CHOOSE

Funded by SPCR
Led by Dr Pearl Mok, Greater Manchester Safety Centre, University of Manchester

This research aims to:

1. Look at how many children and young people in the UK have been diagnosed with a psychiatric disorder or have self-harm recorded in their GP records, comparing the periods before and during the Covid-19 pandemic. Specifically we will look at diagnoses of depression, anxiety disorders, eating disorders, attention-deficit/hyperactivity disorder, and autism spectrum disorder. We will also look at prescriptions offered in GP practices for medications used to treat mental health conditions, and how many children and young people have been referred to mental health services by their GPs.
2. Work with children and young people, parents and other key partners to develop recommendations for GPs, other healthcare services, social services, schools and colleges, on how to help children and young people with their mental health difficulties.

We are working closely with the McPin Foundation, mental health charity, who are supporting the PPIE in this study.

We are working with:

• Young people who have had experience of mental health problems.
• Parents/family carers who have had experience of supporting a young person with mental health problems.
• Healthcare and educational professionals, including GPs, working with children and young people.

Lead researcher in the CHOOSE team, Pearl Mok, alongside researcher Alex Trafford, presented the aims and findings from the study.

Tom Bailey illustrated the webinar which was co-chaired by Professor Carolyn Chew-Graham, an academic GP, and Lauren Beaver, a key member of the CHOOSE young persons, carers and family advisory group. Lauren outlined the vital role that the group had played in the CHOOSE study.

Initial reductions in all diagnoses were seen at the onset of COVID-19 restrictions.

Reasons for these reductions were thought to be related to the public health messages to ‘stay at home’ and the request to ‘protect the NHS’. Whilst it is an important finding, such reductions have also been reported before for both mental and physical health diagnoses and in various health settings, including primary care.

With the exceptions of Self-Harm, Eating Disorders and ADHD in females, the number of diagnoses especially for males has largely remained below expected levels in the two years since the pandemic onset. These findings are reported in the study team’s first paper .

Participants in the webinar who contributed through the ‘Q&A’ feature suggested that school might be an important stressor for children and young people, and the reduction in presentations of mental health problems might be due to not being in school, and not being exposed to the stressors they can experience at school.

Professor Ian Kelleher reflected on the findings of the CHOOSE study and asked how we can make school a more supportive place for all children.

Members of the CHOOSE young people’s, family and carers advisory group suggested that gaming may be protective for some boys.

Discussion focussed on why the findings from the CHOOSE study does not fit the narrative of a great increase in mental health problems post-pandemic. Webinar participants suggested that young people may not consult primary care, but seek help from other sources.

The CHOOSE study demonstrated higher frequencies of Eating Disorder diagnoses and Self-Harm episodes among teenage girls during the first two years of the pandemic; this was highlighted by webinar participants as an urgent need for intervention.

Lauren emphasised the vital role that the advisory group had played in the study, and helped interpret the findings. Lauren reminded us that people with lived experience must be reimbursed for their time and input to research – this makes their contribution feel valued, and recognises the opportunity cost for people with lived experience in supporting research teams.

Lauren emphasised the need to ensure that patient advisory groups include people from diverse backgrounds, so that their voices are heard.

Russell Hogarth from the National Forum for Health and Wellbeing congratulated the research team on their study, but also on the close working relationship with McPin.

Professor Mary Cannon  presented her survey of school children which highlighted an increase self-disclosed mental health concerns, particularly in females and young people who identified as non-binary and trans.

The Right Honourable Sir George Howarth, MP, summed up the webinar, emphasising the need for partnership between research teams and people with lived experience. Sir George also identified the need for collaboration between the NHS and the third sector and charities. He also identified novel methods for dissemination of research findings and clinical topics – citing a recent story in Coronation Street. The research team expressed thanks to Sir George for his support for their work. 

More information about the CHOOSE study will be forthcoming in the very near future.

Carolyn Chew-Graham @CizCG