Currently in the UK, it is estimated that over 2.5 million of neurodiverse adults have not received a diagnosis and therefore struggle to access care. The most common neurodevelopmental conditions, attention deficit hyperactivity disorder (ADHD) and autism (ASD), affect 5% and 1% of children and adults in the UK - on average one child per classroom. Nowadays, the understanding of autism and ADHD has greatly increase. However, a lot of adults and children have not received a diagnosis. Within the UK healthcare system, without a diagnosis, these patients cannot access the care they need. Having ADHD or autism often negatively impacts many aspects of life such as employment, relationship, or school. Studies have shown that adults with undiagnosed and untreated ASD/ADHD are more likely to have educational problems, mental health issues, depression and anxiety, are more likely to commit crimes and abuse substances, are more likely to divorce, be unemployed or commit suicide. These aspects are worse when ASD/ADHD is not diagnosed but can be reduced with early identification and effective support. Diagnosing ASD/ADHD as early as possible is of utmost importance in reducing some of these long terms risks for adults living with these conditions. Recent governmental reports have highlighted the importance of having access to diagnosis and care for these conditions. In order to successfully address these priorities, it is important that research first identifies the costs of living with undiagnosed ASD/ADHD. Previous studies which have looked into the cost and impact of undiagnosed mental health on the individuals, society and economy have shown that the cost of not diagnosing and treating mental health issues was higher than the cost of running services for these issues. This led to the creation of a national NHS service (IAPT), a service helping adults with mental health issues. No research to date has been done on the cost of undiagnosed ASD/ADHD. This new study will highlight the economic and societal cost of undiagnosed ASD/ADHD in order to give policy makers and healthcare providers the necessary information to justify funding appropriate services. Most specifically, the project will answer two questions: 1. What are the long-term risks and impacts (for instance: higher rate of divorce, substance abuse, unemployment) associated with undiagnosed ASD/ADHD? 2. What are the individual, societal and economic costs of these associated risks? To answer these questions, first a literature review of published science articles will summarise the studies which looked into the risks associated with undiagnosed ASD/ADHD. Then I will conduct questionnaires and interviews with adults with ASD/ADHD to see whether the risks highlighted in the literature review reflect real life struggles. These two studies will create a comprehensive summary of the risks associated with undiagnosed ASD/ADHD. Once this summary is completed, an economic evaluation of the costs of these risks will be conducted with undiagnosed adults. In order to understand what these costs mean, they will be compared to three groups, one groups of adults diagnosed with ASD/ADHD in childhood, one group of adults diagnosed in childhood and one group of adults diagnosed in adulthood. This will allow us to establish the true cost of the impact of receiving a diagnosis as early as possible. A group of adults with ASD/ADHD will feedback on all the different tasks of this project to ensure it represents real-life experiences. Many people argue that having conditions such as ASD/ADHD cost a lot more to society than neurotypical individuals (for example, extra support in class). However, this study argues that the cost of not identifying individuals with such difficulties, is likely to cost more in the long term (for example while extra support in class has a cost, school underachievement and unemployment will cost much more to an individual and society in the long run).

The Covid-19 pandemic has had significant adverse effects on university students, whose education and training has been severely disrupted and their social contacts and job prospects lost. Even before the pandemic around of a third of students would had had symptoms of depression, with students who are economically disadvantaged at greatest risk. Depressed students do less well academically which has negative impacts on their employment prospects and they are also less likely to follow health advice. Thus depressed students are particularly vulnerable to the health and economic impacts of the COVID-19 pandemic. This is a particular concern for students in less developed countries such as Zambia where access to mental health services is limited by the lack of resources and by the stigma associated with psychiatric illness. This study aims to address this cycle of disadvantage by providing targeted access to an effective, online treatment programme for depression (moodgym) to a 1000 students who identify themselves as having symptoms of depression. These students will be recruited from universities in Zambia, Malawi and Botswana: all countries identified as eligible for overseas development assistance. Moodgym is based on principles of cognitive behavioural therapy and aims to reduce the risk of depression by helping users to recognize and change those negative thoughts and behaviour patterns which can drive and sustain low mood. The 5 modules are particularly aimed at young people aged 15 to 25 and include exercises, practical assignments and quizzes. This study will investigate whether combining moodgym with a university-wide online COVID-19 prevention programme will improve students' mental health and enhance their ability to withstand the health and economic challenges of COVID-19. The online COVID-19 prevention program, adapted for each local context, will portray health-promotion behaviours such as social distancing and face coverings as a normal part of student life. We will collect feedback data from the prevention programme and survey data before and after the moodgym/ COVID-19 prevention programme intervention to look for improvements in depression, academic performance and COVID prevention behaviours and to check whether benefits are felt equally by men and women. We will also interview participants to try to understand how moodgyam helped them and to explore their feelings about the impact of COVID-19 on their mood and their studies. We also want to find out which factors are associated with improved mental health and academic outcomes so that we can ensure the intervention's sustainability and successful implementation in other less developed countries.

The Neuromod+ network will represent UK research, industry, clinical and patient communities, working together to address the challenge of minimally invasive treatments for brain disorders. Increasingly, people suffer from debilitating and intractable neurological conditions, including neurodegenerative diseases and mental health disorders. Neurotechnology is playing an increasingly important part in solving these problems, leading to recent bioelectronic treatments for depression and dementia. However, the invasiveness of existing approaches limits their overall impact. Neuromod+ will bring together neurotechnology stakeholders to focus on the co-creation of next generation, minimally invasive brain stimulation technologies. The network will focus on transformative research, new collaborations, and facilitating responsible innovation, partnering with bioethicists and policy makers. As broadening the accessibility of brain modification technology my lead to unintended consequences, considering the ethical and societal implications of these technological development is of the utmost importance, and thus we will build in bioethics research as a core network activity. The activities of NEUROMOD+ will have global impact, consolidating the growing role of UK neurotechnology sector.