From adolescence to adulthood: creating a holistic approach to protecting mental health

Using technology to help develop emotional resilience

Ed Watkins, Professor of Experimental and Applied Clinical Psychology at the University of Exeter, leads a pan-European project to help young people learn about their own emotions, develop resilience, and build wellbeing. The MyMoodCoach app was part of the wider ECoWeB project involving 13 universities from eight different countries across Europe, which tests whether technology can help improve young people’s mental health.

MyMoodCoach asked 16 to 22-year-olds to log their mood and emotions each day to give them an overview of their emotional patterns. The app also included strategies to deal with specific issues such as worry and lack of control, with content tailored to the user. The study demonstrated that even very brief use of particular cognitive-behavioural strategies on a mobile app helped to stave off increasing depression over three months for young people who were at higher risk for anxiety and depression.

Creating a blueprint of best practice for universities

For young people who do go onto higher education and university after leaving school, this is a crucial time for promoting improved wellbeing and mental health.

Professor Watkins said: “Going to university is a big transition, and we know that a lot of students have elevated levels of anxiety and depression. We’re trying to bridge the gap between what students require to address these issues and what’s currently available to support them at university.”

Professor Watkins is a leading expert on improving mental health in young people and has worked extensively on the treatment and prevention of depression, anxiety, and rumination and worry. He is also the Chief Investigator of Nurture-U, a collaborative project led by Exeter and including Cardiff, Oxford, King’s College London, Newcastle, and Southampton, which aims to create the blueprint for improving the mental health and wellbeing of students while at university.

In 2020, Universities UK published Stepchange: mentally healthy universities, which is a framework for a ‘whole university approach’ where every aspect of the university works together to facilitate better wellbeing and mental health. Nurture-U aims to understand how universities better implement this approach through their culture, systems, processes, curriculum, and environment – including the ‘Compassionate Campus’, which aims to make campuses more engaging and supportive for students to create a sense of belonging.

Early data from their national survey involving more than 6,000 students has found around 35 percent reported clinical levels of anxiety and depression. Meanwhile, more than 50 per cent reported high levels of loneliness and around a quarter say they don’t have a healthy work-life balance.

The Nurture-U project will make recommendations of best practice for improving student mental health across different stages and domains of the ‘whole university approach’. It will also create a general resilience workbook available to all students, and a prevention app for those who have high levels of worry.

Professor Watkins said: “Between their academic work and paid work to make ends meet, some students don’t have much time for anything else. One of the things we emphasised in the mental health literacy course is a work-life balance and building in recharging activities and recreation. Students who worked through the programme did build up those activities and found their wellbeing improved.”

Training a crucial workforce

The NHS faces a desperate need for therapists to provide vital support and treatments to the national population and this workforce is being trained by Clinical Education Development and Research (CEDAR) at Exeter. CEDAR is an Applied Psychological Practice Centre of Excellence and the largest psychological professionals training provider in the UK.

The growing need for effective interventions to address mental health issues among children and young people is both significant and pressing. Around half of cases start before the age of 15, and three-quarters are established by the age of 25. This age group makes up 45 per cent of the total disease burden, with suicide ranking as the second leading cause of death.

One of CEDAR’s core areas is developing and scaling up the workforce to meet the needs of children and young people with mental health or neurodivergent conditions. Working in the NHS and private practice, CEDAR has already trained thousands of mental health practitioners and psychologists and is also one of the leading contributors nationally to curriculum training, curriculum policy, and influence across children and young people's mental health. In doing so it has supported access to evidence-based treatments for children and young people.

The NHS Long Term Plan has set ambitious goals for expanding mental health services, including 100 per cent access to specialist care for children and young people who need it, and a four-week waiting time target for Child and Adolescent Mental Health Services. To achieve this a significant increase in the mental health workforce is needed, particularly in psychological professions, with proposed expansions ranging from 25 to 50 per cent. This focus on psychological interventions acknowledges their effectiveness as first-line treatments for many common mental disorders.

An example of CEDAR's clinical education leadership evidencing sustained impact, value and reach and transforming student outcomes is the Children’s Wellbeing Practitioner (CWP) curriculum development, training, and role implementation. This training is provided by CEDAR, and staff have been instrumental in the training agenda and development of this new psychological professions role regionally, nationally, and internationally.

CEDAR has provided the intellectual framework and an innovative resource for training programmes that have been adopted nationally by 21 higher education providers, which have collectively trained approximately 2,000 CWPs. Since 2017, we have delivered training to 400 CWPs, receiving excellent feedback from students and stakeholders. Nearly three quarters of the most recent cohort were offered permanent roles on completion of their training, ensuring ongoing access to evidence-based interventions for children and young people with mental health difficulties.