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PROJECT APPROACH The C-STACS project will bring citizen science approaches to mental health. CHALLENGE: CITIZEN SCIENCE IS NEW TO MENTAL HEALTH Citizen science approaches have not yet been used at scale in mental health. We reviewed citizen science platforms. UK-based Zooniverse has no active, paused or finished mental health-related projects. EU-based eu-citizen.science has one project (CoAct) which includes mental health as one of several global concerns being addressed. USA-based scistarter.org has one project (neureka) using gamification for dementia research. The citizen science projects related to health which do exist typically involve biological and physical health research (e.g. www.cellslider.net, 100forParkinsons App, Colony B App). A more general internet search for citizen science and mental health identifies a few specific studies, e.g. the Emotional Brain Study addressing neuropsychological aspects of mental health and the MH2K Oldham project involving a youth-led approach to mental health, both in the UK, and the Games X Mental Health study exploring interactions between people with mental health problems and their informal carers in Spain. Two citizen science projects have taken place in the UK in relation to the overlapping area of wellbeing: the Secrets of Happiness study which ran in 2018 and has not published results, and the Great British Wellbeing Survey running in 2020. In relation to new projects, no mental health studies were funded as a UKRI Citizen Science Exploration Grant. Turning to publications, again very little has been written about citizen science and mental health. The 2020 ECSA report on characteristics of citizen science provides a useful foundation but no mental health specific guidance. A 2020 overview report by RAND Europe on emerging developments in citizen science identified the potential for new types of health research, such as personal health tracking / n-of-1 studies, but with no mention of mental health. A 2018 paper (https://doi.org/10.1093/heapro/daw086) on citizen science applied to public health provides a useful typology of project characteristics: Aims (investigation, education, collective good, action), Approaches (extreme, participatory science, distributed intelligence, crowd sourcing) and Size (local, mass). Our project will be mass participatory science, with aims of collective good (WP2) and action (WP3). Other papers have used citizen science in cognate areas, e.g. urban stress (https://doi.org/10.1057/s41599-020-0460-1). A 2019 position paper locates citizen science in relation to health research (https://doi.org/10.1080/15265161.2019.1619859), noting the connection with participatory action research and community-based participatory research traditions, and identifies community-driven 'n-of-we' studies which align with the current proposal. The paper also discusses general ethical issues of citizen science in health research, including consent, participation risks/benefits, data ownership and attribution, which have informed the WP1 focus on these issues. Finally, a search of the 'Citizen Science' journal identified one paper (https://doi.org/10.5334/cstp.184) discussing patient partners in health research. WORK PACKAGES (WPs) WP1 develops a theoretical foundation for citizen science in mental health, and prepares for WP2 and WP3. Mental health has a very established tradition of public involvement, coproduction and peer-led research, and mapping between mental health and citizen science constructs will be a key project output. WPs 2 and 3 address specific challenges outlined in the case for support, using Zooniverse as an online platform to support mass participation. WP2 creates new knowledge about supporting mental health recovery and WP3 about how people living with mental health problems actually look after themselves. WP4 mobilises the findings from WPs 1 to 3 to maximise impact.

We will work with young people to use digital technology to transform adolescent mental health and provide a safe, and supportive, digital environment to tackle the unmet need arising from mental health disorders in those aged 10-24 years old. We are facing a youth mental health crisis; in the UK, one in eight young people have a mental health disorder, and one in four young women aged 17-19 have significant depression or anxiety with half of those having self-harmed; non-suicidal self-harm has nearly tripled over the past 10 years, while suicide rates per 100,000 adolescents have almost doubled. However, less than a third of all young people with mental health disorders receive any treatment. Many mental health and wellbeing apps exist, but most have no evidence base and some could even be harmful. Meanwhile, few research-based digital interventions have been shown to have impact in the real world. The youth mental health crisis has coincided with huge changes in society with creation of the 'digital environment' where being online and using social media has become central to young people's lives. While social media can be a helpful place for accessing information, exchanging views and receiving support, it has also been linked with depression, suicide and self-harm. Yet not all young people are at risk of mental health problems with social media we don't yet understand why some young people are more vulnerable than others. The COVID-19 crisis has been associated with increased mental health problems and greater online activity in young people. While their need to access trusted support online is greater than ever, social media platforms are not designed to meet mental health needs of young people. Aims & objectives. We will work with young people in our Young Person Advisory Group to: 1. increase understanding of the relationship between digital risk, resilience and adolescent mental health. 2. develop and evaluate preventative and personalised digital interventions. We aim to: - identify risk and resilience factors related to troublesome online experiences and activities, to prevent or reduce the emergence of depression, anxiety, and self-harm in young people. - understand how individual differences affect digital engagement (e.g. with social media and games) and adolescent brain and psychosocial development. - build, adapt and pilot new a generation of personalised and adaptive digital interventions incorporating a mechanistic understanding of human support with a new digital platform for delivery and trials in adolescent mental health conditions. - develop and test a novel socially assistive robot to help regulate difficult emotions with a focus on adolescents who self-harm. - develop and test a new digital tool to help adolescents better manage impulsive and risky behaviour with a focus on reducing the risk of self-harm. Applications & benefits. This work will translate new knowledge into practical tools to support young people negotiate the digital world, develop resilience and protect their mental health. Our involvement of young people means that the outputs from the research will be suitable and meaningful. Young people will be actively involved shaping the research at all stages. Young people, their caregivers, teachers, clinicians and charities will benefit from a range of co-created apps and tools to manage youth mental health issues. Young people will benefit from research training offered as part of their involvement. Policy makers and academics will benefit from new understandings of risk and resilience in the digital world to support novel interventions and evidence-based policy. Our work will establish a new, ethical and responsible way of designing digital platforms and tools that supports young people's mental health. Our Mental Health & Digital Technology Policy Liaison Group and Partners Board will translate our research into a step-change in mental health outcomes.