FriendCircle

My solution team is part of a lab at the University of Oxford in the department of Child and Adolescent Psychiatry.

Adolescence, spanning ages 10 to 24, is a crucial period of growth and transformation. According to the World Health Organization (WHO), about one in seven adolescents aged 10-19 worldwide suffers from a mental disorder, often going unrecognized and untreated. Depression, anxiety, and behavioural disorders are the most common causes of illness in this age group, with suicide being the fourth leading cause of death among 15-29-year-olds. The prevalence of mental health issues among adolescents has shown concerning trends, particularly during crises like the COVID-19 pandemic, which saw significant increases in depression and anxiety rates, affecting approximately 25% and 20% of youth, respectively (Racine et al., 2021). A cross-sectional survey of over 10,500 adolescents in England (OxWell) found that after age 13, at least 50% reported experiencing a mental health issue.

Adolescents struggling with mental health face stigma, social exclusion, and educational challenges, which may lead to risky behaviours and diminish their prospects for a fulfilling adult life. Some groups of adolescents are more vulnerable to developing mental illness, such as adolescents with a diverse gender identity. In my recent analysis of over 28,000 adolescents using the 2023 wave of OxWell, I found that gender diverse adolescents had lower quality friendships, but reached out to their friends the most for support. I also found that gender diverse adolescents had poorer mental health, greater loneliness, and lower well-being. These findings illustrate the urgent need for tailored mental health interventions that meet the unique needs of adolescents.

Global data on adolescent mental health, however, is limited, especially in low- and middle-income countries. Only about 6.7% of the needed epidemiological data is available, leading to a significant gap in resources for addressing these issues effectively (Erskine et al., 2016). This deficiency highlights the critical need for improved mental health literacy and accessible support systems that leverage peer and community involvement to enhance outcomes.

Factors that influence adolescents’ decisions to seek or avoid mental health help include stigma, limited understanding of mental health, and negative attitudes towards seeking help. Additionally, many prefer self-reliance, often struggling to engage fully in the help-seeking process (Radez et al., 2020).

Friendships play a pivotal role in adolescent lives, often becoming the primary source of social support, surpassing even parents and family. The OxWell survey revealed that adolescents most frequently turn to friends for mental health support. However, less than 50% found this support effective. Addressing this gap by providing adolescents with appropriate mental health literacy and support-seeking guidelines can empower them to better assist each other and reduce the stigma associated with mental illness.

My solution is a friendship intervention in the form of an app that can be accessed by young people globally. It is designed by a multidisciplinary team, including child and adolescent psychiatrists, public health researchers, education researchers and young people themselves. The app is entirely research backed--consisting of research which began specifically on friendship interventions for adolescent mental health in 2021. 

"FriendCircle" is a mobile app designed specifically to improve mental health literacy and friend support skills among adolescents, particularly those with limited access to mental health resources. This app functions as a powerful educational tool, guiding young people on how to effectively recognize and respond to mental distress in themselves and others, while offering suggestions for fostering higher quality friendships.

There are three main objectives of my solution:

• Educate young people on mental health, including gender diversity.
• Equip them with skills to recognize when a friend is in distress and provide help or direct them to an adult.
• Enable effective support mechanisms for themselves and their friends.

Here's how it works:

1. Interactive Lessons: The app delivers comprehensive and engaging multimedia lessons on mental health topics, tailored to be inclusive and sensitive to the needs of all adolescents, including gender diversity and ethnic diversity. These lessons cover a range of issues from general emotional well-being to specific mental health conditions. Adolescent-specific language is used for the lessons on mental health and specific signs to recognize mental-ill health in themselves or a friend are provided. 

2. Scenario-Based Learning: Through realistic scenarios, users learn to recognize signs of distress in their peers and understand appropriate responses and techniques for support. Scenarios range from appropriate support for grief/loss to identifying if a friend may need adult support for an eating disorder. This feature employs research-backed techniques, such as behavioural activation, which can be effectively performed by non-professionals, along with active listening to a friend. It prepares users to intervene effectively in a supportive manner, but also provides scenarios in which they should seek help from an adult.

3. Quizzes and Assessments: After participating in lessons and scenarios, users can take quizzes to assess their understanding and retention. These assessments help reinforce learning and encourage self-reflection on the topics covered.

4. Resource Hub: This section offers direct links to professional mental health resources and organizations, tailored to the user's location and needs. It ensures that users have access to professional help when needed and understands the pathways for accessing such support.

5. Tips for Quality Friendships: FriendCircle includes a dedicated module for fostering high-quality friendships. This module provides research-backed tips and strategies for building and maintaining strong, supportive relationships. It covers topics such as communication, empathy, mutual respect, and trust, all crucial for healthy friendships. It also includes modules for supporting a friend who may change their gender identity, and tips for conflict-resolution in friendships.

Technology Utilized: FriendCircle uses advanced app development frameworks to ensure a seamless and engaging user experience across both iOS and Android platforms. 

FriendCircle is specifically designed for adolescents aged 10 to 24, with a particular focus on those who have limited access to mental health resources. This group includes young people from diverse backgrounds, with an emphasis on inclusivity for gender-diverse adolescents who may face additional challenges related to mental health and social integration.

Target Population Details:

1. Adolescents globally, especially in regions with scarce mental health services: This includes areas where mental health resources are either unavailable or inadequate. Many adolescents in these regions lack basic mental health literacy, which is crucial for recognizing and addressing mental health issues.
2. Gender-diverse adolescents: Research indicates that these individuals often experience higher rates of mental health disorders and social isolation due to stigma and lack of understanding within their peer and support networks.

Current Challenges:

• Limited Access to Mental Health Education: Many adolescents are not taught about mental health in schools or communities, leaving them unprepared to deal with personal or peer-related mental health issues. A scoping and systematic review I conducted and published last year found that most mental health interventions seldom include friends despite adolescents having friends as a primary resource for support (Manchanda, 2023). Further, I found that all interventions were conducted in higher income countries and areas, excluding adolescents from marginalized backgrounds. This app will be able to reach adolescents who may need this support as most as they may come from areas where access to mental health support and education is limited.
• Social Stigma and Isolation: Especially pronounced among gender-diverse youths, stigma can lead to social exclusion, which exacerbates mental health difficulties.
• Inadequate Support Systems: Without knowledge of or access to effective support mechanisms, many adolescents struggle to cope with mental health challenges.

How FriendCircle Addresses These Needs:

1. Enhancing Mental Health Literacy: The app provides educational content that demystifies mental health issues, teaching adolescents about various conditions, their symptoms, and ways to manage them. This knowledge empowers them to take proactive steps in caring for their own mental health and that of others around them.

2. Skills for Recognizing and Addressing Distress: Through scenario-based learning and interactive lessons, FriendCircle trains adolescents to identify signs of mental distress in peers. The app teaches practical, research-backed techniques such as behavioral activation, which adolescents can use to support peers effectively, even without professional intervention.

3. Support for Gender-Diverse Adolescents: Recognizing the unique challenges faced by gender-diverse youths, FriendCircle includes tailored content that addresses these specific needs. This content aims to foster greater understanding and support within peer groups, thereby reducing feelings of isolation and stigma.

4. Building Stronger Social Connections: This app provides structured tips on forming and maintaining quality friendships. This guidance is crucial for creating supportive friendship networks that can offer emotional support and enhance overall well-being.

In conclusion, FriendCircle aims to fill the gap in mental health education and support among adolescents, particularly those who are marginalized or living in areas with limited mental health services. By empowering young people with knowledge and practical skills, the app not only enhances individual lives but also contributes to healthier, more supportive adolescent communities.

My team and I are child and adolescent mental health researchers. My team is multidisciplinary and works directly with young people through consulting with them through an advisory group, and surveying thousands of students on their mental health, support-seeking, friendships, mental health services use, school-based support, and demographic background. We have implemented interventions in the past and are equipped with our research background to disseminate this app.

I have selected the stage above because the idea has been created and wire frames of the app prototype have been designed. It has not been user-tested yet.

I am applying to Solve to overcome financial, legal, and technological barriers for app implementation and to get support for app design.