Adolescence, digital technology and mental health care: exploring opportunity and harm.

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This work will pave the way for a substantial programme of research focused on the relevance of adolescents' digital technology use to consultations about mental health. We will explore both opportunities and harms posed by digital technology use and if addressing these in consultations can help clinicians to manage patient risk. Specifically, we will pose questions around whether young people's technology use can be drawn upon to enrich face-to-face consultations, used as a tool to make these work better and more efficiently; and whether clinicians have a role to play in safeguarding against harmful use. There will be three workstreams of activity: 1) we will work closely with young people, their carers, mental health practitioners, general practitioners, social care workers, and technology providers to involve them in shaping our plans. We will ask what they consider to be the most important questions and needs in this area and explore their ideas about possible solutions and the type of research that would be acceptable to carry out. To do this, we will run a series of discussion workshops with these groups, consult practitioners to find out how they currently address issues relating to digital technology, and run a programme of arts-based activities with young people to help them express themselves and think about the issues under discussion. We will generate an online hub to make us a working community. This will help us jointly create research plans for a programme of research. 2) we will work with other researchers, especially those in general practice and data science, taking time to consider the best ways to include these important areas in our programme of research. 3) we will conduct two pilot projects. The first will look at a newly emerging example of where technology use may provide an opportunity: in this instance, for the MeeTwo teenage mental health app to provide information to mental health clinicians about a distressed young person, to help with history-taking and triage. We will build cases studies of where this happens, interviewing the young person and clinician involved to find out whether this was helpful, acceptable, and if it may have improved their relationship and the young person's care. Our second project stems from recent advice issued by the Royal College of Psychiatrists that mental health clinicians should ask young people about their online activities when assessing risk. This is in recognition of the harmful effects of some content, for instance, in relation to body image and self-harm. We know from our previous research that clinicians agree this is important but have concerns about how to engage in such conversations safely. Our project will gather together a virtual panel of mental health clinicians and of young people with experience of mental health difficulties. Each panel will be asked to rate statements (a Delphi study) about how clinicians should ask young people about technology use, including what should be asked, when and by whom. We will look for agreement, keeping the statements that receive a high level of endorsement. We will use the results to design a set of guidelines agreed by clinicians and young people about the best ways for mental health clinicians to talk to young people about technology use. Our pilot projects will provide the foundations for full-scale research. Project 1 leads into feasibility work exploring opportunities for technology enriched history taking and triage to be used more widely. Project 2 leads into research on clinical benefits and interventions that could follow from adding questions about technology use to mental health assessment. Our activities will allow us to design a comprehensive programme of research informed by the key needs, questions, and possible solutions of those to whom it matters most; and to develop relationships with partners (clinical, academic, digital technology providers, and young people) to bring this to fruition