Towards early identification of adolescent mental health problems

儿童或青少年生活的许多方面都会影响他们的心理健康。如果某人有严重的精神健康问题，他们的全科医生（GP）可能会将他们转介到精神健康（精神病学）服务，由专业人员进行评估和治疗。精神卫生服务捉襟见肘，往往干预较晚，使人们遭受不必要的痛苦，从而可能持续更长时间、更严重或更难治疗。心理健康问题的早期预警信号可由本人或他人（如学校工作人员、社会工作者）注意到。许多事情都可能表明心理健康问题，例如早期的困难经历、欺凌、行为改变、上学出勤率或成绩差、或冒险。并不是所有经历过上述一种或多种症状的人都会有心理健康问题，所以我们需要把他们放在一起，找出哪些人出现了问题，哪些人可能需要专业帮助。然而，这些信息（数据）存储在不同的地方，例如由学校、全科医生和社会工作者存储，因此可能不可能及早发现问题。一些研究人员将来自两个或更多来源的数据结合起来，以发现暗示心理健康问题的模式。他们的成功表明了这种方法的良好潜力，但他们并没有产生实际的影响，主要有两个原因：1)模型还不够准确，可能是因为它们忽略了许多可能导致问题的因素；2)由于这些结果是基于匿名数据，因此不能直接用于帮助年轻人。我们将开发一个系统，供卫生、教育或社会工作者使用，以识别出现心理健康问题早期迹象的青少年，以便尽早为他们提供帮助。同时，我们希望为预测心理健康问题的研究提供更好的匿名数据。数据必须安全保存（很可能在NHS），只有参与一个人的护理的人才能看到它，但我们需要了解如何最好地做到这一点。为了在保护隐私的同时将数据用于研究，数据将被匿名化，删除任何直接识别个人的信息（例如姓名、地址、出生日期、NHS号码），并且访问权限将仅限于经批准的研究人员。但是我们还不知道在连接数据库时可能会出现什么技术问题，也不知道系统需要什么数据才能发现出现问题早期迹象的人。最后的挑战是如何在NHS、学校和社会护理机构中开展这项工作，以便及早发现年轻的心理健康问题患者。在接下来的一年里，我们希望通过建立一个包括心理健康研究人员、心理学家、学校、NHS、议会、计算机科学家、安全专家、数学家、提供服务的人以及政策制定者在内的小组来应对这些挑战，他们中的许多人在其他领域做着开创性的工作。我们希望把他们的注意力转向共同解决这些问题。我们必须让年轻人、他们的照顾者和有实际经验的人参与进来：这是他们的数据，我们需要了解他们的观点。我们希望他们能帮助考虑哪些专业人士可以看到他们的数据，以及当一个年轻人被认为有心理健康问题时应该怎么做。我们将就这些问题举办讲习班。我们还获准创建一个初始数据集，其中包含来自卫生、社会服务和教育的数据。我们将匿名化这些信息，并练习链接和分析它们。这些将帮助我们了解挑战，从而使我们的最终计划更详细，更有可能成功。在未来，我们想测试计算机程序是否能更容易地识别心理健康问题，并更早地为年轻人提供治疗，以及他们是否会因此更快地好转。这可能有一系列的好处，包括帮助学习，人际关系，家庭生活，找工作或进入大学，我们想测试这个理论。

Many aspects of a child or young person's life can affect their mental health. If someone has a serious mental health problem their general practitioner (GP) may refer them to mental health (psychiatry) services for assessment and treatment by professionals. Mental health services are stretched so often intervene late, leaving people to suffer unnecessarily with problems that therefore may last longer, be more severe, or be harder to treat.Early warning signs of mental health problems may be noticed by the person themselves or by others (e.g. school staff, social workers). Many things can suggest a mental health problem, such as difficult early experiences, bullying, changes in behaviour, poor school attendance or grades, or risk-taking. Not all who experience one or more of these will have a mental health problem, so we need to take them together to spot patterns that show who is developing problems and may need professional help. However, this information (data) is stored in different places, e.g. by schools, GPs and social workers and so it may be impossible to spot problems early.Some researchers have joined data from two or more sources to find patterns suggesting mental health problems. Their success indicates good potential in this approach, but they have not made a practical difference for two main reasons: 1) the models are not yet accurate enough, probably because they omit many factors that can lead to problems; 2) the results cannot be used directly to help young people as they are based on anonymous data.We will develop a system that can be used by health, education, or social workers to identify adolescents showing early signs of mental health problems, to offer them help sooner. At the same time we want to provide better anonymous data for research into predicting mental health problems.Data must be held securely (most likely in the NHS), and only people involved in a person's care should be able to see it, but we need to understand how best to do this. To use data for research while protecting privacy it will be anonymised, removing anything that directly identifies a person (e.g. name, address, date of birth, NHS number) and access will be restricted to approved researchers. But we do not yet know what technical problems there may be in linking the databases, or what data the system will need in order to detect people showing early signs of a problem. The final challenge is how to make this work within the NHS, schools, and social care settings to enable earlier identification of young sufferers of mental health problems.Over the next year, we want to tackle these challenges by creating a group including mental health researchers, psychologists, schools, the NHS, councils, computer scientists, security experts, mathematicians, people who provide services, and policy makers, many of whom are doing ground-breaking work in other areas. We want to turn their attention to jointly solving these problems. We must involve young people, their carers, and people with lived experience: it is their data and we need to understand their views. We would like their help thinking about which professionals can see their data, and what should happen when a young person is thought to be developing mental health problems.We will hold workshops about these questions. We also have permission to create an initial data set with data from health, social services, and education. We will anonymise these, and practise linking and analysing them. These will help us understand the challenges, so that our final plan will be more detailed and likely to succeed.In the future we want to test if a computer program makes it easier to identify mental health problems and offer young people treatments earlier, and if they get better quicker because of this. This might have a range of benefits including helping with school, relationships, home life, and getting jobs or into university, and we want to test this theory.