 Treffie is a senior researcher at Madison and she has worked on the children's mental health studies since 2017 and she's going to tell you more about the college studies. Thanks Mari. So I'll be presenting an overview of the mental health of children and young people follow up surveys which is a new and valuable longitudinal resource on children's mental health and I'll be touching on some of the things that Tamsyn talked about in her presentation. So I'll be covering some background to the survey series, the methodology used, briefly talking about the questionnaire content and talking about the series key strengths and I think most importantly what you are all here for, how we can access the data and the published reports. So as Tamsyn mentioned the survey series is funded by the Department of Health and Social Care, the Department for Education and is commissioned by NHS England and we actually work alongside a consortium of experts in the field of child mental health so the universities of Cambridge and Exeter provide expertise in questionnaire content and reporting and the Office for National Statistics provide analytical input and they do the waiting for the survey series. And we've also worked alongside Ethan Mind, Robert Goodman who's responsible for developing the SDQ algorithm. So just looking at the survey timeline here, I know Tamsyn's already mentioned this in her presentation but just touching on this again, the follow up surveys are part of a series of surveys looking at the mental health of children and young people in England with data previously published in 1999, 2004 and the most recent survey in 2017 and these were all national surveys conducted face to face in respondents homes. The 2017 survey which is considered the baseline survey achieved a sample size of over 9,000 children and young people aged between 2 and 19 and in this survey as Tamsyn described, mental disorders were identified using the door bar or the development and wellbeing assessment tool. The door bar uses structured questions which ask about symptoms relevant to each disorder type so that's things like hyperactivity, emotional disorders, behavioural and less common disorders like autism. The 2017 achieved sample of children and young people were then followed up in a series of follow up surveys so the first of these were actually conducted in 2020 and then in 2021 and this data provided an initial insight into the impacts of COVID-19 on mental health of children and young people. The sample were then followed up again in 2022 and more recently earlier this year with these surveys we were able to assess life for children and young people after the pandemic and as Tamsyn has already mentioned a measure of mental health which is the strengths and difficulties questionnaire or SDQ was used in all of these follow up surveys including the baseline survey and this provided a consistent and robust measure of assessing mental disorders in the population. I'll talk about the SDQ in the next slide and as Tamsyn has already mentioned it's worth noting that each year the children and young people in our sample have got an older so some of the age groups analysed across the published reports are different so for example in 2022 we looked at 70-10 year olds and as this cohort has got an older by year this year in the 2023 report we'll be looking at 8-10 year olds. So just briefly mentioning the SDQ again so the SDQ was our main measure of mental health across the follow up surveys it's a brief behavioural and emotional screening questionnaire containing 25 items on the child and young persons strengths and difficulties with peer relationships, emotions, behaviours and hyperactivity and parents in our sample were asked to complete the SDQ about their child children aged between 11 and 16 were self-reporting as were young adults and as Tamsyn mentioned there was also an impact supplement that was asked in addition to the 25 items and this asked the respondent whether they think their child or themselves has a problem and if so inquires further about this problem on different elements such as distress, social impairment and burden to others of that problem The SDQ algorithm combines responses from the parents, the children and young people on symptoms and impact and depending on the scoring it then estimates how likely a child or young person has a possible or probable mental disorder and all the estimates we present in our published reports are based on this algorithm and this distinction and you can find more information about the SDQ questions and also the scoring system and algorithm in the technical report which is linked on the slide so if we now briefly touch on the sample design so to ensure representativeness the baseline sample so that's the 2017 sample was drawn from the NHS patient register held by NHS England so all participants in the 2017 survey who agreed to be recontacted for future research during their interviews and who continued to agree to be recontacted during the follow-up surveys were invited to take part so moving on to data collection so one of the key strengths of our survey design is that it uses a multi-informant approach drawing on three potential sources of information in assessing mental health rather than just relying on one self-report account so it uses the parent report for children up to the age of 11 it uses the child and young person's self-report from the age of 11 up to young adulthood a bit more on data collection so we contacted priority cases from ethnic minority groups and those living in the most deprived areas of England first by telephone to boost response in these hard-to-reach groups we then opened up the online survey to the whole of this sample and non-responders to the online survey were offered support with the survey or given the option to complete the survey via the telephone so just looking at response rates this table here shows this sample who agreed to be recontacted for the follow-up surveys the achieved sample size and the response rates for their respective survey waves and the grey column represents the issued sample the achieved sample and the response rates for the 2017 face-to-face baseline survey so just looking at the latest of the follow-up surveys which was the 22 survey we achieved a response rate of 40% and we have seen a steady decline in response rates over the years the first two follow-up surveys were conducted under very different circumstances during lockdown obviously a very different situation to now with the latter surveys sample maintenance has been an issue with non-response and attrition impacting our response rates as we just discussed in Tamsin's presentation and as Tamsin mentioned a number of engagement activities were conducted before the most recent wave in the form of a participant newsletter a postcard with some snapshots of recent survey findings and a gift given to those who had participated in previous waves just so that we could boost that sample and engage people with this longitudinal survey more on responses in the technical report if you want to know more so just a brief look at the questionnaire content and just to say here the tables presented in the following slides include a variety of content that have been asked across the survey years and are not specific to one survey year so just looking at the parent questionnaire this included topics on self-harm, loneliness changes in household circumstances for example questions on the reduction in household income and not being able to buy enough food there's also been questions on the social impacts of Covid on family life as well as service contact a topic that we've asked in every single wave so far moving on to the child questionnaire this is completed by the 11 to 16 year old themselves and this included questions on family dynamics including family functioning experiences of social media including whether they've been bullied online and feelings towards their neighbourhood and local area for example if they feel safe in their local area and then for young adults the topics have ranged from an assessment of psychotic-like experiences using the adolescent psychotic-like symptom screener there's been an assessment of personality using the SAPA scale as well as young people's experiences of education and work and that's just a really brief snapshot of all the wealth of data we've included in all the follow-up surveys so if you do want to know more about individual waves there is more information in the technical report and just to mention briefly here I think Tamsyn touched on it in her presentation so in the latest survey series that's the 2023 survey a follow-up was included that was looking at eating disorders so this included an additional module asking more in-depth questions about eating behaviours, feelings and self-image and as Tamsyn mentioned this included the full door by eating disorder content the avoidant restrictive food intake disorder questionnaire and the mood and feelings questionnaire and data is currently in progress but each case will be sent to the University of Cambridge to be clinically rated and once we get the data back it will be appended to the main dataset and will be available in the UK Data Services Archive to enable further analysis and just quickly to highlight some key strengths of the survey series it's a really valuable dataset because we have pre-pandemic baseline data which was collected in 2017 and in all four surveys we've used a consistent and robust measure of mental health which is the SDQ and this will enable us to measure changes over time the survey series uses a national probability sample of children and young people spanning from childhood right through to emerging adulthood and as you've just seen it includes a wealth of information on lots of core topics as well as new topics year on year and although the reports have largely been based on cross-sectional analysis there is the potential for longitudinal analysis and also the possibility of using the survey data along with administrative records such as the national pupil database and finally the published reports and cross-sectional analysis from the 2017 baseline survey right through to the follow-up surveys are available to access on the NHS England's website there is also supplementary published data tables focusing on children with special educational needs and disabilities which you can have a look at and just to say the 2023 report is currently in progress and as Tamsin mentioned we are due to be able to publish that in late autumn this year and most importantly the data will be available through the UK data services there will be instructions on how to access the data but just to say here that the 2020 data set is imminently due to, for completion we are hoping that it gets archived in late summer so really really soon the 2021 data set is in progress and that should be available later this year the 2022 and 2023 data sets will follow and should be available the following year and just to say thank you for listening