Dr Alice Tunks

Young women who are not in education, employment, or training (NEET) experience poorer health and social outcomes compared to non-NEET young women and to NEET young men, especially in deprived areas with intersecting inequalities. The evidence on effective public health approaches is scarce. Interventions that target hope, which NEET young women notably lack, offer a promising theory-driven and intuitive means to prevent mental health problems and improve social outcomes. Hope can be defined as a goal-focused mindset comprising self-agency (motivation and self-belief) and pathways (identifying routes to achieving goals). Hope is implicated in a variety of evidence-based psychosocial interventions for young people, but is not directly targeted by existing prevention programmes for NEET populations. The current study used a phased qualitative research design and participatory methods to model a hope-focused intervention for NEET young women. Phase 1 investigated population needs and intervention parameters through semi-structured interviews with 28 key informants living or working in disadvantaged coastal communities in South-East England. The sample comprised eight NEET young women, four family members, and 16 practitioners from relevant support organisations. Phase 2 refined intervention parameters and outcomes through co-design sessions with four NEET young women, followed by a theory of change workshop with 10 practitioners. The resulting intervention model is articulated as a mentor-supported, in-person psychosocial intervention that builds hope by enhancing positive sense of self and time spent in meaningful activities, before explicitly teaching the skills needed to identify, set, and pursue personally meaningful goals.

Background: Common mental disorders (CMDs) are prevalent throughout the population. Psychological therapy is often sought via primary care; however, equitable access is not commonplace. This review aims to investigate the barriers and facilitators adults experiencing CMDs perceive when accessing evidence-based psychological treatment in England.Methods: A qualitative systematic review with meta-synthesis was conducted (PROSPERO CRD42020227039). Seven electronic databases were searched for papers from 2008 to October 2022. Results: Searches identified 30 studies from which three themes were developed with seven subthemes. Stigma and patients' perceptions and understandings of CMDs impacted their help-seeking decision-making and engagement with services. This meant that services were not used as a first resort for help-seeking. Upon reaching services, patients appeared to perceive primary care as not prioritising mental health problems, nor as being the place where they would be supported, particularly as healthcare professionals did not appear to know about CMDs and therapy was seen as difficult to access. The interaction between healthcare professional and patients was seen as pivotal to whether patients accessed support or not.Limitations: The review is limited to research conducted within England. Additionally, it only explores access barriers prior to treatment experiences.Conclusion: Knowledge, attitudinal, systemic and relational barriers and facilitators were identified. Future research should focus on developing stigma reduction initiatives. Clinical implications include provision of standardised training across primary care HCP (healthcare professionals).

Often journal articles and other common scholarly outputs are inaccessible or incomprehensible to readers who do not work in the field, even when made openly available. Exploring alternative mechanisms around science communication is an important issue in addressing equity and diversity issues in open research.  Routinely collected health and administrative data is used in research across the globe to address the critical health challenges of our age, including mental health crises, health inequalities and response to pandemics. Few members of the public know that their anonymised data is lawfully used in research. This makes it especially important that the outputs of such research communicate openly and accessibly about the work that is going on. Embedding participatory methods throughout projects can improve their legitimacy and impact. Using co-design to produce research outputs improves the diversity of patients and members of the public who can engage with the research in a meaningful way. In this presentation, we will describe a participatory co-design method for producing communication materials about science which are accessible and transparent for a wide audience. We present a collaborative UK project between Brighton and Sussex Medical School, and Akrivia Health Ltd, a company which curates mental health data for NHS, academic and industry research purposes, in particular by developing clinically-informed AI to derive medically-relevant information from unstructured clinical notes. Objective: Akrivia Health wanted to make patient facing information material about their data curation and research services, so that patients would know how their data were being used.   Method: We recruited six patient representatives across Southeast England, and held online and face-to-face sessions, working to achieve accessibility for participants with diverse needs. We hosted one session of information giving (online) and a day-long in-person session of deliberation and design, using the nominal group technique. Suggestions were generated about what information should be contained in the infographic, which graphics should be used, how it should be worded, and where the infographic should be publicised.  Suggestions were grouped by facilitators, and then prioritised by participants. A mock-up infographic was created, and additional feedback offered. A later iteration of the infographic was sent to participants and email feedback received. Participants were paid £190 for their full participation and reimbursed for travel expenses. Results and Conclusions: Workshops provided detailed design of the infographic in terms of the graphics, layout, quantity of words and content. There was high engagement from PPI members who mentioned they felt listened to and felt they had contributed to something concrete, particularly since they saw the infographic created in real time. The final infographic was very different to that which the Akrivia team had envisaged prior to the consultation. We learned: “what you think people want is often very different to what they do want”. See this presentation in this video recording.

The aftermath of the Covid-19 pandemic has seen an increase in persistent school absenteeism and Emotionally-Based School Avoidance (EBSA). However, suitable evidence-based psychological interventions are often unavailable. We aimed to assess the feasibility and acceptability of a new parent-focused online program, Intervention for School Anxiety and Absenteeism in Children (ISAAC), which has been co-designed with parents and practitioners. This exploratory mixed-method study recruited participants from three schools in southern England, enrolling N = 9 parents for whom a child, aged 5-11 years, was experiencing signs of EBSA. The intervention consisted of three web-based psychoeducational modules respectively addressing parental stress, accommodating parenting behaviors, and communication with school staff. Module completion was assisted by weekly calls with a non-specialist "coach." Feasibility was measured using indicators of retention, module participation, overall program completion and coaching fidelity. Acceptability was assessed using semi-structured interviews, module ratings and written qualitative feedback. We also explored baseline-post change in parent-reported measures of children's school avoidance, absences, anxiety, parental stress, accommodating parenting behaviors, and quality of parent-school communication. Overall, the intervention was feasible to deliver to parents with six (67%) participants completing the full intervention. Participants found the intervention acceptable across thematic domains of affective attitude, burden, coherence, self-efficacy and perceived effectiveness. Participants particularly appreciated the coach's support. We observed small to moderate reductions in school avoidance behaviours (d with Hedges correction = 0.36), child anxiety (d with Hedges correction = 0.33) and accommodating behaviours (d with Hedges correction = 0.44) at the post timepoint compared to baseline. In conclusion, ISAAC shows early promise with the potential to deliver scalable online support for families affected by emerging EBSA. Future research should move toward establishing effectiveness in a randomized controlled trial.