Networks of Care: Insights from the OxWell Student Survey

The ‘Insights from the OxWell Student Survey‘ series is a new mini-in conversation series that will explore the OxWell study and the impact of its findings for parents, teachers, policymakers and mental health professionals.

In this episode, Professor Mina Fazel, Dr. Emma Soneson, and Dr. Simon White will provide insight into what the OxWell Student Survey is, discuss some key findings, and explore the implications of these findings for networks of care.

Discussion points include:

• What the OxWell Student Survey is, and how it came about.
• How mental health support was studied and how they arrived at the networks of care analysis.
• Insight into where young people most likely found support when it came to their mental health.
• The preferences of different groups of young people in terms of accessing mental health support.
• How we can make child and adolescent mental health services (CAMHS) better suited to help young people.
• How we can support friends and family as the most commonly-accessed sources of support.
• How we can partner with schools to better support young people’s mental health.

OxWell is a large-scale student survey designed to measure the wellbeing of children and young people. It looks at mental wellbeing, anxiety, indicators of vulnerability such as bullying and loneliness, school experience, access to services, safety online and many more areas. It is a joint effort between schools, young people, the NHS, local authorities and the OxWell research team at the University of Oxford’s Department of Psychiatry.

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Professor Mina Fazel is a Professor of Adolescent Psychiatry at the University of Oxford and a consultant child and adolescent psychiatrist in the Department of Children’s Psychological Medicine at the Oxford Children’s Hospital. She has been working for two decades on how to improve mental health services for vulnerable and hard to reach populations which has led to an interest in school-based mental health services. She has worked with local CAMHS services to change how they interface with education. She also conducts the OxWell Student Survey which in 2021 had responses from over 30,000 students from 180 schools, guiding our understanding of what school-aged students say they want and need. Her other main interest is in improving access to evidence-based trauma therapies, especially for young people suffering from PTSD, having worked with refugee populations for many years. In her clinical work, she is part of a team helping children and young people with chronic health difficulties and pain.

Dr. Emma Soneson is a postdoctoral researcher at the University of Oxford. Her research focuses on the intersections between education and child and adolescent mental health. She is particularly interested in the role of schools in promoting and protecting mental health and preventing the onset of mental health difficulties.

Dr. Simon R. White is a Senior Research Associate at the University of Cambridge, jointly within the Department of Psychiatry and MRC Biostatistics Unit. His research involves developing statistical methods for applications in neuroimaging, cognition and ageing, and adolescent psychiatry with a focus on heterogeneity and missing data. Simon is also active in public engagement and outreach activities to promote statistical literacy; as an Royal Statistical Society Statistical Ambassador, contributor to the Science Media Centre, and as a STEM Ambassador.

Other resources

• Episode 2 – ‘Friendships and Mental Health: Insights from the OxWell Student Survey’, with Tanya Manchanda
• Episode 3 – ‘Online Behaviours and the Impact on Mental Health: Insights from the OxWell Student Survey’, with Dr. Simona Skripkauskaite and Dr. Holly Bear
• Episode 4 – ‘Self-harm Behaviours and Loneliness: Insights from the OxWell Student Survey’, with Dr. Galit Geulayov and Dr. Rohan Borschmann

Transcript

[00:00:01.439] Clara Faria: Hello, welcome to the Insights from the OxWell Student Survey series for the Association for Child and Adolescent Mental Health, or ACAMH for short. This is a new mini In Conversation series that will explore the OxWell Study and the impact of its findings for parents, Teachers, policymakers, and mental health professionals. I’m Clara Faria, an ACAMH Young Person Ambassador, and today, I have the pleasure of interviewing three Senior Researchers from the OxWell Team. These are Professor Mina Fazel, Professor of Child and Adolescent Psychiatry at the University of Oxford and the Study Principal Investigator, Dr. Emma Soneson, Postdoctoral Researcher at the Department of Psychiatry, University of Oxford, and Dr. Simon White, Senior Statistician at the OxWell Team.

OxWell is a large-scale student survey designed to measure the wellbeing of children and young people. It looks at mental wellbeing, anxiety, indicators of vulnerability, such as bullying and loneliness, school experiences, access to services, safety online, and many more areas. It is a joint effort between schools, young people, the NHS, local authorities, and the OxWell Research Team.

In this episode, we will focus on what the OxWell Student Survey is, and the implications of its findings for Networks of Care.

If you are a fan of our In Conversation series, please subscribe on your preferred streaming platform. Let us know how we did with a rating or review and do share with friends and colleagues. Welcome everyone. It’s a huge pleasure to have you here. Can we start with an introduction, each of you giving a short overview of what you do, please?

[00:01:47.290] Professor Mina Fazel: Thank you. I’m Mina Fazel. I’m a Child and Adolescent Psychiatrist, particularly interested in helping adolescents better access mental health support. My clinical work, which is currently at the Oxford Children’s Hospital, constantly reminds me of the hurdles children and families can experience in accessing care, either because of what’s offered, is it a place difficult to access, or at time that’s impossible, or with something they might be anxious to meet? So, I started my research career a couple of decades ago looking at the mental health needs of refugee children living in the UK. And all of this has led me to an interest in the provision of services in schools and broader school mental health issues. Emma, over to you.

[00:02:26.990] Dr. Emma Soneson: Thanks Mina, and thank you, Clara, for having us. My name is Emma Soneson, and as you’ve already mentioned, I am a Postdoctoral Researcher in Child and Adolescent Psychiatry at Oxford. I’ve been working on the OxWell Student Survey for about five years now and I really come to it with a public health focus, meaning that I’m interested in how we can act at a population level to support youth mental health. Over to Simon.

[00:02:50.950] Dr. Simon White: Hi, there, I’m Simon White. I’m a Senior Research Associate at the University of Cambridge, and I’m a Statistician. So, my area that I bring into mental health and adolescent mental health is trying to understand what we can learn from the data and how to best leverage the information we get to get a meaningful understanding of what young people are telling us about their experience. And one of my particular focuses is on missing and incomplete data. So, particularly in survey responses, we find a lot of people choose not to respond or prefer not to answer, and how we handle that and how we report that is a great area of interest to me.

[00:03:28.349] Clara Faria: So, our first question today is, what is the OxWell Student Survey and how did the idea for such an interesting project came up?

[00:03:35.000] Professor Mina Fazel: Well, this is quite a large survey conducted in schools. So, why it’s important, I think, is ‘cause what we try to do is include as many young people as possible to take part. And because it takes place in school, often within a specific lesson, we feel that it’s an important way to enable all children and adolescents who are attending school who might not otherwise participate in research, makes it easier for them to take part. So, it’s completed only by young people. So, we prioritise the adolescent voice and what they experience and what they want, and it’s now collected information from young people in what we call four different waves.

So, it started in 2019, so pre-pandemic and then, also collected data in 2020, 2021, and now, most recently, in 2023. And we ask over 200 questions of the young people. We had over 40,000 young people take part this last time, from the ages of eight to 18, and so, we feel that we get an incredibly privileged insight into what so many young people are telling us and what they’re experiencing. And through that, we have more confidence to take these findings to decisionmakers around services or determining need and saying, “Actually, this is what young people are telling us.”

[00:05:00.009] Clara Faria: That’s amazing, and could you briefly describe how you’ve studied mental health support in the OxWell Survey?

[00:05:06.320] Professor Mina Fazel: So, the service part of the OxWell Survey has always been very important. We actually started the survey on the back of something that had already been running for ten years. So, it’s somewhat what we call a legacy survey that we changed, but it was originally set up and funded by the Commissioners, people who take decisions about how to fund services. So, this has always been a really important part of OxWell, is actually, how can we use the information to shape what we’re doing and to better do it?

So, in OxWell, what we ask about mental health support, we ask about accessibility. So, “Have you gone to any of these types of services?” And our learning is that mental health services has many different levels. You could have informal support from friends and family. You can have semi-formal support or, you know, the support you can get from other adults and individuals in your communities, or at school. And then, you could have what we call formal support, so those you get from formal mental health services in the UK. That’s called CAMHS, Child and Adolescent Mental Health Services, or from your Primary Care Doctors or General Practitioners or from specific Counsellors and Therapists.

So, in OxWell, we ask about all those different types of support, and then, what we also do is ask if they’ve accessed it, whether they found it helpful, and I think that’s a really important part of the picture. And then we also ask if they wish they could’ve accessed any services and why they didn’t. So, we’re learning about this other area, that’s called barriers to accessing care, that is – you know, I think all of us here are particularly passionate about, what are they, and what can we learn about what we can do to change it?

[00:06:52.620] Clara Faria: Could you tell us a bit about how did you arrive at the Networks of Care analysis and about the methods you used in the survey?

[00:06:59.990] Dr. Simon White: OxWell asks about 17 different types of support. Actually, we also asked about any other type that we didn’t think of when we wrote the survey. So, there are actually 18 types of support we ask about. It might be tempting to analyse each of these separately. To get a bit statistical with you, we’d call that a univariate analysis, which means one at a time. But that’s not really how we should think about young people’s experience of access to support. And we want to think a bit more in a multi-variate or, essentially, all at once approach, and that got us thinking about patterns and trying to understand the patterns of accessing support, and to do that, we thought about trying to work a network. And a network has things called nodes, and the nodes correspond to the type of support, and then, there are lines joining the nodes, which represent how many young people use both types of support in tandem.

Now, if you want to think of this as an analogy, you could think of it like a road network. So, the nodes are cities and towns, and bigger cities and smaller towns are more or less young people using types of support, and the lines are like the roads joining them. So, you’ve got big motorways with lots of lanes, where lots of young people go between, and then, there’s small country lanes, where there are fewer people. These networks allow us a very visual representation of a complex dataset. So lots of different types of support, lots of different interconnections.

Where it gets really interesting is when we include the follow-up questions that Mina mentioned earlier into this representation. So, we also asked our responders whether they found each type of support helpful or not helpful. And we can use that to colour the nodes or using the analogy, cities, and this gives us a visual representation of the whole landscape of support, both formal and informal. Where it gets really exciting is we can gain a greater understanding of young people’s experience by anchoring. And so, what I mean by anchoring, is we take a new network, but only for young people who find a specific type of support helpful, or not helpful, and looking at these anchored networks, we can see patterns of access and support for people with a specific experience of the service landscape.

[00:09:06.070] Clara Faria: That was really interesting. Could you share with us a bit about the findings? Where are young people most likely to find support when it comes to their mental health, in your analysis? What type of support did they find most helpful?

[00:09:19.670] Dr. Emma Soneson: So, right now, my primary research interest is in the mental health care gap, which refers to the children and adolescents who have a mental health need but who aren’t accessing support for that need. In other words, the ones who are slipping through the cracks, if you will, of our current support systems. So, some of my previous research within the OxWell Study during my PhD already demonstrated quite substantial unmet need in this population, particularly among those from marginalised and minoritised groups. So, for me, these networks now are really the next step in understanding adolescents help-seeking preferences and their experiences, and the networks provide such interesting insight that we can use to better address their needs and reduce that care gap that I was just talking about.

In terms of the findings of these analyses, honestly, I could go on forever about all of the interesting things we found, but I’ll try to stick to the highlights. So, to start, we knew that about one in four students reported that they’re either currently accessing mental health support or that they’ve done so in the past. And this, kind of, tracks of what we’re seeing in other national surveys as well, such as the Mental Health of Children and Young People Survey.

For those who had accessed support, the greatest number were turning to their parents or caregivers or to their friends, and in general, they found these more informal supports to be really helpful. So for example, around 85% of those who reached out to their parents found it helpful and around 90% of those who reached out to their friends, either friends that they knew online or friends that they knew in person, and to me, these are really huge success rates.

Even when we look at those adolescents with the highest levels of depression and anxiety, parents and friends were still a key source of support as well, and they perceive them, even then, to be really helpful. So, schools were another quite common type of support for these young people, both in terms of staff with specific pastoral roles, like a SENCo or a Counsellor, but also Teachers and other adults at the school, as well. So, these sources of support weren’t perceived to be quite as helpful as friends and family, but still, between around 60 and 80% of young people who reached out to someone at school did report finding it helpful. So, clearly, the current policy focus on supporting schools to look after student mental health really does seem to align with what we’re seeing in the OxWell Survey.

And finally, before I hand over to Mina, I do want to talk about the more formal health and social care services like GPs, Child and Adolescent Mental Health Services and Social Workers. So, as might be expected, these types of support weren’t as readily accessed as others, which we would, you know, we would expect to see that. But unfortunately, along with helplines and online support services, these more formal types of support were also not really perceived to be as useful as other types of support. So, here, only around half of adolescents reported finding these types of support helpful. And when we look specifically at those with high levels of depression and anxiety, they were viewed as even less helpful, which is really worrying to me, given that higher level of need for these young people.

[00:12:27.690] Professor Mina Fazel: I think, Emma, you’ve summarised it really well, and also, our overwhelming excitement about this, because actually, we can really take to the table what we are finding. And I’m having a lot of discussions with Commissioners, and when I start to talk in this way around the different networks and which groups are more likely to access which, that’s actually what Commissioners want to hear. ‘Cause this is a complicated jigsaw that we’re dealing with here. It’s not a one size fits all that we want to promote.

Another area that I think that we’re finding quite interesting is then, looking at those who don’t find, for example, their carer helpful, and understanding who, then, is helpful. And I suppose what’s coming out more and more across these groups that we sometimes talk about as marginalised or those groups that aren’t able to access more traditional service, as well, is that other individuals that are outside these formal provisions, so other adults at school, maybe those not in key pastoral roles, but other adults, or other adults in the community or those that work in the third sector or charities or maybe clubs, these are starting to emerge as more helpful and useful for those groups that aren’t able, really, to access care through their families and friends or the more traditional services. So, that helps us really understand the importance of all of these different types of provision and the roles they play, as well.

[00:13:56.670] Clara Faria: OxWell is really a pioneer when it comes to studying how young people want to access mental health support. Can you share, Simon, a bit of what you’ve learned about the preferences of different groups of young people?

[00:14:08.899] Dr. Simon White: So, one thing we’ve been able to do with our Networks of Care approach is we can consider a number of comparisons between different groups of young people. And so, a couple of those, I’m just going to pick out now that we’ve looked at, are comparison between neurodivergent and neurotypical, ever excluded or never excluded from school, gender conforming and gender non-conforming, and those who’ve ever had special education need support on, which we’re going to call SEN or no SEN.

So, what we end up with is these pairs of networks, and we can compare them side-by-side and look at changes in the patterns of accessing different types of support. Now, I don’t want to get all statistical, but we have to have a small aside. When we were asking people how helpful they found these services, essentially, we binarised that into helpful and not helpful. And so, when we say helpful and not helpful, that’s essentially, a proportion from that binary response. But when we talk about things being less helpful, that doesn’t mean they might not be not helpful. Oh, that was a bit of a twist. So, we just have to be careful when we say things are less helpful, that doesn’t mean that young people aren’t, on average, finding them helpful. I just want to say that up upfront before my next bit, where I talk about when we find these things in terms of relative helpfulness.

But what we have found is that gender non-conforming young people tend to find friends more helpful than direct family, so, parents and carers and siblings. Whereas we find neurodivergent young people find friends and siblings most helpful in that sort of informal mental health support part of our landscape. Perhaps as expected, those who’ve ever been excluded from school tend to find more formal mental health support, especially things like school-related services, less helpful. And so, it, sort of, reinforces what we would expect to see, which is quite nice to see that present in our networks.

Perhaps slightly interestingly, those with special education needs support, we tend to find that they find charity services most helpful, compared to those who’ve got no SEN support or no need for any SEN support, and the wider overall response rate. So, we do find these interesting patterns amongst these subgroups and then particular, comparing subgroups where we’re, sort of, dividing respondents into these categories. But again, there’s, sort of, lots of ways you can view these types of categories and then, we can look in multiple ways, sort of, gender non-conforming SEN, but when we get into the problem of perhaps small sample sizes. So, we have to be slightly careful about how robust these networks are, depending on the sample sizes in the comparison groups, and that’s something that we’re going to come back to in a later question.

[00:16:49.529] Clara Faria: And now, one of my personal favourite questions and a question directed to the three of you. Which findings of the survey were most interesting or perhaps curious to you? Did anything surprise you?

[00:17:02.200] Dr. Emma Soneson: So, for me, what was really surprising was just how important adolescents found informal sources of support, so their parents and carers, their siblings, their friends, other family members. Not only were these individuals the most common form of mental health support access, but they were also perceived to be some of the most helpful types of support, as well. And maybe I was being naïve, but I really did think that the more formal sources of support, you know, schools or maybe CAMHS, would come out on top in these networks, but this is definitely not the case, at all.

And then, what I found even more surprising was the fact that this held true even for the adolescents with the highest rates of anxiety and depression. So, originally, I figured that when we looked at that group with high levels of anxiety and depression, that their mental health needs might be too severe or too complex to be effectively managed by support from friends and family. But again, the data really proved me wrong here because friends and family still came out on top in these networks, as well. So, clearly, informal supports are so important for these young people, and I think they probably deserve more attention than they’re currently getting. How about you, Simon?

[00:18:14.130] Dr. Simon White: Well, one of the interesting findings that came out looking at our networks was when we look at our overall networks, we found that helplines, so, either, sort of, telephone or text-based or online websites and forums, were generally less helpful, on average. So, still, sort of, over half of our respondents were finding them helpful, but amongst all of the 16/17 types of support we were asking about, they were at the lower end of helpful. But what was particularly surprising was when we looked at our anchored networks. So, this is where we’re going to anchor to people who find a particular type of support not helpful. I’m going to stress that again, the ones who find it not helpful in our binary classification.

So, for example, those who found parents and carers not helpful, among those young people, we find 64% found that helplines were not helpful, and that’s compared to 45% overall. And equally, 68% of them reported that online websites and forums were not helpful compared to 41% overall. So, for those young people who are finding particular types not helpful, then these online and helplines are also not being found to be a helpful source of support. And I thought that was a particularly surprising counter to, sort of, the general way that we’ve approached delivering support via these mediums.

[00:19:40.820] Professor Mina Fazel: I think, for me, well, apart from the really exciting statistical analysis that Simon’s done, because actually, it is quite remarkable how – you know, when you’ve got someone with such skill and expertise, what they can bring to help you understand an area is really important. And so, for that, actually, I’m just grateful, but it’s also helped bring it all to life.

I also think what has interested me so much is that actually the group who don’t – just talking about the group that Simon’s been referring to that we’ve been anchoring. So, we’ve taken, for example, the group who don’t find their parents or carers helpful. Actually, it’s an incredibly different picture for those young people than for those that find them helpful. So, the majority of young people do find the carer helpful, but if you don’t, it seems that that seems to also impact on the whole range of other types of provision out there that you also don’t necessarily find that helpful. And so, it just highlights, I suppose, these groups of young people for whom we really need to start thinking in different ways about how to access them, how to support them, how to help them, because there are groups that are finding most provision just not meeting their needs, or not something that they feel acceptable or accessible.

[00:20:59.050] Clara Faria: Thank you, Mina. The finding that CAMHS was one of the least helpful forms of support for young people was quite surprising to me. In your opinion, as a Psychiatrist, Mina, how can we make CAMHS better suited to help young people and see them thrive?

[00:21:13.370] Professor Mina Fazel: Yeah. This was, I suppose as a Psychiatrist, really disappointing that so many of the young people who had seen CAMHS didn’t necessarily find it as helpful as I thought they would, to be honest. So – but I think what we need to be aware of is that the group that actually make it to services right now, a time when actually there’s a lot of demand on services, only a small group actually are actually able to get there. They’re likely to have experienced many hurdles in accessing care. They might have had to wait quite a long time to get to CAMHS.

So, it might be that they are not finding CAMHS helpful. It might just be that they’ve not found that whole journey of waiting two years to see CAMHS, if that’s what’s happened, that’s clouded their perspective. So, this highlights the importance of what, you know, we call mixed methods research, where actually, it’s very important to interview young people, really understand what they’re saying. But in reality, it does look like a very large number of young people who are accessing CAMHS are saying that it’s not that helpful.

So, some of what I understand is happening that can help us improve the offer is that there are difficulties in staff recruitment and retention across many services, Child and Adolescent Mental Health Services. But we do know that young people who access services really value consistency of the person with whom they are working. So, to not have any changes is valued, and so, we know that when services are stressed and there is more staff turnover and changes, that can also be quite difficult countertherapeutic, potentially, for young people.

And it might be that there is a public perception that, you know, if you’ve got a problem, you need to go to CAMHS. Well, it might not necessarily be that CAMHS is the best place for every type of problem. You know, that it is for the treatment of severe mental illness, but it might be that for other difficulties, those that don’t meet the CAMHS criteria, where CAMHS is best suited to treat a certain group, if you don’t fall in there, it might be that CAMHS isn’t the right place for you and there are better services. And so, there might be something about, also, understanding the offer, that we need to better help people understand which types of difficulties are best supported in which types of environments.

One last thing I will say is, we really have to start thinking about how do we bring young people’s voices into the room? How did they work with us to shape services? And I don’t think we can improve what we do without that really essential bit of co-production, we call it, of getting young people. And those in services, those not yet in services, their families and siblings, all of them contributing to helping us improve, as well.

[00:24:03.630] Clara Faria: Absolutely, and as you’ve mentioned, friends and family were one of the most commonly accessed sorts of support, and I wanted to know, in your opinion, how can we support friends and family in this role, which can be very challenging?

[00:24:16.960] Professor Mina Fazel: Well, it’s no surprise, is it, that they are accessed? But I suppose I share Emma’s comment that, actually, we were surprised at how many of them said that. So, it’s a really good reminder to those of us in services that actually, we can’t ignore this massive thing that’s happening by a lot of people. And actually, many friends might be feeling that they are not able to help their friends the way they want to. So there are difficulties there, aren’t there? You don’t want a friend to feel that they’re responsible for someone who turns to them at a time of need, but you also don’t want them to turn their back on them or – you know, there are important roles that these what we call informal sources of support play. So, number one, they’re being accessed, that’s probably why they’re friends, so, they’re turned on at times of need.

So, we also asked another question this year for the first time, where we asked, where do they want to get help? So, one of our Commissioners said that – asked us to add that question in. So, they said, “Can you ask people where they want to access help? Do they want to access it at school or in formal services or in the community or at home?” And actually, looking at that data, I was quite surprised at how many young people say they actually would like to get support in their homes. Now, this is not something that services are doing very well right now, because well, it’s very, very resource intense to do that. But actually we need to also start to think about, well, what does that actually mean? And it could be that when we’re learning how best to work with friends and family, that actually we need to understand that we need to potentially be bringing more support into homes.

And like Simon did mention, this isn’t about online access at home, that you’re sitting at home on a computer. It’s actually about someone in-person coming. So, I’m particularly curious about that now. Like, how do we support? You know, it can’t be to be a Therapist, necessarily, that’s not fair or correct, but it might be about understanding the role of active listening or understanding the role of how to signpost to the support. Given that there are so many different types of support out there, how do we then work out which one is best suited to that person in front of us?

[00:26:27.890] Clara Faria: And the findings also showed that many young people look for mental health support at school. In your opinion, Emma, and I know you’ve done amazing work during your PhD in this subject, how can we partner with schools to better support young people’s mental health?

[00:26:42.090] Dr. Emma Soneson: That’s a great question. For me, one thing that’s always been really clear, not just since I’ve been in research, but since I was in school myself, is that schools are a key setting for accessing mental health support. So, school staff are some of our best partners for promoting and protecting youth mental health on that population level I was talking about before. And so, to me, it was really unsurprising, actually, that they were so central in these networks of care. However, I think we need to be really careful as well that we’re not overburdening an already stretched education system. So, really, it’s about ensuring that we are sharing with schools and not task shifting and expecting them to take on this entire role by themselves.

We’ve actually just written an article in the International Journal of Environmental and Public Health Research, called “Partnerships at the Interface,” which talks about a few ways that mental health professionals and schools can actually work together to support youth mental health. So, this might look like mental health professionals providing training for school staff to identify and support students who have mental health needs or providing liaison services to support staff in this caring pastoral role. And I think as the policy focus on these cross-sector partnerships increases, that we’ll be seeing many more innovative ways over the coming years of joint working.

[00:28:03.679] Clara Faria: Amazing. As a closing question, looking to the future, could you share a bit more about your plans for the next OxWell waves?

[00:28:10.769] Dr. Simon White: So, I think one of the interesting challenges of taking particularly this idea of our networks of care and understanding these patterns, is when we try to consider changes across waves. So, we’re not linking individuals between waves. So, that’s not how the OxWell Survey is set up, but we’ll have these patterns now, so what does a change in pattern look like in the future? What would be an appropriate way to make that comparison? Because these networks are already a slightly complicated multivariate, you know, multifaceted view of the problem that we’re trying to understand. So what would a change look like? I think, really, I just got lots of interesting research questions and they mostly boil down to, what is our question?

[00:28:55.830] Professor Mina Fazel: Looking to the future, well, the plans are really first, with the current wave, to make sure that as many people as possible could access the data. So, I’m really – feel very strongly about us not wasting time, not collecting redundant information, that other people don’t collect exactly the same information that actually has already been gathered. So a big bit of it is learning about how to gather information and make it available so that as many partners as possible can look at it, be that in research, be that in services, be that in schools, be that in charities, and then knocking on our door the whole time now to start to look at it. And so, I think I want to improve those processes.

So, hopefully, the next OxWell wave, which will – I’m planning to be in 2025, in two years, dependent on getting some funding for it, but that’s just down to me to get my act together with that. But actually, that we are in a really good place where we can ensure that the information is heard in the right places, ‘cause that’s why the kids are filling it out and they’re incredibly generous in their time in filling out the survey. So, it’s making best use of that.

[00:30:03.120] Dr. Emma Soneson: My answer is quite similar to Mina’s, as well, because for me, the next steps are definitely about implementation. You know, there’s so much that we still have to learn about the help-seeking preferences and experiences of children and adolescents. But I do think these networks provide a really solid foundation that we can use to start to make real changes in the ways that we support youth mental health. So, for me, in the coming months and years, I’m really looking forward to really getting the word out there about what young people want, what young people need, in terms of their mental health support, but also empowering those around them to actually provide that support in some of the ways that we’ve discussed throughout this podcast. So, it’s a big task, but it’s one that needs urgent attention and action if we want to make real change in this field.

[00:30:51.660] Clara Faria: Brilliant. Thank you all so much for your time today, and for more details on Professor Mina Fazel, Dr. Emma Soneson and Dr. Simon White, please visit the OxWell and ACAMH websites, acamh.org and oxwell.org. We also have a Twitter @acamh, ACAMH is spelled A-C-A-M-H. Do keep an eye out for other podcasts and the insight from the OxWell Student Survey series, including episodes on friendship, self-harm, sleep, and more. And don’t forget to follow us on your preferred streaming platform, let us know if you enjoyed the podcast, with a rating or review, and do share with your friends and colleagues.