Award Title: Improving mental health among at-risk young people in a challenging border region.
Funder: Public Health Agency, NI

Abstract: "Northern Ireland has one of the highest rates of mental health problems in Europe with almost 25% of people having reported a mental health disorder in their lifetime. In the North-Western border region (Derry/Donegal), the rates of suicide and depression are particularly high, coincident with socioeconomic deprivation and extremely high unemployment rates among young adults. Many mental health problems emerge before age 18 with the period from 18-25 being a particularly susceptible developmental time in a person’s life and there is growing concern about the high numbers of college students with mental disorders. Colleges are an excellent environment for detecting young people at high risk of mental disorders and applying evidence-based treatment approaches to prevent and treat common mental disorders at an early stage. We currently form an interdisciplinary team (Psychology, Psychiatry, Stratified Medicine, Genetics, Mental Health Charity) conducting the Ulster University Student Wellbeing study and associated analyses. This study commenced in September 2015, as part of the WHO World Mental Health Surveys International College Student Project and has recruited 1600 participants to date. Consistent with other recent studies prevalence rates of lifetime and 12-month mental health and substance disorders, ADHD and suicidality in students were high, with more 50% of new undergraduate students reporting any lifetime disorder (McLafferty et al PLoS ONE, under revision). While 10% of new entry students received treatment for emotional problems in the previous year, 22.3% of students with problems said they would not seek help, indicating a large unmet need. We have also profiled biological markers in saliva samples from students and excitingly, preliminary analyses indicate DNA methylation changes as a potential biomarker for depression (Lapsley et al, in prep). We wish to extend this screening trial to a partner Institution (Letterkenny Institute of Technology) in Donegal to establish rates of depression, other mental illnesses, and biomarker status in the matched population. We also wish to undertake an RCT to provide a treatment which is effective, increases therapy accessibility and availability and overcomes stigmatization worries by maintaining student’s anonymity. The HIT will incorporate a randomised control trial. Participants will be randomized to either a novel cognitive-behavioural and problem-solving therapy developed by our collaborators in The Netherlands (world-leaders in this area), or receive usual care. Impact of the intervention will be assessed by longitudinal follow-up throughout the course of study. The primary psychosocial outcome measure will be presence of depression/anxiety symptoms following the intervention and secondary outcomes will include academic performance, participation/engagement, dropout and presence of mental and physical health disorders. In addition, biological outcomes such as changes in the novel DNA methylation markers we have identified will be assessed. Overall the study aims to extend our screening trial based on our current successful model for recruitment and identification of likely beneficiaries based on psychometric and biological markers, as well as trialling a novel intervention based on the latest developments in cognitive-behavioural approaches, comparing this to a standard treatment model as part of this personalised medicine driven trial."


Research Activity Codes: 4.4 POPULATION SCREENING;6.4 SURGERY
Health Categories: MENTAL HEALTH