B3959 - Rethinking mental health difficulties - 20/12/2021

B number: 
Principal applicant name: 
Jenny Retzler | University of Huddersfield
Dr Chris Retzler
Title of project: 
Rethinking mental health difficulties
Proposal summary: 

The symptoms experienced by young people with mental health difficulties rarely fit neatly into one diagnosis. For more than half of young people with difficulties, the symptoms experienced can be divided into two, or even more, diagnoses, while for others, there is no diagnostic category into which they fit. These problems with our diagnostic categories make it difficult for researchers and doctors who want to know how and why, some people develop mental health difficulties, and how best to support them.

To solve these problems, we need to look at mental health difficulties in a different way. In the last five years, researchers have started using ‘person-centred’ statistical techniques, which produce an alternative to the diagnostic categories we use at the moment, to look at mental health difficulties in teenage groups. Person-centred techniques look for patterns in data that show how symptoms might group in certain ways for some individuals, and in different ways for others. For example, having poor concentration might be grouped together with feeling anxious and being withdrawn in some young people. In others, poor concentration might, instead, be grouped together with feeling restless and breaking rules. With traditional diagnoses, both sets of young people might be diagnosed with ADHD, but using a person-centred perspective we can find these different groupings that reflect the variety of difficulties being experienced. This should give researchers a better chance of understanding what might make it more (or less) likely that somebody has the problems they do, and what type of support might help them most.

The challenge we face is that person-centred techniques are still quite new and we don’t yet know whether the new groupings they produce are consistent, or any more representative or useful than the current ways we diagnose. This is what this project aims to assess. At the same time, we want to get input from young people with experience of mental health difficulties as we do this. Phase 1 will start by understanding more from young people about their experiences of mental health difficulties and the diagnostic journey. We want to know what has been important to them, what they think might have influenced the symptoms they live with, and what sorts of things help make life easier. Researchers will use the understanding we gain from these sessions to plan how they will do the statistical analysis in phase two to make sure that it captures what is important to young people. Phase 2 will be the statistical analysis, shaped by Phase 1. We will use ALSPAC data, which has followed up thousands of people from childhood and through the teenage years, and use person-centred techniques to find new groupings with shared patterns of symptoms. We will then test the statistical strength and consistency of the new groupings, and use understanding gained from Phase 1 to see whether the new groupings can help us to learn more about the factors that impact mental health. In Phase 3, we want to come back to young people to see how far they feel the new perspectives on mental health difficulties that were generated in Phase 2 fit with their experiences. They can help us to see what will and won’t be an improvement over existing diagnoses, and can consider with us how the findings can be used to improve the diagnostic journey. During this phase, we also want to discuss the findings with groups who make decisions about how CAMHS runs, to identify positive ways to use the knowledge that has been generated.

Impact of research: 
This project will benefit young people living with mental health conditions in a number of ways. In the short-term it would give those in charge of mental health services some ideas about what is important to consider during diagnosis and management, and a new way to look at mental health difficulties. Longer term, this can be used to inform a diagnostic process that truly reflects the pattern of difficulties individuals have. From a research perspective, we hope that in the short-term, our project will make any benefits of using person-centred techniques to define mental health difficulties clearer to researchers, so that they can use them effectively. With this understanding, knowledge of new ways to prevent and support these difficulties will be possible long-term. Adolescent mental health research will also benefit from the way this project combines the experiences of young people with complicated statistical analysis. Usually, these two parts of research are kept separate, but we want to show how much more we can understand if we bring the two together, and give other researchers an example that they can follow of how to do this effectively.
Date proposal received: 
Thursday, 16 December, 2021
Date proposal approved: 
Monday, 20 December, 2021
Mental health - Psychology, Psychiatry, Cognition, Behaviour - e.g. antisocial behaviour, risk behaviour, etc., Developmental disorders - autism, Cognitive impairment, Eating disorders - anorexia, bulimia, Mental health, Computer simulations/modelling/algorithms, Statistical methods, Childhood - childcare, childhood adversity, Cognition - cognitive function, Development, Statistical methods