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

有压倒性的证据表明，终身心理健康的基础始于童年和青春期。目前，超过一半的年轻人将在21岁之前经历心理健康困难[3，4]。这一点令人担忧，因为青春期的心理健康问题通常会持续到成年[5]。对年轻人、他们的家庭和医疗保健系统来说，心理健康状况不佳的代价是巨大的。在英国，对专科精神健康服务的需求远远超过了资源，只有四分之一的被转介到专科服务的人会得到治疗[7]。年轻人和家庭经常被留下来独自应对心理健康问题。该项目符合国家和国际政策的战略转变[8，9]，即通过公共卫生倡议促进精神健康，并符合在出现精神健康困难时进行早期干预的建议[5]。在地区(利兹)实施NHS英格兰和卫生部的未来考虑战略的计划[8]中，年轻人说“我们希望很容易找到有关心理健康和幸福的信息，这样我们就可以帮助自己”，“我们希望能够在我们请求帮助时能够快速和轻松地得到帮助”[10]。因此，该项目采用公共卫生的方法来审查信息处方的潜力，以帮助有早期心理健康困难迹象的年轻人获得他们自助所需的信息。信息处方包括在正确的时间开出以证据为基础的个性化信息和指导，帮助人们了解他们的经历，并为他们配备知识、战略和动力，以改善他们的福祉。对成年人的研究表明，用户对身心健康自助信息干预措施的满意度很高[11，12]，但自助信息处方帮助年轻人心理健康的潜力尚未被探索。目前还没有可以在学校提供的针对青少年心理健康的信息处方干预。我们将开发一种数字信息处方干预措施并进行可行性测试，适合受过培训的学校工作人员向14-18岁正经历轻至中度(但非临床)心理健康困难并处于求助阶段的儿童提供服务[13]。将为父母/照顾者制定姐妹干预措施，因为他们目前报告说，他们没有足够的能力提供帮助。干预的主要目的是阻止早期精神健康困难的发展，并通过发展他们的知识、理解和资源来改善他们的精神健康，帮助年轻人恢复富有成效和愉快的生活。我们的项目采用康复方法，强调服务使用者的第一人称观点，包括对康复和良好心理健康意味着什么的个人观点[14]。我们的早期研究将与有心理健康困难的青年团、有困难的青年团的家长、学校教职员工和精神健康专业人员密切合作，以确定他们的支持和信息需求，然后建立一个与当地学校青少年经历的六个最常见的心理健康困难有关的信息库，并适合通过学校信息处方进行早期干预。我们将把这个资料库转变为一个安全、互动的多媒体平台，适合基于网络和应用程序的访问，并具有监控潜力，由训练有素的学校工作人员提供。该项目还将共同设计以学校为基础的执行和培训材料以及安全和评估方案，以确保任何需要增加的年轻人都能迅速得到帮助。我们将利用这项研究结果共同设计一项试验，比较干预与其他早期干预方法对年轻人心理健康的有效性。

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.