Population Mental Health objectives, platform and challenge areas

Reducing the individual and societal burden of children’s and young people's mental health problems is a national priority.

Three quarters of mental health conditions are apparent by age 24, with evidence of a rise in certain conditions since the pandemic in adolescents and young people. Children and young people’s unmet mental health needs are at their highest and are severely overrepresented in deprived areas. In the last decade, the UK government has made policy commitments to enhance children and young people’s mental health.

The objective of this challenge area is to develop mental health intelligence systems to support school leaders, local decision-makers, and central government in planning and evaluating equitable mental health preventative interventions in children and young people.

Using existing innovative linked whole-country national pupil-level data between education and health in England and in Wales, we will examine patterns of children and young people’s mental health service activity, to produce evidence about ‘known’ mental health needs. We will help to identify schools with the highest discrepancies between reported-need and access to services.

We will also use the data frameworks developed to examine whether children and young people’s preventative programmes are fairly distributed according to local area and school-level mental health need.

For example, we will examine whether mental health inequities in schools have been impacted by the provision of Mental Health Support Teams, who bear the main responsibility for delivering whole-school mental health prevention programmes in England but will only be available in 50 per cent of secondary schools and 25 per cent of primary schools by 2025. To support universal accessibility, we will investigate how intervention estimates are altered in children and young people who are neurodiverse or racially minoritised.

Collaborators

Forward Thinking Birmingham, Place2Be, STEM4, Department for Education 

Evaluate the effectiveness of population-level policies and public health interventions impacting suicide and self-harm inequalities.

Approximately six thousand people die by suicide annually in the UK. The economic cost and the effect on those bereaved by suicide and societal impacts are significant. There is emerging evidence for inequalities in suicide risk by region, socioeconomic indices, and ethnicity in England. These inequalities could be exacerbated by the current cost of living crisis and other post-pandemic societal stressors.

Therefore population-wide monitoring of trends, as well as effective public health interventions that reduce risk across all sociodemographic groups, must be prioritised. Suicide and self-harm prevention requires coordinated collaborative action across multiple sectors, including health, education, local government, welfare, business and trade unions, criminal justice and police, defence, transport, and the media.

The objective of this challenge area is to evaluate the effectiveness of UK population-level policies and public health interventions impacting suicide and self-harm inequalities in the short, medium, and long-term.

We will consider two types of interventions: those with a primary intention to prevent self-harm and/or suicide, versus those that had a different intended beneficial impact; for instance, initiatives designed to ameliorate known risk factors for suicidal behaviours such as childhood adversity, domestic violence, gambling, and loneliness.

Evaluate policies, interventions and approaches impacting mental health inequalities in people living with multiple long-term conditions.

Other than suicide, most premature deaths in people with mental health conditions are from preventable physical causes. Mental and physical health have important bi-directional associations; our work has found that multiple long-term conditions can exacerbate each other, with a spiral of worsening physical, emotional, cognitive, and social functioning.

We also know that racially minoritised people residing in deprived areas of the UK develop multiple long-term conditions 10-15 years earlier than their White British counterparts residing in more affluent areas.

The objective of this challenge area is to evaluate policies, public health interventions, and group-level approaches impacting mental health inequalities in people with multiple long-term conditions.

We will work to identify relevant policy or public health interventions for evaluation. This could include assessing national rollout of population-based programmes for physical health to evaluate impacts on mental health. Examples of other potential interventions include devolution of powers to local government for health and social care, physical activity campaigns, alcohol minimum pricing, and extending the age of retirement, for example.

We will triangulate evidence to explore the extent to which these provide consistent findings about the impact of population interventions on mental health prevention in the context of multiple long-term conditions, with a focus on health inequalities.

Collaborators

Mental Health Foundation, Action Mental Health 

The disconnect between research, public policy, practice and lived experience is a significant limitation for improving the mental health of society.

The disconnect between academic research, public policy, practice, and lived experience is a significant limitation for improving the mental health of all members of society. The lack of effective communication and integration across these interdependent groups has led to siloed systems and structures which perpetuate inequality and restrict improvement for health outcomes.

The objective of this cross-cutting platform is to build a coalition across government, public sector agencies, voluntary organisations, people with lived experience, and academic stakeholders, to innovate creative methods for practice-informed evidence synthesis and policy-driven research, centred on lived experience.

The key outputs of this platform will democratise processes around how knowledge is produced, shared, and used. This will include developing:

1. An embedded peer researcher methodology.

2. Creative methods approaches.

3. Three ‘sandpit’ events, which are inclusive of people who have not applied their expertise to population health previously, to innovate intervention development.

4. Policy roundtables, led by the Mental Health Foundation with support from English, Scottish, Welsh, and Northern Ireland Government representatives, to bring together stakeholders, experts, policymakers, and the public to gather feedback, build consensus, and develop actionable recommendations on the Population Mental Health Consortium challenges.

Collaborators

Office for Health Improvement and Disparities, Public Health Northern Ireland, Public Health Wales, Centre for Mental Health, Toynbee Hall, Greater London Authority, Mental Health Foundation, Inspire Wellbeing, National Youth Theatre, NICVA, Dr Paul Patterson (Forward Thinking Birmingham), Professor Lisa Marzano (Middlesex University), Dr Caglar Koksal (University of Manchester)

Platform to leverage data and refine methods to evaluate policy, public health or impact of large-scale ‘shocks’ on population mental health inequalities.

Despite a large evidence base of observational studies indicating strong associations between a range of social determinants with mental health, evaluating the effectiveness of population-level interventions to prevent mental ill-health has proven difficult, as complex interventions designed to address the social determinants of mental health are rarely amenable to randomised controlled trials.

The objective of this cross-cutting platform is to leverage novel large-scale and linked data, and refine state-of-the-art natural experiment and causal inference methods, to evaluate policy, public health or the impact of other large-scale ‘shocks’ on population mental health inequalities.

The UK is a world leader in longitudinal cohorts and repeated cross-sectional surveys with embedded mental health outcomes in large, nationally representative population-based samples. Various candidate data sources will be explored and used, and we will establish the potential for cross-country comparative analyses across challenge area topics.

Collaborators

Professor Ann John (Swansea University), Dr Alex Dregan and Professor Jayati Das-Munshi (King's College London), Professor Gerard Leavey (University of Ulster), Thrive LDN Real Time Surveillance System, Greater London Authority City Intelligence Unit

Develop/refine measures for the assessment of intersectional inequalities to ensure population based/policy/systems interventions are equitable.

National surveys indicate that common mental health conditions are more prevalent among systematically disadvantaged groups, with strong associations noted between broader social determinants and the onset of mental distress and illness. Health inequities are large, avoidable, and unjust differences in the experience of health and illness.

They are caused by systems of discrimination, powerlessness, and disadvantage that intersect across social class, gender, ethnicity, sexuality, age, and disability. Co-produced research that integrates an intersectional equity lens can reduce these inequalities. 

The objective of this cross-cutting platform is to develop and refine measures for the assessment of intersectional inequalities to ensure population-based, policy, and systems interventions are equitable.

Throughout, we will use Equality Impact Assessments and the Health Inequalities Assessment Toolkit to integrate an intersectional equity lens into our research and involve individuals with lived experience and policy/practice expertise. This tool will allow us to map inequalities, integrate intersectional equity into all research questions, prioritise evidence for action, and ensure accountability in tackling identified inequalities.

We will develop and refine quantitative and qualitative methods to enable assessments of intersectional inequalities in population mental health and ensure that interventions and policies do not contribute to a widening of inequalities.

Key outputs for the platform will include:

1. Evidence-based policy recommendations to reduce health disparities.

2. Interactive mapping of place-based inequities.

3. Insights on drivers of mental health inequalities across intersecting identities.

4. Amplified lived experiences through a photovoice exhibition.

Collaborators

London Association of Directors of Public Health, North East London Integrated Health and Care System, NHS Race and Health Observatory, Traumascapes, Dr Tassia Oswald (King's College London)

Develop an interdisciplinary training programme to support the development of the next generation of leaders in population mental health.

High fidelity training which provides consistent and coherent approaches to an understanding of mental health remain absent in the wider provision of public health training.

The objective of this cross-cutting platform is to develop an interdisciplinary training programme spanning public health, local government, policy, data sciences, population mental health, and lived experience, to support the development of the next generation of leaders in population mental health.

Drawing on wide-ranging interdisciplinary expertise across the Population Mental Health Consortium, we will tackle this challenge by developing a unique and tailored education and training programme in population mental health.

Training will support a range of target audiences, including non-academic partners and public health practitioners, university academics, clinicians, early career researchers, and peer-researchers. We will develop a bespoke programme tailored to meet the needs of the wide range of target groups, to develop knowledge, skills, and understanding around key issues in the field of population mental health.

Collaborators

Dyer-Workforce Equity Fellows (NHS-E/I), peer researchers (Fischer, Traumascapes), Thrive LDN