'We want our podcast to take the good data and bridge the gap into practice and clinical work'

How do we sift through fearmongering headlines, look at the evidence and challenge how things are done? Clinical Psychologist Dr Jane Gilmour and Professor Umar Toseeb aim to do this in their new podcast, Mind The Kids – bridging the gap between rigorous research and practical application, and featuring expert discussions on mental health. Here, they look at gaps where psychology could make a difference…

The mental health care gap

Umar: We know that autistic young people currently experience poorer mental health than neurotypical people, and so dedicating an episode to why this is the case feels important. In my work, I spend a lot of time thinking about how the experiences of friendship, family and school may be different for autistic children, and why these kids have a poorer time. We know that they will experience distress in a way that neurotypical people won't because of the way the world operates.

Jane: On top of this, Russell's 2021 paper indicated the number of people diagnosed with autism has gone up by 800 per cent in the past 20 years, so it was great to talk to Dr Miriam Martini from the Karolinska Institute on the show. Her research confirms, using whole population patterns rather than a pre-determined group, that young people with a neurodevelopmental diagnosis, especially women, often have multiple mental diagnoses. 

In the research space, we can be guilty of looking at individual labels and sticking quite rigidly to them rather than supporting the person as a whole. Miriam's study confirmed that neurodiversity often gets overlooked in mental health care. We still don't know the best way to bring all the best support together. Young women in particular are often seen in services on several different occasions with other co-occurrences before autism is diagnosed.

Bridging the gap

Jane: We need to ask what impact one diagnosis has over another. We know autistic girls may camouflage to try and "fit in" with their peers, or, as researcher Laura Hill describes, "putting on my best normal". I often work in a different way with young autistic people in the clinic using techniques that are adapted to that group, so it's important, as we discussed with Miriam, to screen for autism as soon as young people come into services. That way, provision could potentially be tailored to an individual's needs sooner.

Umar: We need to recognise that diagnostic labels do not give us the full picture of what the young person is experiencing. Some of my own work shows that diagnostic labels only partly capture the difficulties that children and young people experience. Two young people can have the same diagnostic label and have a different set of strengths and challenges. So it's important for us to look beyond diagnostic labels and move towards a transdiagnostic approach. One which is needs-based, focusing support based on specific challenges rather than diagnostic labels.

The friendship gap

Umar: In our episode, Mental health: best mates and classmates, we got an opportunity to look at the connections between peer relationships and emotional wellbeing in young people. We spoke to Dr Tom Wu from UCL, whose research has included a study on interpersonal outcomes (i.e. friendship quality and perceived popularity) and mental health problems during preadolescence. 

We already know that kids who are more popular and have good friendships tend to have better mental health, but, as Tom said, if you already have a child who has a low mood and is withdrawn, then it's conceivable they will have difficulties establishing and building friendships with others. Lower popularity may then contribute to depression and loneliness, which in turn, might make it even harder to make friends – a vicious cycle.

Jane: Holding this in mind, perhaps potentially addressing mental health issues before friendship issues arise could be beneficial. When I see a young person in the clinic, I want to know about their one-to-one friendships, but also their peer group experiences, perhaps with questions such as, "How would your class describe you?" Tom used teachers' data in his study, as they have a unique perspective and insight into kids' group dynamics in situations like play time or drama lessons.

Bridging the gap

Jane: The takeaway from this episode for me is how the education and clinical worlds are connected. In a therapeutic setting, you might be thinking about social skills training, which may involve modelling or testing out how a young person interprets ambiguous social signals and supporting them to use prosocial responses. Schoolteachers also have a valuable place in clinical work. We know that emotional literacy and relationship skills are teachable, and there is some evidence for whole school interventions that support emotional literacy. 

In fact, couldn't evidence-based emotional literacy programmes be given equal billing to the three Rs in the national curriculum? Young people with psychopathology will benefit as will those without, so everyone reaps the rewards.

The content gap

Jane: Nowhere is the generational gap highlighted more than in our phone usage. The potentially harmful content that children and young people can view is often of particular concern, and this has been brought to the mainstream forum by the TV show Adolescence. We dedicated one of our episodes to the manosphere – i.e. the online spaces which can include disturbing misogynistic, anti-feminist content.

Umar: For me, the manosphere episode was shocking and interesting because I'd not even heard of it before. I'd heard of Andrew Tate, but I hadn't realised the extent to which this content was potentially a problem in terms of how much is being consumed, especially for young boys. 

We spoke to Professor Harriet from the University of York, who has been studying prejudice for many years and is currently carrying out research around online misogyny and its impact on young people. Harriet's research found that 76 per cent of secondary school teachers are extremely concerned about the impact the manosphere has on young people. 

She talks about the unique challenges of collecting data in this area. One way is to ask young people to donate their data so that their social media histories – so everything they've viewed on YouTube, what they've engaged with on Reddit, etc., can give researchers an understanding of viewing habits. In this episode, we look at causality and ask about the increased risk of disenfranchised young people who already have poor mental health going down this pathway.

Jane: We also discuss factors such as social isolation and socioeconomic vulnerability – lots of content providers in the manosphere talk about how to get rich. If you are growing up in a place where there's little economic parity, you might feel a sense of injustice, and it may propel some vulnerable boys to explore and go deeper into the manosphere.

Bridging the gap

Jane: It can be tempting, as an adult, if we learn a young person has been viewing worrying content, to get angry and shut them down. But as clinicians, we know it's important not to shame a young person for looking at certain content or to ban their phones – it's more likely to drive them away from you at the very time you need to strengthen your relationship.

As a parent, anxiety and anger is often our first response, especially if something is morally abhorrent to us, but being able to open up conversations and allowing children to express what it means to them, is vital because then we can figure out alternative, less harmful ways of fulfilling what they are searching for.'

Umar: Harriet also discussed developing interventions with pre-existing social media creators. She made the point that academics are not necessarily experts in being interesting, but influencers are. Content on a platform that teenagers trust is more likely to be engaged with.

The cultural gap

Umar: One of the things I've asked nearly all our guests about on the podcast is cultural differences and how these differences have implications for children and young people in terms of research and interventions. It's not a criticism of our academics and researchers, just more of an acknowledgement about the state of the psychology field. I don't believe it's a case of people not wanting to do research that is culturally diverse. 

As researchers, we work within the systems that are available to us, and if you're doing, for example, analysis of existing data sets, you work with the populations that you have access to. There are also challenges around engaging with certain cultural backgrounds and ethnic communities that you might not be aware of. Or you might find it difficult to engage with some communities, and they might have a lack of trust in the research, scientists, etc. So, there are lots of good reasons why people don't do research with diverse cultural groups, but, as a result, the people who could benefit from it are missing out.

Bridging the gap

Umar: I'd like our profession to find a way to move forward because it has a real implication for how we support children and young people. There's a reasonable proportion of the UK population who isn't white British, so how do we then take what we know about children's development and apply it to different cultural contexts if we don't know what works for all children and young people?

The language gap

Jane: There is also, of course, a generational gap when older people try to connect with teenagers, especially over the different language they use. A young person may refer to "my anxiety", whereas an older person will say, "I'm a bit wound up or worried".

There's a significant rise in reported mental health difficulties amongst young people and lots of factors to consider in terms of what is behind this, but there is a narrative in society which means we can all too easily dismiss teenagers. Young people in every generation create their own values, references and language, and this means the older generation may misunderstand or fail to engage with them. (Check out the brilliant linguistics professor on YouTube, Arieh Smith, who gives a lecture to his students in Gen Alpha speak).

Bridging the gap

Jane: 'It's important to respect that young people want to use their own language. I've been told that using uppercase letters or full stops in a text can sound like we're shouting. There's a subtlety to their language that is lost on us unless we are prepared to recognise that we don't know and be curious enough to ask or at least recognise that we don't know.'

The psychology gap

Jane: We need to "de-psychologise" our language to connect with other disciplines more effectively; for example, Harriet Over discussed connecting with influencers to change young people's online experience. This is why we want our podcast to take the good data and bridge the gap into practice and clinical work. 

I was at a party with a bunch of other therapists recently, and instead of saying, "Hi, I haven't seen you for ages", I noticed people say things like, "I'm aware that I haven't seen you for some time now". It may not seem that different, but "therapy speak" distances us from other people. There's something about the language used in each domain that can pull other disciplines apart rather than bring them together.

Umar: I think with the podcast, we were quite mindful about making our language as accessible as possible, not in a condescending way, but remembering that just because we talk about these things all day, every day, there's still a need to be mindful about broadening out our audience without compromising the quality of the data.

Bridging the gap

Jane: We shouldn't be afraid of looking at how we can work across disciplines, and part of that means communicating using language that is accessible to all. We both feel strongly about that. If you understand a topic in real depth, if you're a true expert, you can explain it using plain, simple language, and I think that's one way of allowing collaborations to happen and getting more psychological ideas diffused around communities. We need to be embedded everywhere, not just in a clinical setting.

'Mind the Kids' from the Association of Child and Adolescent Mental Health (ACAMH) is available on YouTube and all major podcast platforms.