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21/04 Children and young people's mental health highlight notice

 

Contents

Closing date: 3 June 2021

Scope

The Health Service & Delivery Research (HS&DR) Programme is collaborating with the What Works for Children’s Social Care (WWCSC) and looking to receive applications for high-quality, evaluative research to improve the quality of care, support and access to services for children and young people (CYP) with mental health conditions, including children who have, or have had a social worker.

  • Applications received with a focus on CYP with mental health conditions who currently have or previously had a social worker will be considered for joint funding by the HS&DR Programme and WWCSC.
  • Applications that involve CYP who have not been in touch with the children’s social care system that are within the remit of the HS&DR Programme are welcomed and will be considered for funding by the HS&DR Programme alone.

WWCSC and NIHR wish to see partnerships between sector professionals (including, but not limited to, children’s social care professionals in local authorities, Children and Adolescent Mental Health Services (CAMHS), other multi-agency partners or third sector providers) and researchers when submitting applications. Further information about the joint funding opportunity, and the support WWCSC is providing to facilitate these collaborations, can be found in the supporting information document.

Background

Early childhood and adolescence are critical times when it comes to an individual’s mental health. Having a mental health difficulty in childhood is known to have long-term consequences for educational attainment and employment opportunities. In 2017, one in eight CYP in England aged between 5 and 19 had a diagnosable mental health condition [1]. The NHS mental health, learning disability and autism services were accessed by 0.6 million children in 2018/19 [2]. A recent survey by Young Minds, of 2,000 parents and carers showed 76% thought their child’s mental health had deteriorated while waiting to access CAMHS [3]. With 50% of mental health problems being established by the age of 14 and 75% by the age of 24, protecting and improving the mental health and wellbeing of CYP is vitally important [4].

The NHS Long Term Plan sets out priorities for expanding Children and Young People’s Mental Health Services (CYPMHS) over the next 10 years [5]. It aims to widen access to services closer to home, reduce unnecessary delays, and deliver specialist mental health care that is based on a clearer understanding of young people’s needs and delivered in ways that work better for them. One of the recommendations from The Five Year Forward View for Mental Health (5YFVMH) report is to improve outcomes for CYP requiring a joint multi-agency approach including action to intervene early and build resilience as well as improving access to high-quality evidence-based treatment and services [6]. In response to the 5YFVMH report, a Framework for Mental Health Research was developed by the Department of Health in 2017 [7]. The framework emphasises the importance of research in driving innovation in mental health care and importance of involving people with mental health problems at all stages of research with a specific focus on CYP. More recently, the Mental Health Research Goals 2020-2030 [8], led by the Department of Health and Social Care (DHSC) and supported by a broad range of people across the mental health community builds on the Framework for Mental Health Research (2017) and previous research priority exercise such as “A Roadmap for Mental Health Research in Europe (ROAMER) [9]. The goals set out include halving the number of CYP experiencing persistent mental health problems and improving choice of, and access to, mental health care, treatment and support in hospital and community settings [8].

In a survey carried out by Mind during the current pandemic, 28% of young people did not access support as they did not think that their issue was serious enough. Young people were more likely to find it difficult to access mental health support, and less likely to feel comfortable accessing mental health support over the phone or on a video-call [10].

Access to mental health services varies from area to area, and there is limited information about rural areas specifically, making it hard to understand access issues in these areas. Children living in remote rural areas in the UK are at risk of missing out on mental health support. The Space between us report, stated children living in remote areas faced isolation and struggled to get help for their mental health because of poor transport, a lack of safe space to meet in and poor digital connectivity. In addition, rural areas are often poorly served by specialist mental health services [11]. Children living in poverty in the UK are four times more likely to have mental health problems compared to children from high-income families [12]. In turn, black Asian and minority ethnic (BAME) children are more likely to be living in poverty compared to white British children. The mental health of BAME communities is important because people from these communities often face individual and societal challenges that can affect access to healthcare and their overall mental health [13].

Areas of interest

The James Lind Alliance Priority Setting Partnerships – Mental Health in Children and Young People has identified a number of research priorities, some of which are included in the areas of interest below, though other issues may be proposed.

Applicants need to demonstrate the proposed work is complementary to the existing evidence base and does not overlap with ongoing research. Applicants should provide a clear justification as to why the research proposed is needed (such as what gap in existing knowledge will the research fill) and what difference it will make to children and young people’s mental health, and CYP mental health services. All research funded under this call must consider addressing the needs of all CYP who should be benefitting from this research. This means applicants will have to show inclusivity in how and where the study is to be conducted. Findings will need to be sufficiently granular as to be applicable to different groups of people across the BAME community. Applicants will also need to show they are going to locate the research geographically in areas where findings will be most needed or impactful.

Early identification and interventions

  • Early identification of CYP with mental health conditions including use of a multisectoral approach
  • Early interventions or strategies for improving mental health resilience in CYP with mental health conditions
  • Involving CYP in decision-making about their mental health care plan and the impact on treatment outcomes

Access to services

  • Improving access to care and support services for CYP with mental health conditions by promoting joint working and liaison between health and social care professionals
  • Organisation and delivery of mental health services to reduce waiting times and to protect and support the mental health of CYP
  • Support the delivery of culturally appropriate services, particularly for ethnic minority groups
  • New models for delivery of mental health services for CYP in rural areas

References

  1. NHS Digital. Mental health of Children and young People in England, 2017. Summary of Key findings. NHS Digital 2018. Accessed online September 2020
  2. Baker C. Mental health statistics for England: prevalence, services and funding. Briefing Paper Number 6988. House of Commons Library January 2020.
  3. Young Minds. A new era for young people’s mental health. Young Minds London. Accessed online September 2020
  4. PHE. Universal approaches to improving children and young people’s mental health and wellbeing. Report of the findings of a Special Interest Group. Public Health England 2019
  5. NHSE. The NHS Long Term Plan. NHS England 2019
  6. NHSE. The Five Year Forward View for Mental Health. A report from the independent Mental Health Taskforce to the NHS in England. NHS England 2016
  7. DoH. A Framework for Mental Health Research. Department of Health 2017. Accessed online December 2020
  8. AMS. Mental Health Research Goals 2020-2023. The Academy of Medical Sciences 2020. Accessed online October 2020
  9. ROAMER. A Roadmap for Mental Health Research in Europe. European Commission 2015. Accessed online December 2020
  10. Mind. The mental health emergency. How has the coronavirus pandemic impacted our mental health? Mind; London 2020
  11. Allwood L. The space between us. Children’s mental health and wellbeing in isolated areas. Centre for Mental Health 2020
  12. Gutman L, Joshi H, Parsonage M, et al. Children of the new century: mental health findings from the Millennium Cohort Study, Centre for Mental Health 2015. Accessed online September 2020
  13. Pople L, Rees G. Good Childhood Report. The Children’s Society 2017. Accessed online September 2020

General guidance

The NIHR Health Services and Delivery Research programme supports applied research with the aim of improving health and social care services across the nation and is open to any methodology which is appropriate to answer the proposed research question; this must be fully explained and justified. In order to enhance the success of a proposal a clear theory of change and pathway to impact with links into the NHS and social care delivery process is suggested. It is useful to consider in your study design how outcomes could be scaled up to maximise impact and value for money across the NHS and social care– the focus is on applied research with tangible impacts on systems that improve the quality, accessibility and organisation of health and social care services. This also includes stakeholder engagement and the development of processes, tools and guidelines to strengthen workforce capacity. Further general information about the Health Services and Delivery Research Programme can be found here.

WWCSC is an independent charity, funded by the Department for Education, that seeks better outcomes for children, young people and families by bringing the best available evidence to practitioners and other decision makers across the children’s social care sector.

The research funded by WWCSC looks at the point of referral through to permanence, including adoption, care-leaver support and targeted early help. WWCSC research focuses on children’s social care practice in England and draws on shared learning at the international level. Engagement and co-design are central to WWCSC’s approach and it works in close consultation with leaders, practitioners, children and young people, families and researchers across the sector to:

  • Identify gaps in the evidence, and create new evidence through trials and evaluations
  • Collate, synthesise and review existing evidence
  • Develop, test and publish tools and services that support the greater use of evidence and inform the design of the future centre
  • Champion the application of robust standards of evidence in children’s social care research.

Research proposals should be co-produced with national organisations and professional bodies, health and social care service professionals, and service users. Links with health and social care planners and professional bodies is encouraged to facilitate the impact and scaling up of research findings to benefit the wider health and social care system.

The COVID-19 outbreak is having a significant impact across the Health and Social Care Systems. As this research may be conducted during the COVID-19 response and recovery stage, the research should consider how the impact of COVID-19 response and recovery may affect your ability to conduct your research.

The NIHR is committed to actively and openly supporting and promoting equality, diversity and inclusion (EDI). All NIHR applications need to demonstrate they have met the requirements of the Equality Act (2010) by embedding EDI throughout the research proposal, ensuring there is no discrimination across the following domains; age; disability; race, including colour, nationality, ethnic or national origin; religion or belief; sex; sexual orientation; gender reassignment; being married or in a civil partnership; being pregnant or on maternity leave. Applicants are expected to pay attention to populations in locations with greatest need, socioeconomic disadvantage, which have disproportionately less access to health and social care services and are of an under researched area.

Further information on the HS&DR and WWCSC joint funding is provided in the supporting information document.