Future Minds NI

Northern Ireland (NI) has high rates of mental illness and suicide, and one reason is the region's history of conflict. A new generation of young people who have not known the worst of the violence are also experiencing high rates of mental illness. There are concerns about the effects of intergenerational transmission of trauma, where parental trauma exposure and mental illness increase the risk of mental illness in children. Several mechanisms may be at play, including the effects of trauma on parenting, possible biological effects of trauma that may be passed to the next generation, and the effects of living in a community that has suffered deprivation and violence. The project therefore has two themes: adolescent mental health and suicidal behaviour, and intergenerational trauma. There are two targeted groups, marginalised young people in deprived areas and college students. This work will contiguously align with the research team's ongoing projects, but add in substantial new elements to them; particularly the EU-funded, £6million Our Generation (OG) project which will deliver trauma-informed interventions to over 30,000 young people in areas affected by the conflict; and the Student Psychological Intervention Trial (SPIT) of a novel online intervention for mild mental illness.

Future Minds will identify the mental health research needs for young people in NI through an agenda setting exercise with young people themselves, and an evidence review, both of which will be disseminated to stakeholders as a report and policy briefing, and launched at the mini conferences and policy round table, in collaboration with our partner mental health charities, Action Mental Health and Mental Health Foundation. This project also includes two pilot studies to expand and connect ongoing multidisciplinary research projects. The first is in the use of chatbots to augment mental health services. The applicants are currently developing and testing chatbots to support adults with mental illness in a range of ways. This pilot will allow us to examine the utility of chatbots in adolescent mental health and suicide prevention. In keeping with our themes, the target groups are marginalised young people (including people with disabilities and people who identify as LGBTQIA+) and college students. The second pilot will co-design and test the feasibility of a study on intergenerational trauma across 2 or 3 generations, recruiting those involved in OG. This study will include the same questionnaires as an ongoing prevalence study of mental illness and adversity in young people, currently being undertaken by one of our collaborators. This study will also establish a protocol for and examine the feasibility, of collecting and analysing DNA samples, in a similar way to that currently used in the SPIT project.

Young people are at the core of this project. The project will provide 5 £500 Bootstrap awards to young people to promote novel ways of highlighting issues relating to adolescent mental health. These will be showcased at our dissemination events. Young people (student mental health ambassadors) identified the themes for this project and endorsed the bootstrap awards idea. Future Minds is a partnership with the NI Childrens' Commissioner and Youth Action NI, and will be guided by a young people's advisory group which will include a diverse range of young people from across NI, identified with our partners and the OG advisory board. Future Minds will support the establishment of a research community and multidisciplinary teams to build research with and for young people to promote adolescent mental health and suicide prevention, and address intergenerational trauma. Future Minds will have benefits for young people in NI, the UK, and internationally. It will underpin future studies to advance our understanding of adolescent mental illness, and support the development of novel interventions to promote the well-being of future generations.

This project involves 3 pilot studies, all co-created and co-produced with young people:
1. An on-line survey and focus group study to identify the priorities for young people's mental health research. The research areas in the survey will be based on those identified in an evidence review. The survey will be distributed to young people, carers and parents and promoted through secondary schools (representative of NI), community groups and young people involved in OG, and through our partner organisations' networks. The findings will be discussed, and the priorities refined to establish the final list in 4 focus groups with young people in different parts of NI.
2. Our team are developing chatbot interfaces and systems, and examining their utility in adult mental health. This pilot will allow us to examine the utility of chatbots in adolescent mental health and suicide prevention. Four focus groups will examine the acceptability of chatbots to marginalised young people and college students:
-To improve access to services, by signposting to sources of support; and to enhance the delivery of services;
-To identify and promote help seeking for suicidal thoughts and behaviours.
We will record the discussions and analyse the data using thematic analysis.
3. We will co-design and test the feasibility of a study of intergenerational trauma examining the role of parental trauma and mental illness, parenting practices, and community and socioeconomic factors. We will co-design the protocol and pilot test using psychological scales, many of whom feature in a Children and young peoples' prevalence study in NI, to promote comparability across cohorts. Additionally, we will test the feasibility of collecting saliva samples to allow the examination of genotype, epigenetics and microbiome.
Both pilot studies will build a foundation for future multidisciplinary studies in key areas relating to adolescent mental health and suicide prevention, and intergenerational trauma

Adolescent mental illness and suicidal behaviour are important and costly public health problems that prevent young people from realising their full potential. Marginalised young people in deprived areas are at particular risk, and in NI the risk is exacerbated by the impact of the conflict and the implications of the intergenerational transmission of trauma. The transition to college is also a time when mental illness starts to emerge and this context presents opportunities for early intervention to prevent mental illness, reduce dropout and maximise our investment in third level education.

Young people
Young people, particularly marginalised young people in deprived areas, and college students, are the main beneficiaries because the projects will inform the development of effective interventions and approaches to the delivery of treatment and care. We will also directly empower young people by incorporating them as partners throughout the process, ensuring we identify with them the problems that they wish addressed, and start to create together the tools with which to start to remedy these. Through our Bootstrap awards we will allow them to have wholly-owned projects which they can bring from conception to realisation, boosting their self-belief and fostering genuine youth-led innovative solutions.

Wider society
By improving the mental health of young people, and addressing the intergenerational transmission of trauma we will enhance the mental wellbeing of the next generation, which will in turn have a positive impact on wider society.

Policy makers
The project pilot studies and agenda setting study will give policy makers evidence to inform policies to improve the mental health of the next, and future generations, and find better ways of identifying and supporting young people who have suicidal thoughts and behaviours. The application includes letters of support from the Department of Health (welcoming the project to inform strategic direction and services), The Royal College of Psychiatrists in NI (endorsing the themes and population groups targeted), and key NI political parties (expressing a willingness to engage and an endorsement of the themes).

Health and social care professionals, community workers and mental health care practitioners
The information from the pilot studies will inform practice and promote the development and delivery of interventions to support young people's mental health, to promote resilience, halt the effects of intergenerational trauma, and for suicide prevention.

Groups working with, and representing young people
Our partner agencies and mental health charities will be able to highlight the young people's mental health research priorities identified in our agenda setting study. They will be able to work with academics to campaign to ensure that these research needs are addressed. These organisations will also benefit from the information garnered though the agenda setting study, about young people's mental health research priorities.

Academic Researchers
By underpinning future novel studies exploring the mechanisms in the intergenerational transmission of trauma and the use of chatbots to support young people's mental health and suicide prevention, our studies will accelerate the advancement of these research fields.
The findings and methodological advancements will therefore benefit academic researchers.