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.

Many people experience adolescent depression. If we can find out who will do this and understand the reasons why, then we will be in a better position to find ways to support them to become more resilient and help them stop developing depression. This is our goal in Regulating Emotions - Strengthening Adolescent Resilience (RE-STAR). To achieve this, we will work with groups of people known already to be likely to develop depression during adolescence - those with high levels of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD); both those with diagnoses and those with high levels of these characteristics with no diagnoses - referred to overall as young people with neuroatypicalities (YPN). In RE-STAR, we will be especially interested in whether YPN who develop depression by late adolescence already show differences in how they react emotionally to challenges they experience in their day-to-day lives in early adolescence. We chose this focus because we know that YPN often have difficulties controlling their emotions when facing challenges and because emotional problems in early adolescence can lead to adolescent depression in other groups. In RE-STAR, different experts will work together in a team including scientists, artists, teachers and doctors. They will work with YPN themselves who will be part of our Youth Researcher Panel. RE-STAR will place YPN's views, based on their day-to-day experiences, at the heart of its work to make sure it has an authentic view of the emotional challenges YPN face. We will learn about these experiences by listening to YPN discuss them but also through their performance in plays, dance and creative writing. This will then guide our search for the underlying reasons why YPN have difficulties controlling their emotions and how these change during adolescence and if - and how - they become linked to depression. RE-STAR will focus on YPN's experiences at school. This is because YPN face some of their most significant emotional challenges there. At the same time, school offers a great place to work with YPN to help them to deal with these challenges more effectively. Crucially, YPN will be involved in RE-STAR throughout. Our Youth Researcher Panel members will be actively engaged in shaping the research questions, designing the studies, collecting data and interpreting findings in the light of their experiences. They will also fully contribute to the co-development of our new approach to helping YPN handle emotional challenges better to stop them developing depression. RE-STAR will have 6 work packages (WPs). In WP1 we will work with YPN to develop a new way of measuring emotion regulation difficulties - the Emotion Regulation in Neurodiversity Index (ERNI) - based on YPN's own accounts of their experiences. In WP2, based on this new understanding, we will conduct experiments to explore how YPN's difficulties in emotion regulation are linked to differences in their minds, brains and bodies. This will be followed in WP3 by a study of the way emotion regulation abilities change during adolescence and how this becomes linked to the experience of depression - especially when individuals are faced with daily hassles and stressors. In WP4 we will use creative performance-based practices to delve deeper into YPN's understanding of their experiences and how this impacts, and is impacted by, emotion regulation and mental health. WP5 will focus on the school as a context for YPN's emotion regulation challenges to build a platform for effective intervention. Finally, in WP6 the key findings from the prior WPs will be brought together to shape the new school-based strategy to improve YPN's ability to handle emotional challenges and provide them with skills to help them reduce depression. Throughout RE-STAR we will ask how people with ADHD and ASD are similar and/or different from one another and whether they need different sorts of support with emotion regulation.