Background

There is a huge gap between need and access to help for many adolescents experiencing depression symptoms. This leaves many feeling unable to ask for help.

This is particularly true of those from excluded groups, who are also more likely to experience depression. Both not knowing what help is available, and the stigma attached to this, can prevent or delay them from seeking help. Even when they do ask for help, most must wait to access it because services prioritise those who are most severely ill.

Project aims

This project aims to help make therapy support available on demand and anonymously. We hope this will improve the provision of early help for symptoms of depression.

To do this, we need to:

• discover the best ways to let adolescents know about early help that is available
• design and build ways to let them know about early help options - like one-off single session interventions (SSIs) - and adapt these for the UK context
• test if two brief online anonymous SSIs can help to reduce depression symptoms compared to a supportive control SSI

Project team members and partners

Project team

• Dr Maria Loades
• Research Assistant (TBC)
• PhD student (TBC)

Partners

• Dr Debra Desrochers, School of Management (University of Bath)
• Prof Paul Stallard, Department for Health (University of Bath)
• Minervation
• Prof Richard Hooper and Pragmatic Clinical Trials Unit
• Assistant Prof Jessica Schleider and Lab for Scalable Mental Health
• Prof Roz Shafran, UCL
• Norfolk & Suffolk NHS Foundation Trust Research

Expected outcomes

We want to improve early access to mental health support for adolescents with symptoms of depression who are seeking help.

We hope our findings will lead to better ways to let adolescents know about early help for depression symptoms by improving the credibility, relevance, and accessibility of information about help on offer.

We will with advisory groups to share our findings. This will include different, creative ways to share my findings widely with adolescents (infographics, zines), practitioners (blogs, podcasts), policymakers (webinars, blogs) and other researchers (conferences, journal publications).

The findings will also jumpstart our ability to offer effective online SSIs as an openly accessible, scalable, anonymous, and low-cost addition to existing child and adolescent mental health treatments.

Project phases

This research has three phases.

Phase 1

Drawing on the social marketing expertise of the members of this project, we plan to collect and analyse adverts (‘messages’) used by services (NHS, charities, etc.) sharing information about early help for adolescent mental health. We’ll analyse how messaging has been used around the world to advertise research studies offering early help for mental health to adolescents.

Alongside this, we’ll use creative workshops to capture a diverse range of adolescents’ views about early help for adolescent depression and online SSIs. We’ll then explore their views in greater detail using individual interviews - including ‘think aloud’ techniques where the person is asked to voice their thoughts aloud while looking at example materials shown to them.

We will also survey professionals who may be the first port of call for adolescents seeking help, including school mental health staff and GPs to get their views too.

Phase 2

Together with our Young Person’s Advisory Group (YPAG) and subject and methods expert advisors, we will negotiate permission with the owner (mentor: Schleider) to adapt two online single therapy sessions (SSI), which have been shown to reduce depression symptoms in adolescents in the USA for use in the UK.

We will also develop a website and recruitment strategy, and ethics process for using these widely and safely in the UK.

Phase 3

In a randomised control trial (RCT), we’ll test these two SSIs with 470 adolescents (age 13-18).

Participants will be randomly allocated to one of the two interventions being tested (one focuses on doing more of what matters, and the other on flexible thinking), or to a supportive control SSI.

We hope this will help us to find out whether the participants who do the behaviour SSI and the thinking SSI have lower depression symptoms 1-month and 6-months later compared to the control.