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Tackle young people's mental health now to protect the future

Published: 10 May 2023

Professor Cathy Creswell, ‘Mental Health Across the Life Course’ theme lead and Professor of Developmental Clinical Psychology at the University of Oxford, writes about how NIHR ARCs are working to tackle the youth mental health challenges of the next decade. Professor Creswell is part of the team at ARC Oxford and Thames Valley.

It is well known that many mental health problems first start in childhood or adolescence, and recent national data in England has shown increases in likely mental health problems among children and adolescents, rising from 1 in 9 in 2017 to 1 in 6 in 2020.

In recent work with The Emerging Minds Network our consultations highlighted a particular ‘Big Question’ we face: ‘How do we implement effective promotion of good mental health, prevention and early treatment at scale for mental health problems amongst children and young people?’

How the ARCs are improving mental health

The 15 NIHR Applied Research Collaborations (NIHR ARCs) are ideally placed to address this ‘Big Question’ for child and adolescent mental health. The NIHR ARCs are local collaborations to support applied health research and research on the implementation of health and care evidence into day-to-day practice.

An example of our own Oxford and Thames Valley NIHR ARC-supported work, which links in with this year’s Mental Health Awareness Week theme of anxiety, focuses on increasing access to evidence-based psychological treatment for child anxiety problems.

Parent-led cognitive behaviour therapy

Over the last decade, with NIHR funding, we have developed and evaluated a brief form of treatment in which parents and carers are supported by a therapist to implement evidence-based strategies in their child’s day-to-day life to help them overcome problems with anxiety. We have shown this ‘parent-led CBT’ (Cognitive Behaviour Therapy) approach is clinically and cost effective. It is now widely implemented across the country. However, although the treatment is brief, we found that many parents still faced barriers to getting help, including concerns about the stigma associated with help-seeking and the realities of busy family lives.

To address this, we worked with families and clinicians to create an online version of the treatment (OSI) that parents could access from their own homes at a time that suited them, with remote individual support from a therapist. With ARC support and further funding from the MRC and NIHR, we were able to rapidly scale up our evaluation when the pandemic hit to meet the need for remote interventions. Ultimately we recruited 444 families from over 70 clinical teams around the country to a randomised controlled trial (results to be released soon).

Ongoing ARC support is now enabling us to see how families and clinical teams get on with OSI outside of a trial, when it is used as part of routine service delivery. We have been blown away by the enthusiasm among clinical teams, with 14 NHS Trusts already signed up and over 170 staff trained.

Alongside this, the Oxford and Thames Valley ARC and the ARC Mental Health Implementation Network are supporting three studies in the East and North West of England to explore different approaches to implementing parent-led CBT and OSI in practice. This work already includes 35 schools. This learning will be critical for successful implementation of our current programmes, but also as we build further evidence to improve identification and link it to early intervention for anxiety problems through schools and, we hope, ultimately for prevention.

These studies can only go ahead because of the willingness of families to get involved and take part. Across the ARCs we need more people to help shape the future, take part in studies and to get involved. There are more than 200 mental health studies recruiting right now, all requiring different levels of commitment from participants.

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