University of Bradford MHLA

Bradford, the 7th largest city in England, has a diverse population with a range of socioeconomic profiles.

It includes some of the most affluent wards outside of London, and highly deprived neighbourhoods (with 51.7% of children living in absolute poverty) ?(1?). There are a high proportion of ethnic minority groups, including South Asian and Eastern European heritages.

Bradford therefore offers a unique opportunity to conduct research on the impact of social and cultural factors on mental health in under-represented communities. This will facilitate the development of evidence-based approaches to reducing inequalities.

A report by City of Bradford Metropolitan District Council (CBMDC) highlighted that CYP mental health challenges were increasingly prevalent ?(2)?.

Bradford has one of the youngest populations in the country with approximately 1/3 of the population under the age of 20-years, thus urgently investing in CYP mental health is paramount to improve life chances.

This is reflected in local data which estimates that >18,000 CYP in the district have an undiagnosed mental health disorder.

Similarly, approximately 15% have clinical or borderline anxiety and depression, which is considerably higher than the national average (2). Inequalities play a major role in this, with higher prevalence rates in more deprived areas ?(2)?.

Working with local co-production groups in a scoping study for this application, it was evident that there is a need to focus on upstream determinants of mental health, including physical activity, sleep, and eating.

Furthermore, there is increasing concern around difficulties accessing diagnosis and support for children with neurodevelopmental delays, which impact mental health (including those with diagnoses and those below diagnostic thresholds but would benefit from additional support). There are >50 different services supporting CYP mental health in Bradford.

Although work is underway to try to integrate these services, there remains a lack of cohesion, which exacerbates barriers to accessing services, particularly for the most disadvantaged.

Co-production groups emphasised the need for a whole-system approach to increase awareness and reduce stigma around mental health challenges.

Specifically, there was a desire to move support out of traditional healthcare settings (for which there is widespread distrust) towards a more community approach.

Despite these challenges, there is excellent research infrastructure in the city that could be mobilised to address these challenges.

Specifically, epidemiological and public health research is strong through Born in Bradford (BiB) ?(3)?, one of the world s largest birth cohort studies.

There is a history of embedding research into practice within the district, for example with existing close ties between the Public Health team, and Health Determinants Research Collaborative in CBMDC alongside local academic organisations, and the Centre for Applied Education Research (CAER) ?(4)?, which is leading the way for understanding health barriers to education.

Existing relationships within this infrastructure will be leveraged to ensure the development of an innovative Mental Health Research Group that fosters synergistic cross-institutional collaboration. BiB and CAER research highlight a need for increased mental health research focused on CYP ?(5)?.

BiB started to address the lack of research in adolescents through the Wellcome-funded Age of Wonder study and the NIHR PGfAR.

Data collected from these programmes have shown alarming trends of CYP mental health challenges and a critical need to take a population health, preventative approach, targeting early childhood when intervention is most effective. However, research on early childhood mental health is lacking. To date, BiB and CAER have outsourced expertise in mental health to York (UoY), Bristol, Liverpool and Sheffield.

The MHLA would enable UoB to build capacity and capability to meaningfully contri