Award Title: Learning from the trajectories of mental health challenges for children, young people and parents over the course of the Covid-19 pandemic
Funder: Economic and Social Research Council

Abstract: Our two studies conducted throughout the pandemic in the UK and Japan have shown that the pandemic has continued to affect the mental health of children and young people and parents, that there are unmet needs, and that the pandemic-related effects and needs differ by individuals' background characteristics, as well as by country. Consequently, the main objective of the research is to use the existing structure of the Co-SPACE and C-C nation-wide cohort studies in the two countries, to improve our understanding how to best support families coming out of the COVID-19 pandemic and, in particular, how that may vary across countries and pandemic-contexts.  Specifically, we will examine:

(i)	How mental health consequences for children, young people, and parents vary according to key characteristics during the pandemic, and how this relates to the different experiences families have had within and across countries; 
(ii)	Who is and is not 'bouncing back' over longer term and while coming out of the pandemic; 
(iii)	What would help the immediate and long-term recovery of families in both Japan and UK.  
 
A further objective is to support and improve use of patient and public involvement (PPI in research in Japan to achieve direct societal impact. While PPI is common in health and social care research in the UK, the concept is still relatively new in Japan and rarely included in studies other than clinical trials. The Co-SPACE group has rich experience of including PPI in their previous work and have involved groups of teachers, parents, and young people throughout the research process since the start of the project. Inspired by the collaboration with the Co-SPACE team, the C-C group launched the C-C conference in 2020 to involve adolescents in the selection of survey items, a novel approach in Japan where PPI is not as commonly conducted or required in health and social care research. Hence, we will continue working in partnership with young people, parents, and members of the public to plan, manage, design, and carry out the currently proposed research. We will work with young people via Leaders Unlocked to co-develop guidance for policy makers and practitioners in Japan and the UK, this way improving policy, communication, and service design post COVID-19 pandemic.

Lay Abstract: COVID-19 and the related public health measures have led to major disruptions to families' lives, with different pressures arising for children, young people, and their families over time. The Co-SPACE project in the UK and CORONA-CODOMO (C-C) project in Japan are two nation-wide online survey-based studies tracking how children, young people, and parents have been affected since the start of the pandemic. Both studies, separately, have found that lockdowns and school closures were associated with deteriorating mental health and increased stress in young people and parents. Certain groups (e.g., families with financial difficulties, and with children with special education needs) appear to have been particularly vulnerable to elevated stress and mental health symptoms throughout the pandemic. However, at this point, we still know little about how to best support families coming out of the COVID-19 pandemic and, in particular, how needs may vary across countries and pandemic-contexts.

The proposed project builds on a successful existing collaboration that will further utilize available expertise in international data analysis, text-mining approaches, patient and public involvement, and translating research into practice. In turn, it will promote knowledge exchange and involvement of early career researchers. The aim of this proposal is to: (i) capitalise on what can be learned from these parallel international surveys about the impact of COVID-19 and how it has been managed across countries; (ii) develop a further understanding of medium and long-term impacts of the pandemic on the mental health symptoms of young people and parents, as well as their pathways to recovery; and (iii) together with young people and families, co-design guidelines for policy makers and health authorities, which will help to mitigate identified medium to long-term mental health consequences of the pandemic and current policies and to tailor future pandemic management strategies to minimise mental health impacts on young people and families.

The above aims will be achieved through three workstreams, while actively engaging young people and parents from both countries in decision making throughout the research lifecycle:
(1)	The already collected online survey (including cross-sectional) data will be merged and analysed using a multi-level modelling approach to examine how immediate mental health consequences for children, young people, and parents across Japan and the UK have varied over the COVID-19 pandemic according to policies and restrictions, as well as child, family, and other key characteristics; 
(2)	Three 6-monthly follow-up surveys with comparable measures will be conducted and analysed using time series and text-mining approaches across both countries to examine who is and is not 'bouncing back' and what are the medium and long-term consequences of the pandemic; 
(3)	Through a series of online events, we will co-design guidance for policy makers and practitioners with young people from both countries in collaboration with the Leaders Unlocked, an organisation which enables young people and underrepresented groups to have a voice on issues that matter.

Research Activity Codes: 2.4 SURVEILLANCE AND DISTRIBUTION;8.3 POLICY, ETHICS AND RESEARCH GOVERNANCE
Health Categories: MENTAL HEALTH;INFECTION