The problem

There is a huge gap between need and access to help. Many adolescents feel unable to ask for help when experiencing depression symptoms.

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 stigma can prevent or delay help-seeking. Even when they do ask for help, adolescents must wait to access it because services prioritise those who are most severely ill.

Proposed solution

This research aims to help make therapy support available on demand and anonymously, thus boosting the provision of early help for depression symptoms. 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, and adapt these for the UK context
• Test whether two brief online anonymous single session interventions (SSIs) can help to reduce depression symptoms compared to a supportive control SSI

Our plan

Our research will be split into three stages.

Stage one

Drawing on social marketing expertise, we will collect and analyse adverts (‘messages’) used by services (NHS, Charities) sharing information about early help for adolescent mental health. We will also look at 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 diverse adolescents’ views about early help for adolescent depression and online SSIs. We'll then explore these 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.

Stage two

Together with the 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'll also develop a website and recruitment strategy, and ethics process for using these widely and safely in the UK.

Stage three

In a randomised control trial (RCT), we will test these two SSIs with 470 adolescents (aged 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. I want to find out whether the participants who do the behaviour SSI and the thinking SSI have lower depression symptoms one month and six months later compared to the control.

The difference this will make

We will work with the advisory groups to plan for sharing our research findings. We expect that this will include different, creative ways to share the findings widely with adolescents (infographics, zines), practitioners (blogs, podcasts), policymakers (webinars, blogs) and other researchers (conferences, journal publications).

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

Therefore, we aim to improve early access to mental health support for adolescents with symptoms of depression who are seeking help.

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