Kailo - A systemic approach to improving adolescent mental health

青少年的心理健康和福祉至关重要，不仅对他们自身的福祉和发展，而且对我们社会的健康、社会和经济繁荣作出了贡献。然而，有证据表明，心理健康状况不佳的人数正在上升：有意义的社会关系受到侵蚀、歧视、环境问题以及对经济和就业前景的不确定性（仅举几例）加剧了这一现象。这些影响的感受并不平等——社会中最脆弱的群体是受打击最严重的群体，加上最近的COVID-19等冲击，情况更加复杂。促进弱势青年心理健康的典型做法往往远远不能提供青年所需的帮助。目前的精神卫生系统在很大程度上是为了在问题发生后做出反应而设计的，由于该系统如此紧张，提供的帮助往往太迟了，也不一定是年轻人需要的。我们的工作将采用一种完全不同的方法。作为领先的科学家、设计师、实践者和社区活动家的合作伙伴，我们设计了一种名为“Kailo”的方法——意思是“连接”或“整体”。Kailo是一个循证框架，将支持地方伙伴关系共同设计战略，解决精神卫生的潜在驱动因素。这些战略和活动将以促进青少年心理健康的最新科学证据为依据，但将根据当地的需要和情况进行灵活调整。这些战略将促成促进社会联系、提高心理卫生素养、建立更好的相互联系的支持系统以及为改变当地环境和基础设施提供信息的活动，所有这些都将有助于促进青少年心理卫生。这些战略和活动将由年轻人、社区成员、地方当局/卫生系统从业人员和领导层共同设计（在结构化的Kailo框架和研究团队的指导下）。实现Kailo的前两个区域故意选择了非常不同的位置。一个是东伦敦的纽汉（Newham）：一个多元化、人口稠密的内城地区。另一个是北德文郡：一个很大的农村地区。这两个领域都有丰富的资产和优势，同时心理健康需求水平较高，面临当地特有的挑战。我们在这两个截然不同的领域开展工作，因为这将使我们能够探索并帮助改进该方法，以便它能够在尽可能多的不同上下文中工作。由经验丰富的研究人员和评估人员组成的团队将与Kailo在这两个领域的实施一起运行，他们将测试哪些是有效的，并确定挑战所在。这将为框架2.0版提供信息，然后将在新的领域实施，同时进一步评估其对青少年心理健康的影响和差异，以及相关的驱动因素。这些评估活动将包括最先进的方法方法和系统建模技术，使我们能够有意义地探索工作中固有的细微差别和复杂性。最后，这类工作的一个共同挑战是确保战略和活动在长期内是可持续的，而不是失败。同样，我们也希望确保英国各地和其他地方都能采用Kailo框架，以便尽可能多的年轻人受益。因此，我们将与领先的企业家和具有商业头脑的伙伴合作，确保我们的方法能够得到广泛采用和持续，同时仍能反映当地的细微差别和特定社区的需求。

The mental health and well-being of adolescents is vitally important, not only for their own well-being and development, but also as a contributor to the health, social and economic prosperity of our society. Yet evidence suggests poor mental health is on the rise: fuelled by an erosion of meaningful social connections, discrimination, environmental concerns and uncertainty about economic and employment prospects (to name a few). These influences are not felt equally - the most vulnerable in society are those hardest hit, compounded by recent shocks such as COVID-19.Typical approaches to promoting the mental health of vulnerable young people often fall far short of providing the help that young people need. The mental health system as it stands is largely designed to react to problems once they have taken hold, and as the system is so stretched, help that is made available is often too late, nor is necessarily what young people need. Our work will take a radically different approach. As a partnership of leading scientists, designers, practitioners and community activists, we have designed an approach called 'Kailo' - which means 'connected' or 'whole'. Kailo is an evidence-informed framework that will support local partnerships to co-design strategies that address the underlying drivers of mental health. The strategies and activities will be informed by the latest scientific evidence about promoting adolescent mental health, yet will be flexed and tailored to suit local needs and contexts. These strategies will result in activities that foster social connections, enhance mental health literacy, create better connected systems of support, and inform changes to local environments and infrastructure, all of which will contribute to promoting adolescent mental health. These strategies and activities will be co-designed by young people, community members, local authority / health system practitioners and leadership (guided by the structured Kailo framework and research team). The first two areas implementing Kailo are intentionally very different locations. One is Newham, in East London: a diverse, densely populated inner-city area. The other is North Devon: a large, rural area. Both areas have rich assets and strengths, alongside heightened levels of mental health needs and locally specific challenges. We are working in these two contrasting areas as it will allow us to explore and help refine the approach so that it can work across many different contexts as possible. Running alongside implementation of Kailo in these two areas will be a team of experienced researchers and evaluators, who test what works well, and identify where the challenges lie. This will inform a version 2.0 of the framework, which will then be implemented in new areas, accompanied by a further evaluation exploring the impact and difference it makes to adolescent mental health, and the associated drivers of this. These evaluation activities will include state-of-the-art methodological approaches and system modelling techniques allowing us to meaningfully explore the nuances and complexity inherent in the work. Finally, a common challenge in this sort of work is ensuring that strategies and activities are sustainable in the long-run, and don't fizzle out. Similarly, we also want to make sure that as many places around the UK and beyond can adopt the Kailo framework so that the maximum amount of young people can benefit. As such, we will be working with leading entrepreneurs and business-minded partners to ensure that our approaches can be widely adopted and sustained, yet still reflect the local nuance and needs of specific communities.