Young Healthy Minds aims to identify the risk factors and early signs of severe mental illness and is generously supported by a legacy donation from Mary Downing.

Background

In the 1990s, researchers developed criteria to identify individuals who are at risk of developing psychosis - a so-called 'high-risk mental state'. Since then criteria were developed to identify individuals who are at risk of developing bipolar disorder and other mental health conditions. The ultimate objective of these criteria was to try and identify individuals before they became severely unwell, so as to offer them early intervention and support.

There are several reasons to believe that early intervention may be beneficial for people suffering with mental health problems. Firstly, young people often seek help before they meet traditional criteria for diagnoses, suggesting that there is a need for early-intervention services. Additionally, these early intervention services are often beneficial, improving treatment outcomes for early-phase psychosis and bi-polar disorder. Collectively, this suggests that we should try to identify individuals who are at risk of developing severe mental illness before they meet full diagnostic criteria and offer them support. This would hopefully improve treatment outcomes and prevent the associated suffering that comes with the onset of symptoms.

Additionally, it may be sensible to look at early risk factors for several mental health conditions, all in one study; this is because mental health conditions often co-occur. Furthermore, there is significant symptom overlap, which might suggest shared risk factors. In fact, recent theories suggest there might a 'pluripotential' at-risk state (that is, a single high-risk state that confers a risk of developing a range of severe disorders).

Objectives

Building on previous research, we have a list of things that we think are risk factors for developing mental health problems. Our aim is to pull all of these risk factors together (from across many different research studies) to see if the combination of these risk factors can predict who is more likely to struggle with their mental health in the future. Develop an algorithm that predicts mental health problems.
We also hope to develop a longitudinal cohort of participants. By creating a cohort of participants that we can follow up and invite to future studies, we can investigate follow-up hypotheses, replicate findings, and solidify our knowledge of mental health. Create a cohort to research mental health problems.
Ultimately, a future aim is to develop better prediction protocols for identifying targets for mental health intervention. Improve mental health interventions.

What does this research involve?

The Young Healthy Minds Project will be a series of studies investigating risk factors for severe mental illness in the general population.

For our first study, we plan to recruit 600-1,000 students. We are looking to recruit both individuals who feel mentally well and those who do not. You do not need any special qualities or characteristics to take part. You can still take part if you are experiencing mental health issues. The only exclusion criteria are:

1) People younger than 18 or older than 35 at the start of the study (this is to align with NHS early intervention services)

2) Anybody who is not a student at either Sheffield University or Sheffield Hallam (for practical purposes).

3) Anybody who is not a first year or foundation student (for practical purposes).

See the figure opposite for the planned timeline of the study and what is involved. We will reimburse participants for their time and effort with a £10 Love2Shop voucher for each of the three instalments of the project and a £15 Love2Shop voucher if invited for an online interview.

What are the mental health disorders researched in this study?

Mental health disorders are frameworks for understanding patterns of symptoms that often co-occur. However, mental health disorders do not form perfect categories. An individual might have symptoms of multiple disorders. Similarly, a few symptoms, or problems, do not necessarily mean a person has a mental health disorder. Nonetheless, for practical reasons, thinking about mental health in terms of diagnoses can be useful. These frameworks can help professionals and individuals make sense of complex emotional and behavioural needs. This project seeks to understand the risk factors and early indicators of four disorders. We have chosen to investigate three of these disorders as they are the conditions that have been researched the most, in terms of risk factors and early signs and symptoms (schizophrenia, bipolar disorder and major depression). We know less about borderline personality disorder and want to compile the little research there is. Although these are the four conditions we've chosen, we recognise that there are other severe mental health problems which lie beyond the scope of this study, which may cause individuals considerable distress.

The four disorders we wish to understand better are:

Bipolar disorder

Bipolar disorder is characterised by extreme mood swings, swinging between high-energy ‘manic’ episodes and low-energy ‘depressive’ episodes. During manic episodes, individuals may feel overly confident, impulsive, and reckless. During depressive episodes, they may feel hopeless, tired, and lose interest in activities they used to enjoy. These mood changes aren’t just typical ups and downs, they can be intense, affecting work, relationships, and overall well-being.

Schizophrenia / psychosis

Schizophrenia is a complex mental disorder that affects how a person thinks, feels, and behaves. People may experience 'negative symptoms' (a reduction in normal processes) like reduced motivation or difficulties in thinking clearly. People with schizophrenia may also experience 'positive symptoms' (the addition of unusual experiences), like hallucinations (e.g., hearing or seeing things that aren’t there) or delusions (believing things that most people would deem extreme, bizarre and untrue).

Borderline personality disorder

Borderline personality disorder is marked by intense emotions, intense and unstable relationships and an unstable self-image. People with borderline personality disorder often feel deeply insecure or abandoned and might react strongly to stress. This can lead to impulsive actions, such as risky behaviour or self-harm.

Major depression

Depression is a common mental health disorder that affects how a person feels and thinks. Unlike occasional sadness, depression causes persistent feelings of emptiness, hopelessness, or numbness that last for weeks or longer. People with depression may lose interest in activities they once enjoyed, experience fatigue, and have trouble sleeping, eating or concentrating.

What does it mean to be 'high risk' for mental health problems?

Being 'high risk' for mental health problems means that certain factors in a person’s life might make them more likely to develop a mental health condition. There are many risk factors and these include things like early childhood experiences, personality traits, coping mechanisms, lifestyle habits, physical health and genetics. Most of us will meet criteria for a few of these risk factors, which is nothing to worry about. However, when someone meets criteria for many risk factors, their risk of developing mental health issues may be higher than average.

Being 'high risk' doesn’t necessarily mean that someone will definitely develop a mental health problem, but rather it might be a sign that a bit of extra support or attention to mental health could make a positive difference. An analogy might be having high blood pressure. High blood pressure in itself is harmless. However, if untreated it might lead to more serious health problems. So people tend to keep an eye on it, to make sure it doesn't creep up too high and cause issues. The same analogy might apply here, there's nothing wrong with meeting high-risk criteria per se, but it might be worth keeping an eye on your mental health, in case things worsen in the future.

If I am identified as 'high risk' will you offer me help and support?

We do not categorise participants as 'high risk' or 'low risk'. We look at the combination of traits and experiences and assess whether they seem to predict mental illness. This means that we focus on evaluating the predictors, not individual participants.

A future goal of our research is to help secure help and support for people who are both high-risk for mental health problems and currently in distress. We believe early intervention is beneficial and health care practitioners should not wait for a person to meet diagnostic criteria if a person is already distressed and struggling with their mental health. However, in order to do this, we have to make an argument that early intervention is important. If we can better understand how traits and experiences interact and lead to mental-health problems, we can make an argument to the NHS, policy makers and other stake holders that intervention should be taken when a person is in distress, even if they do not meet diagnostic criteria for a disorder.

How can I look after my mental health?

We should all actively try to look after our mental health just as much as we do our physical health, regardless of whether we have mental-health issues or not, or whether we believe we are 'high-risk' for future mental-health issues or not. This isn't always easy and when we're not feeling great, it can be difficult to look after our wellbeing. That's why it's all the more important to try and engage in positive practices when we are feeling well, or when we experience the first signs of poor mental health. For ideas on how to boost wellbeing, see the resources below.

Student Minds has great information and advice, including identifying when help is needed.
The NHS outline 5 steps to wellbeing here
The National institute of Health has information on health-promoting activities here.
Mentalhealth.org has great research-backed tips and advice available here

Where can I find help?

Contact your GP if you are struggling with your mental health.
If you are in extreme distress and need urgent support call the NHS's urgent mental health helpline on 111

Other sources of support:

Explore the mental health resources on the Mind website
Call 116 123 to talk to the Samaritans, for a listening service
Text the Shout Crisis Text Line
Contact Togetherall, an anonymous digital mental health support service open 24/7

Further information and how to take part

We are recruiting foundation or first-year undergraduates from the University of Sheffield or Sheffield Hallam University.

You must be aged 18-35 at the start of the study to take part.

If you are interested in taking part in this research, please see the information sheet here

If you have read the information sheet and would like to take part, you can follow this link.

If you would like further details about this project, please contact Jayne Pickering on yhm.research@sheffield.ac.uk

Meet the research team

Professor Richard Bentall

Richard is the lead researcher for the Young Healthy Minds project. He is a trained clinical psychologist and professor at Sheffield University and has had a long distinguished career, primarily focused on better understanding psychosis, bipolar disorder and at-risk mental states. He has written several books for the interested nonexpert, including Madness Explained and Doctoring the Mind.

Dr Jayne Pickering

Jayne is a Research Associate at Sheffield University and is responsible for the day-to-day project management of Young Healthy Minds. Her PhD research focused on the effect of pain on cognition but after working as a support worker with young people from the care system, she became interested in mental health treatments and preventions.

Professor Scott Weich

Scott is an Honorary Consultant in the North Recovery Team for Sheffield NHS. He is a Psychiatrist and professor at Sheffield University. Scott has broad interests including epidemiology (distribution and causes of mental disorders), positive mental wellbeing and the role of socio-economic status, ethnicity and gender within mental health.

Dr Caroline Dalton

Caroline is an Associate Professor of Neuroscience and Genetics at Sheffield Hallam University. Her research interests include the molecular mechanisms underlying schizophrenia, the effect of drugs on epigenetic markers and physical activity as a therapy.

Professor Markus Reuber

Markus is a Professor of Clinical Neurology at The University of Sheffield and an Honorary Consultant Neurologist at Sheffield Teaching Hospitals. Markus's research focuses on the management and diagnosis of seizure disorders and communication between patients and health professionals. Markus has pioneered the use of Conversation Analysis as a diagnostic method in neurology.

Dr Chris Taylor

Chris is a consultant clinical psychologist and a senior lecturer in psychology at the University of Sheffield. Chris is particularly interested in understanding and developing new psychological therapies for people with severe mental health experiences, including psychosis, with a focus on schemas and mental imagery.

Dr Myles Jones

Myles is a Senior Lecturer and cognitive neuroscientist at Sheffield University. Myles has expertise in functional magnetic imaging (fMRI) and electroencephalogram (EEG) and genetic research. He is particularly interested in individual differences and the effect that different neurodevelopmental conditions may have on psychophysical task performance.

Dr Jessica Kingston

Jessica is a Senior Lecturer in Clinical Psychology at Royal Holloway University of London. She is primarily interested in investigating the application of mindfulness, acceptance, and values-based psychological interventions for mental health difficulties. This includes the full spectrum of mild non-clinical experiences to severe and enduring mental health difficulties. Jess has a specific interest in understanding and treating symptoms of psychosis and examining the use of Acceptance and Commitment Therapy for enduring conditions.

Chris Gibbs

Chris is a research involvement manager at CNTW NHS Trust. He's also a visiting scholar at Northumbria University and an expert in public and patient involvement and engagement within mental health research. He works as a research involvement manager for Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust

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