School based mental health intervention for young people: development and feasibility study of a digital information prescription intervention.

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There is overwhelming evidence that the foundation of lifelong mental health begins in childhood and adolescence. Currently, more than half of young people will, by the age of 21, have experienced mental health difficulties [3,4]. This is of concern since mental health difficulties in adolescence typically persist into adulthood [5]. The cost of poor mental health to the young person, their families, and the healthcare system is extensive [6]. In the UK, the need for specialist mental health services far outweighs resources, and only a quarter of those referred to specialist services will be seen [7]. Young people and families are often left to cope with mental health difficulties on their own. This project aligns with strategic shifts in national and international policy [8,9] to promote mental health through public health initiatives and with recommendations for early intervention when mental health difficulties arise [5]. In regional (Leeds) plans for implementing the NHS England and Department of Health's Future in Mind strategy [8], young people say that "We want it to be easy to find information about mental health and well-being so we can help ourselves" and "We want to be able to get help quickly and easily when we ask for it" [10]. This project therefore adopts a public health approach to examine the potential of information prescription to help young people with early signs of mental health difficulties get the information they need to help themselves. Information prescription involves the prescription of evidence-based, personalised information and guidance, at the right time, to help people understand their experiences, and equip them with knowledge, strategies and motivation to improve their well-being. Studies with adults show high levels of user satisfaction with self-help information interventions for physical and mental health conditions [11, 12], but the potential of self-help information prescription to help the mental health of young people is unexplored. There is currently no information prescription intervention for young people's mental health that can be delivered in schools. We will develop and feasibility test a digital information prescription intervention suitable for delivery by trained staff in schools to 14-18 year olds who are experiencing mild-moderate (but non-clinical) mental health difficulties and who are in the help-seeking stage [13]. A sister intervention for parents/carers will be developed as they currently report feeling insufficiently equipped to help. The primary aim of the intervention is to halt the progression of early mental health difficulties and to help the young person resume a productive and enjoyable life by developing their knowledge, understanding and resources to improve their mental health. Our project adopts a recovery approach, stressing the first person view of the service user, including personal views of what recovery and good mental health means [14].Our early phase study will work closely with YP with mental health difficulties, parents of YP with difficulties, school staff and mental health professionals to identify their support and information needs, before building an information repository relevant to the six most common mental health difficulties experienced by young people in local schools, and which would be suitable for early intervention via information prescription in school. We will convert this repository into a secure, interactive, multi-media platform, suitable for web and app based access, with monitoring potential, delivered via trained school staff. The project will also co-design school based implementation and training materials as well as safety and evaluation protocols to ensure that any young person whose need escalates will receive help quickly. We will use the study outcomes to co-design a trial comparing the effectiveness of the intervention with other early intervention approaches for young peoples' mental health.