or scripted? Was the conversation natural, safe, and worth a young person’s time?
The goal was to evaluate Derin’s tone, pacing, question design, follow-up behavior, and overall interaction quality."We needed to understand how comfortable youth would actually feel talking to Derin before we deployed it nationally…Without testing it first, we risked youth disengaging or abandoning surveys altogether, which would have undermined the entire point: getting richer insight to inform interventions and policy that actually help youth mental health," explains Christina Mehranbod.
In Tandem engaged Youth Partners in facilitated testing sessions focused on real YMHT research topics, including the relationship between online and offline social spaces and contrasting experiences of financial stress and optimism.
“I feel like we would have been missing so many different types of voices. They [Youth Partners] are very engaged and they’re critical, which helps ensure we are capturing nuance and adding context to our research.” - Christina Mehranbod, Senior Research Scientist, Surgo Health
Youth Partners completed a Derin conversation, then joined a facilitated debrief. The discussion moved beyond whether they liked the tool. It examined what made the interaction feel natural or unnatural, which questions felt relevant, where Derin repeated itself, and whether the experience reached the context behind a young person’s answer.
For sensitive topics, the testing design gave participants options: they could answer from their own experience or use a peer-framed perspective. Active safeguards remained in place, and transcripts were reviewed before being released for analysis.
Surgo Health and In Tandem brought distinct responsibilities to the work. Surgo Health owned the research and product decisions. In Tandem created the conditions for young people to participate safely, reliably, and candidly.
|
Surgo Health Owned |
In Tandem Owned |
|---|---|
|
|
That division of responsibilities made rapid iteration possible. Surgo Health could focus on the conversation design, platform behavior, and meaning of the feedback, while In Tandem managed the operational work required to engage the right young people and protect the integrity of the process.
“Working with Surgo brought together complementary areas of expertise. Surgo Health's experience with youth-centered research and iterative product testing was balanced with our expertise creating the infrastructure and safety protocols needed to meaningfully support young people throughout the R&D cycle. Together we were able to recruit, test, learn and adapt ultimately helping Surgo launch a new product on a tight development timeline.”- Vanessa Zuidema, Director of Customer Success, In Tandem
Surgo Health refined prompts, wording, pacing, and follow-up behavior as feedback emerged. Small adjustments led to noticeably better engagement across rounds, demonstrating how quickly interaction quality can improve when youth feedback is close to the build process.
What they were able to achieve was youth feedback inside the iteration loop.
“The insight that stuck with us most was that youth are conditionally open to AI on sensitive topics…That reshaped how we think about consent and framing at a national scale. Trust was not going to come from the topic we asked about. It was going to come from the details of the interaction itself.” - Shums Alikhan, Senior Manager, Surgo Health
Youth testing helped Surgo Health move from broad assumptions about an AI interviewer to concrete product decisions. The team could see that trust would not be created through content alone. It would be built through the details of the interaction: how long Derin spoke, how closely it followed a response, how it framed sensitive questions, and how clearly it communicated safety and privacy.
The feedback informed refinements to prompt wording, response length, pacing, follow-up behavior, sensitive-topic framing, and the safeguards surrounding the experience. Just as importantly, the testing clarified what young people would need in order to see the tool as useful rather than intrusive.
The result was not simply a better interview flow, but also a stronger development process; one where specific product improvement could happen alongside greater attention to candor, privacy, and care.
“(This process) definitely did push our engineers and our product team… it pushed the launch, but we were proud of it when it went out because as we were more confident it would work for youth and for our partners who are launching this tool.”- Christina Mehranbod, Senior Research Scientist
The Derin work builds on two years of collaboration with In Tandem around the Youth Mental Health Tracker. Surgo Health now doesn’t have the need to rebuild a youth engagement process each time a new question emerges, and youth input does not have to be limited to a single advisory meeting or final-stage review.
With In Tandem’s recruitment, consent, communication, logistics, and demographic targeting infrastructure in place, Surgo Health can engage young people in the form the work requires, from recurring advisory conversations to focused rounds of product testing.
“Working with In Tandem on this iterative testing process has been genuinely valuable. From the start, we trusted that they were protecting the young people involved, including reviewing every transcript before we saw it, so we knew we were not collecting anything that could put a participant at risk. We used what we learned in each session to improve the product, then tested it again with some of the same youth and some new ones. That cycle is what gives us confidence in the results we get from Derin now, and it shows up in something concrete: more youth completing the full survey. Without that partnership, we would not have built that trust or that data quality this quickly.”- Shums Alikhan, Senior Manager, Surgo Health
To learn more about Surgo Health and their tools, visit them here.