Foster interdisciplinary working

Embracing complexity requires working together with different subject matter across disciplines. As ECRs we see an increasing drive towards interdisciplinary and multidisciplinary ways of working. We think interdisciplinarity ought to be embraced in its widest sense, which includes collaborating with different scientific fields (e.g. physics, sociology, mathematics, biology) as well as with clinicians, lived experience experts, and policy and practice experts. Interdisciplinary working will, in our view, need to become the norm to address the current issues.

It is our experience that this does not simply happen spontaneously: it requires time, funding and ongoing attention to interdisciplinary input in research and practice. Moreover, at times, a deliberate decision to create a level playing field for approaches, disciplines and theoretical frameworks may be needed. Funders play an important role in encouraging interdisciplinary and translational research. We have been encouraged by recent funding calls where interdisciplinarity is crucial (e.g. MQ Transdisciplinary Grants ⁸ ). Indeed, some funding calls simply cannot be delivered within a singular discipline, such as the recent Wellcome Mental Health Data Prize, ⁹ where data science, mental health science and lived experience perspectives were required to deliver translational tools to improve mental health.

From an educational perspective, some of us have benefited from, for instance, the Doctoral Training Partnerships or Wellcome PhD programmes. Both provide highly interdisciplinary curricula and supervisory structures, allowing future researchers to learn to conduct research in an interdisciplinary setting from the start. It will be beneficial to encourage, and make possible, interdisciplinary training opportunities worldwide.

Interdisciplinarity can occur at funder and training levels, but there are also opportunities to foster interdisciplinary working at institutional and journal levels. Institutionally, structures and spaces for inter-faculty collaboration, clinician–researcher collaboration and lived experience involvement can be established. This may include small seed funding for bid development or cross-faculty events. Journals can develop special issues where interdisciplinarity and work across diagnostic boundaries are encouraged.

Translation from the start

Embracing complexity extends to efforts that consider how research is implemented in practice. Resources for research, implementation and service delivery are scarce. To develop maximum impact, even for basic research, we argue that we need to consider how our research can affect and influence practice from the start. For instance, evidence-based digital mental health interventions often do not transition from research to practice and face significant challenges when implemented, including technical difficulties, low awareness of data standards and privacy, and low engagement and retention rates. As ECRs, we suggest that drawing on implementation science and realist evaluations, while co-designing provisions with the intended target audience and setting, would contribute to the adoption of effective interventions in our reality of complex contexts and needs.

Co-production/stakeholder involvement

Under the United Nations Convention on the Rights of the Child, ¹¹ children and young people have the right to be involved in decisions about them and their lives. This has been translated and developed through child and youth participation practices and models. ^{Reference Lundy12} Guidelines, such as those from the National Institute for Health and Care Research (NIHR), ¹³ state that research should be with or by the population of interest, rather than to or about. It is our responsibility to ensure that children and young people (alongside parents/carers) are involved meaningfully and to facilitate research that is transparent, relevant and responsible. This is often broadly referred to as patient and public involvement and engagement (PPIE) or, where individuals are more fully embedded in design and process, as co-production. This can enhance understandings of children’s and young people’s experiences and, in turn, enhances development and evaluation of practices and interventions. Despite these potential benefits and growing expectations of such practices from some funders, the conditions for this work do not always support best practice. ^{Reference Smith, Budworth and Grindey14}

There are multiple practical barriers to working with peer researchers. These can include confusion at ethical system levels regarding how co-production differs from research and that peer researchers are not participants but people with lived experience who offer expertise to help create more effective, meaningful research. A further challenge is institutions not having structures to remunerate peer researchers in timely ways without affecting benefits or unemployment status, often with long delays in payment systems that can damage trust. As we grapple with these systemic challenges, ECRs who have been integrating co-production into their work from the beginning of their careers are especially well-placed to develop innovative processes to facilitate smoother processes, but often lack the authority to alter existing processes.

Genuine and effective co-production throughout a project necessitates investing in strong relationships with peer researchers. We see this as central to what a researcher does, not an ad hoc task on specific projects. ECRs often do not have access to co-production funds, rendering it difficult to properly build and maintain these relationships over time and to integrate them into the entire research process. Funding, including within PhD programmes and via strategic ECR schemes, should facilitate co-production work during the conceptualisation and design of projects, rather than only creating capacity for co-production afterwards. Good examples of such support exist, such as via the NIHR Research Support Service, ¹⁵ but such services often have limited funds and sometimes focus on specific applications/funders.

Marginalised groups

In highlighting diverse voices, focusing on inclusion and engagement of marginalised communities is central. In our resonance checking, the young people we consulted felt that improving the diversity of research participants and researchers was one of the most important areas for development. Yet, they recognised the far-reaching systemic barriers to including marginalised voices in research. The mental health of members of marginalised communities is significantly poorer than that of other groups. ^{Reference Sapiro and Ward16,Reference Cleary, Horsfall and Escott17} Our experience as ECRs highlights the lack of diversity of researchers and participants in child and youth mental health research, substantially limiting research knowledge about critical issues. This is related to practical, ethical and organisational problems. ^{Reference Farr, Davies, Davies, Bagnall, Brangan and Andrews18} To develop a more accurate understanding of children and young people’s mental health, it is vital that we make research more accessible and facilitate the engagement of a wider range of participants to engage. Putting marginalised voices at the centre of practice should be a priority, instead of allowing those voices to remain unheard through lack of accessibility or action.

Improving diversity, engagement and inclusion is of importance in asking not only who we engage with as participants, but also who we are as a research community. As ECRs, we all have our own experience of the struggle to maintain a career within research. There is a clear leaky pipeline in mental health research, wherein talented young women and ethnic minority researchers are more likely to drop out early and many leave mental health research because of lack of funding. ^{Reference Breedvelt, Rowe, Bowden-Jones, Shridhar, Lovett and Bockting19,20} Less research is available on disability, gender and sexual orientation; however, based on our experiences, research is often not an accessible place for disabled people or those from minoritised genders and sexual orientations. In fact, temporary and insecure work in academic research disproportionately affects ECRs, women and ethnic minorities. ²¹ This is in line with our experiences at the time of writing, with many of us on precarious contracts, often short and fixed term. A healthy research culture can contribute to better quality research and stimulate innovation. Investing in researchers from early in their careers makes them better at what they do and improves retention, particularly improving outcomes for those most likely to be excluded. This necessitates that institutions and funding bodies account for the marginalisation that an applicant has experienced and use the methods at their disposal to ensure representation from across minoritised groups. One example of this is the American Psychological Association’s editorial fellowship programme, which offers early-career psychologists from historically underrepresented groups structured opportunities for capacity building in academic publishing.

Structural challenges

Our shared experiences highlight the difficulties in overcoming structural barriers, including juggling heavy teaching and administrative workloads and working in fixed-term postdoctoral roles with little time for launching our own research. These roles often do not include protected time or costs for our own research interests, which end up squeezed into weekends and holidays. ECRs’ contributions to the advancement of our field often rely unduly on our unpaid labour. Excessive workloads and unpaid overtime are associated with burnout and drop-out from the higher education sector. ^{Reference Gewin23,Reference Johnson and Weivoda24} Disadvantaged groups, including parents/carers, working class, disabled and otherwise minoritised applicants face barriers to unpaid work that have an impact on their career progression. ^{Reference Johnson and Weivoda24–Reference Arday26} Female academics in the mental health sector are underpaid, under-cited and under-represented at senior levels, contributing to the leaky pipeline problem. ^{Reference Breedvelt, Rowe, Bowden-Jones, Shridhar, Lovett and Bockting19} Perpetuating inequalities results in a loss of community diversity and expertise.

There are some ECR opportunities, but they often do not go far enough. Fellowship schemes and funding open to ECRs to lead or co-lead exist but are often short-term and do not guarantee job stability. The highly competitive nature of these schemes, coupled with a limited number of funded positions, leaves many ECRs disappointed and at risk of leaving the sector. Definitions of ECR also vary, with some schemes allowing for post-PhD parental leave or part-time working and others taking a purely chronological approach to calculating eligibility. ECRs may also require more time for proposal development compared with senior researchers with established networks and collaborations. We appreciate initiatives that seemingly exceed the Concordat, such as repeated calls (e.g. NIHR’s bi-annual fellowship schemes ²⁷ ) and advanced warning of upcoming themed funding competitions (e.g. Wellcome’s ‘bus timetable’) ²⁸ , that aim to level the playing field.

The labour required for ECR grant and fellowship applications should not be underestimated. Building collaborations, conducting PPIE work, and developing budgets can represent months of work, or even longer for ECRs relying on evening- and weekend-working. Researchers can then be kept waiting for a response and can be unable to resubmit rejected application to other schemes (e.g. UKRI policy), even when feedback denotes high quality. This can result in months and even years of time invested, often during precarious or heavy-workload employment, to plan work that cannot proceed. The knock-on effects can have a substantive impact on progression and well-being.

Learning lessons from the pandemic

During the COVID-19 pandemic, we witnessed funders responding quickly, allowing institutions and researchers to contribute to policy development, and ECRs adapting to unexpected challenges. ECRs are well equipped for complexity with a focus on collaboration, responsiveness, flexibility and interdisciplinarity. However, many of us have experienced first-hand or through our colleagues the precarity of our positions, with unrenewed contracts and redundancies. Going beyond the Concordat, we must actively maintain supportive relationships with ECRs as they navigate moves between different roles and institutions, ensuring continuity in their research careers. There is often a trend for senior academics to spend less time ‘on the ground’ or with research participants. ECRs have an important role to play in ensuring implementation of the research or interventions developed and thus the introduction of effective child and youth mental health research into practice, but only if they are acknowledged and not lost at the end of their fixed-term contract.

A global ECR workforce

ECRs are operating in an increasingly global research context, benefiting from increased opportunities for international collaboration due, for instance, to greater use of online meetings. Despite the expansion of child and youth mental health research, researchers, including ECRs, in high-income countries like the UK must acknowledge their privileged perspective. There is a chance to learn and share globally, challenging biases by building capacity with international counterparts. Many challenges in child and youth mental health research are global, requiring ambitious, collaborative efforts to address problems such as siloed health systems, insufficient focus on prevention and structural inequalities. ^{Reference Ordóñez and Collins29–Reference Mei, Fitzsimons, Allen, Alvarez-Jimenez, Amminger and Browne31} We need ambitious joined-up thinking that cuts across hierarchies, structures and contexts. The global workforce of ECRs is a valuable resource that, with proper support, can contribute significantly to addressing these challenges.

In conclusion, we have explored key themes aligned with the challenges and opportunities within child and youth mental health research with a view to continual development of an infrastructure and ecosystem that facilitates complexity, inclusiveness and sustainability: namely (a) embracing complexity, including a move beyond reductionist approaches to understanding mental health, interdisciplinary collaboration, attending to complex systems, and producing research that can contribute to policy and provision; (b) centring diverse voices, including planning for meaningful coproduction, engaging with marginalised groups and considering accessibility requirements, as well as ensuring that our own researchs community includes and supports researchers from diverse backgrounds; and (c) facilitating sustainable research environments and fundings systems, including ensuring sustained funding approaches to exploring long-term study outcomes, creating a more level playing field, and supporting mentorship and community.

We have discussed these areas separately but highlight these as interconnected areas of infrastructure and practices, and thus interconnected challenges and interconnected opportunities. For instance, collaborative working across disciplines and sectors can facilitate the centring of diverse voices in a range of ways, and support communities and the sharing of opportunities and systemic practices. It is clear that there are many intersecting influences contributing to the current environment in child and youth mental health research. Funding decisions, for instance, are influenced not only by funders but also by policy agendas, academic panels, reviewer input and senior researchers who have the capacity to advocate for priorities, including ECR inclusion. To comprehensively understand how these systems function and interact, and their potential for mobilisation towards progress, a rigorous mapping exercise including representation across all stakeholders, from ECRs to funders, is required. This could be used to inform, for instance, a detailed theory of change, elucidating pathways – both bottom-up and top-down – towards advancing the field.

Such priorities, and the strengths and challenges in these areas, require careful and systematic attention from audiences including funders, institutions, field leaders, research managers and researchers themselves. In Box 1, we set out key recommendations stemming from discussions throughout this paper and we invite key partners to consider these recommendations alongside active exploration of needs within their local contexts and communities to actively and collaboratively drive transformative progress. We hope to emphasise the imperative need to grant ECRs a prominent place in the discourse surrounding child and youth mental health research. ECRs must be provided the space, support and resources essential for nurturing their potential as future field leaders. Encouragingly, we have witnessed promising developments, exemplified by initiatives like the UKRI-funded networks, such as Emerging Minds, which have demonstrated the value of ECR-inclusive collaboration and encouraged cross-sector and multidisciplinary working. To move this agenda forwards, structured approaches to promote the development and voice of ECRs in the child and youth mental health field must continue to be actively explored.