School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
Institute for Mental Health, University of Birmingham, Birmingham, UK.
BMJ Open. 2024 Feb 29;14(2):e076700. doi: 10.1136/bmjopen-2023-076700.
Mental disorders are prevalent during adolescence. Self-harm and suicide are more common in adolescents with a probable mental disorder, with one in four reporting to have attempted self-harm. Research involving adolescents is, therefore, likely to include participants experiencing mental ill health, even if mental health is not the primary focus. Researchers should adopt procedures and principles that safeguard adolescent mental health in their research practice. Yet there are gaps between theory and practice of research with adolescents in relation to their mental health, and limited guidance is available.We discuss emerging safeguarding dilemmas and procedures in adolescent mental health research. Our experiences of safeguarding adolescent mental health are grounded in the UK National Institute for Health and Care Research-funded SMART Schools Study. Drawing from this secondary school-based study, we focus on how our research team encountered and addressed a high prevalence of participants (aged 12-13 and 14-15 years) reporting thoughts and behaviours related to self-harm or suicide (24% of participants). This included reviewing our existing risk mitigation processes and consulting with several committees including young people with lived experiences of mental health.We present the SMART Schools study safeguarding approach for adolescent mental health. This encompasses key safeguarding principles, study procedures and relevant justifications. We address school and university roles and responsibilities, pupil understanding, and efficient, effective and secure communication pathways. We embed guidance throughout this article for researchers working with adolescents in the context of mental health. Lastly, we present five key recommendations to safeguard the mental health of adolescents participating in research, including (1) appointing a safeguarding lead within the research team; (2) codesigning a bespoke study safeguarding approach; (3) adopting a responsive approach to mental health safeguarding; (4) being transparent about the study mental health safeguarding approach and (5) report the implementation and outcomes of safeguarding approaches.Trial registration number ISRCTN77948572.
精神障碍在青少年中较为普遍。患有精神障碍的青少年更有可能自残和自杀，其中四分之一的人报告曾试图自残。因此，涉及青少年的研究很可能包括经历心理健康问题的参与者，即使心理健康不是主要关注点。研究人员应在研究实践中采用保护青少年心理健康的程序和原则。然而，在涉及青少年心理健康的研究中，理论与实践之间存在差距，并且可用的指导有限。我们讨论了青少年精神健康研究中出现的保护困境和程序。我们在英国国家健康与保健研究所资助的 SMART 学校研究中积累了保护青少年心理健康的经验。从这项基于中学的研究中，我们重点介绍了我们的研究团队如何遇到并解决参与者普遍报告与自残或自杀相关的想法和行为（占参与者的 24%）这一问题，包括审查我们现有的风险缓解流程，并咨询包括有心理健康经历的年轻人在内的几个委员会。我们提出了 SMART 学校研究的青少年心理健康保护方法。这包括关键的保护原则、研究程序和相关理由。我们讨论了学校和大学的角色和责任、学生的理解以及高效、有效和安全的沟通途径。我们在整篇文章中嵌入了针对在心理健康背景下与青少年合作的研究人员的指导。最后，我们提出了五项保护参与研究的青少年心理健康的关键建议，包括（1）在研究团队中任命一名保护负责人；（2）共同设计专门的研究保护方法；（3）对精神健康保护采取响应式方法；（4）对研究精神健康保护方法保持透明；（5）报告保护方法的实施情况和结果。试验注册号 ISRCTN77948572。
