Adopting an evidence-based approach to support adolescent mental health

In this interview, we discuss the new Guy’s and St Thomas’ Charity programme dedicated to support adolescent mental health. Tamsyn Roberts, Programme Director, and Rob Parker, Head of Data Analytics, present the challenges, the methodology and the support provided by Trilateral Research in adopting emerging technologies to develop an evidence-based approach.

What is the impact of poor mentalhealth on young people?

We’re in the early stages of developing our programme on adolescent mental health – and part of that work is building our understanding of the issue as it affects young people in our boroughs, including the support that is available (or not) and how effective and accessible it is.

More broadly, we know that adolescent mental health is a major issue for the UK, with one in eight children and young people experiencing a diagnosable condition.

The risk factors associated with living in inner-city areas such as Lambeth and Southwark in London – areas that are densely populated, with a rich ethnic and social mix, and where poverty and affluence sit side by side – appear to amplify the risk of poor mental health.

We also know that without intervention or support, mental health conditions can have long term impacts on young people’s mental health and life chances, as well as a high cost to society.

We are aware that mental health provision is overstretched and under resourced – only about 25% of children and young people with mental health issues receive support, with an average delay of 10 years between the first onset of symptoms and getting help. 

Do socio-economic factors play a role in how mental health affects young people?

The most recent NHS Digital survey ‘Mental Health of Children and Young People in England’ found that living in a household on a low income or with a parent in receipt of income-related benefits was associated with higher rates of mental disorder in children.

In particular, children and young people from families on low incomes are almost four times as likely to have a behavioural mental health disorder and more than twice as likely to have an emotional mental health disorder than those from families on higher incomes.

As we have seen across our programmes, inequality is a key determinant of mental as well as physical health.

What are the new Guy’s and St Thomas’ Charity programme’s focus and goals in addressing poor adolescent mental health?  

We are currently in the exploratory phase of the programme, collecting qualitative and quantitative data to identify the unique role we can play in addressing adolescent mental health. We plan to start developing the programme in the autumn – commissioning projects to test and learn how we can make the biggest impact.

When we have gathered enough evidence to guide our delivery phase, we will support a portfolio of diverse projects to drive lasting change in our boroughs and to identify insights that will be relevant for other cities in the UK and internationally.

We have commissioned a series of research projects to help us understand the issue of adolescent mental health better and where we should focus our programme. We are testing our early hypothesis that behavioural mental health disorders should be a priority because of the significant and long-term impacts they have on life chances.

We know that the limited resources in existing mental health services for young people tend not to focus on behavioural disorders. An initial investigation suggests that behavioural disorders may be more prevalent in our boroughs than the currently available data indicates.

What type of methodology is the programme adopting?

We take a place-based approach to urban health. This means developing an understanding of how the local environment – such as the social context and economic factors – affects people’s health. We create partnerships to address the many different causes of complex health challenges such as adolescent mental health. Using our funding and expertise, we back evidence-based approaches from around the world, home-grown initiatives and brand-new ideas.

We work at three scales:

  • Neighbourhood – we test whole-system solutions by setting up a range of projects and initiatives within a small and defined geography, to test and demonstrate their combined impact
  • Borough – we address systemic obstacles to help adopt approaches and ideas that depend on a larger scale model to have impact
  • National and international – we influence social and policy barriers, and encourage others to adopt successful local approaches

We do this by:

  • focusing on long-term, specific goals
  • looking at the wider needs of people and the broader determinants of their health
  • concentrating our efforts where evidence shows we will have the greatest impact, and then layering up several projects, ideas and initiatives that approach the issue from different angles
  • supporting a variety of projects and partners, scaling up over time and refining as we go
  • investing in evaluation and learning to make improvements to help share what we find with others

How can Trilateral’s work support you?

We hope Trilateral’s work will help us:

  • Use the cloud-based dashboard to monitor the incidence of violent crime – a predictor of mental health issues – across the boroughs, spot trends over time, and identify hotspots.
  • Use the models to estimate the numbers of people that may be suffering from different mental health issues across different neighbourhoods in Lambeth and Southwark, based on different scenarios.
  • Use the models to estimate how one of the potential determinants of mental health – in this case, crime – would change depending on adjustments to underlying factors such as the percentage of green space available, the number of pubs, and household income levels.

What challenges do you envision in an evidence-based methodology?

The lack of data around adolescent mental health is a challenge, and the fact that, based on what else we know about it, we don’t think the data we have is telling the whole story. So we need to find other ways to combine data, lived experience, and other evidence to build a picture of the problem and help us shape our response to it.

What benefits do you expect from data collection, data visualisation and building scenarios based on data analysis?

As a place-based foundation we have a unique opportunity to test emerging technologies on the ground, in real time. This gives us access to crucial data and insights that we can use to make lasting change. Some of the tech we’re utilising includes:

  • An interactive crime data visualisation dashboard.

This takes crime data from the open source Police Crime API and visualises it in granular detail, with temporal, geospatial, crime type and outcome data visualisation tools. It enables the Charity to monitor incidence of violent crime – a predictor of mental health issues – across the boroughs, spot trends over time, and identify hotspots.

  • Scenarios for the prevalence of adolescent mental health.

This deploys cloud-based architecture to build a scenario exploring how the ethnic profile of Lambeth and Southwark may lead to under-reporting of mental health issues. This enables us to estimate the numbers of people that may be suffering from different mental health issues across different neighbourhoods in Lambeth and Southwark, based on different scenarios (such as Lambeth and Southwark having the same ethnic mix as the England average).

  • Predictive machine learning models of crime and adolescent mental health.

This uses a machine learning model that predicts the crime level in each geographical area based on local socio-economic indicators including mental health. This enables us to estimate how one of the potential determinants of mental health – in this case, crime – would change depending on adjustments to underlying factors such as the percentage of green space available, the number of pubs, and household income levels.

Has this approach previously been used in other Guy’s and St Thomas’ Charity programmes?

We use data analysis and visualisation throughout our programmatic work. Working with Trilateral Research, the Charity will use for the first time real-time data through an API, cloud architecture, and machine learning.

What strengths have caught your eye in Trilateral’s approach?

We value Trilateral’s use of techniques from both social science and technology and the way these are combined to gather the richest insights. Also, Trilateral’s ability to blend data science with software development, something that opens the door for new and exciting research opportunities.


For more information, please contact our team:

Hayley Watson, Senior Practice Manager at Trilateral Research

Hayley Watson


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