Over the coming decades the world will face a wide range of complex, new and persistent public mental health challenges, exacerbated by disruptive events, many of which can be fully addressed only through strategies and investments that improve lifelong public mental health outcomes for everyone. 1 in 6 adults in England have a common mental health condition. Mental distress and ill health are associated with significant disability, sickness absence, unemployment, and suicide attempts. Three quarters of all mental health conditions have occurred in young people by the age of 24 years. Despite widespread acknowledgement that mental distress and illness make a substantial contribution to the global burden of disease, there is still a major gap in evidence to inform policy making for their primary prevention. We will establish the 'Prevention of Risks and Onset of Mental Health problems through Interdisciplinary Stakeholder Engagement' (PROMISE) Population Mental Health Improvement Cluster, which will create new opportunities for population-based improvements in mental health. We will focus on three challenge areas: 1. Children and young people; 2. Suicide and self-harm prevention; 3. Multiple long-term conditions. Challenge areas will be supported by four cross-cutting themes: 1. Partners in policy, implementation and lived experience; 2. Data, linkages and causal inference; 3. Narrowing inequalities; 4. Training and capacity building. We will work with stakeholders across public health, local government, voluntary organisations and interdisciplinary academic experts, and people with lived experience of adversities which impact mental health, to identify and rigorously evaluate population-level interventions which hold the greatest promise for the improvement of mental health. The structure of our cluster reflects the integration of academic, policy and lived experience in leadership and delivery, which will lead to systems change and the ability to work effectively across traditional silos which have held progress in this area behind. We will use a range of large-scale datasets, including representative studies which follow people over time, nationally representative studies of health, and data generated when people come into contact with health and other services, take part in census, alongside information from children in schools, and the linkages between these, for our investigations. We will use statistical methods in this data to understand which population-interventions benefit people's mental health and reduce inequalities. We will draw on the wide-ranging interdisciplinary expertise of our team to develop a unique suite of training (seminars/ tutorials/ short training videos) which will be freely available, the training will be entitled "New ways of working in population mental health" and will cover a range of topics useful to researchers, practitioners, and people with lived experience. Our cluster will foster methods to develop creative and innovative solutions by working with people who have not applied their expertise to improving population health before, through a range of approaches:1. We will work with arts-based practitioners to develop creative outputs (films, children's books/ comic strips, animations, infographics, public photography and art exhibitions), which will also ensure inclusive engagement. 2. We will convene a series of interdisciplinary 'sandpit' events to engage a wide range of interdisciplinary groups, to develop innovative projects across challenge areas. 3. We will convene policy roundtables with support from English, Scottish, Welsh and Northern Ireland Government representatives, to bring together stakeholders, experts, policymakers, and the public to engage in discussion on cluster challenges to gather feedback, build consensus, and develop actionable recommendations. Our findings will be co-produced with people with lived experience.

What is the problem? Current health communication and behaviour change programmes do not support UK Black and Asian populations in making healthier dietary and physical activity (PA) choices, and maintaining a healthier weight. We talked to Black Caribbean, Black African and South Asian women and men and to health practitioners to develop this project. In these conversations people shared that they are very motivated to improve their diet and PA behaviours to prevent serious health conditions such as type 2 diabetes. However, some also told us that worrying about or experiencing racism, and other barriers such as time and expense, stopped them from taking part in healthy lifestyle programmes. It was felt that existing services lacked relevance for Black and Asian people and were poorly communicated. When asked what ideal help with health behaviour change would look like to them, services with mental health support delivered by staff of the same ethnic group and similar lived experience were common opinions. The importance of being able to keep eating their traditional foods, and that dancing or walking were popular activities, was also emphasised. Weight loss, if needed, was seen as something that happened naturally, if healthy habits could be maintained. In terms of programme delivery, the need for low cost and flexible sessions, and a preference for community rather than medical settings, was stated. We also looked at existing published research and while there are some studies on what helps and hinders healthy behaviours among Black and South Asian ethnic groups, there has been very little research developing and testing interventions suitable for these groups. How will the problem be addressed? We have formed a group made up of researchers, members of the public, charities, health professionals, and policy makers. Together we aim to co-design 'Health Connections'- a new intervention tailored to the needs of Black Caribbean, Black African and South Asian men and women, based in communities and delivered by community educators supported by health professionals. We will look at how a culturally sensitive communication campaign and mental health support can be included in an intervention programme to improve diet and PA choices, and promote healthy weight. We will also examine how health professionals can be trained in cultural competency (being able to see things from the point of view of people from other cultures), so that partnerships between health professionals and community educators are improved. Throughout the project there will be meetings every two months and other activities such as questionnaires and a workshop, and support meetings for group members from the public, to make sure all views are represented. We will conduct interviews with men and women from diverse ethnic groups to understand their experiences, opinions and intervention needs, adding to our existing data. Findings will be summarised in a plain English report. We will also gather examples of existing intervention resources (such as culturally adapted recipes) and local practice. Based on the information gathered, we will make a list of potential programme sessions, their content, and how they will be delivered. The project group will complete questionnaires regarding the list, and discuss the results in a workshop to come to an agreement on the best ideas. Examples of session content (e.g. recipe cards and exercise videos) will be made and we will hold a community event in Leeds, UK, to see what the public think of the ideas and materials. The final stage will be to write a manual documenting the intervention and to share the project findings in publications, presentations, and an infographic. The findings will then be the basis of planning the next phase of research, which will be to carry out a trial to test whether the newly designed intervention can be carried out and is acceptable among Black and South Asian adults.

Children and young people (CYP) are experiencing a significant mental health (MH) crisis that is threatening their future. Deeply rooted health inequalities perpetuate this crisis and call for immediate action. This project will promote easy access to best practice in local arts activities that support the diverse MH needs of CYP and thus enable them to take better control of their lives. By supporting the MH of CYP the project will meet an important NHS priority contributing towards tackling the health inequalities affecting their lives. We will build on successes from Arts for the Blues (AH/W007983/1), a project that received funding from AHRC for phase one of this programme and successfully scaled up the use of an evidence-based creative psychological intervention in the North West. We will also draw on a track-record of 25+ years of engaging CYP in arts activities, and on our extensive co-production experience. Co-creation will therefore become central to this work. We will focus on CYP aged 9-13, a group at significant risk of developing MH problems whilst transitioning from childhood to early adolescence. They will be encouraged to act as co-researchers developing skills they can use after the completion of the project, ensuring direct benefits. We expect that co-creation will lead to meaningful engagement of CYP with this study that aims to generate new, scalable evidence concerning: (A) how to access arts activities that best support the MH of CYP; (B) how to evaluate arts activities that meet the diverse MH needs of CYP; (C) how to maximise the benefit of arts activities for as many CYP as possible. We will create a digital platform where evidence-based local arts activities will become easily accessible for CYP, their families, relevant organisations and services. We will do this by identifying good local arts practice that addresses the diverse MH needs of CYP, especially those who are often under-represented. Six CYP Creative Health Associates will be employed to work in areas with marked health inequalities and establish local collaborations between community partners and existing social prescribing link workers. They will also work with the research team to provide easy and sustainable access to arts activities and thus, bypass local barriers. The active involvement of Integrated Care Boards (ICBs) (e.g., Lancashire and South Cumbria and Cheshire and Mersey Care), medical leads and medical directors of CYP's MH, NHS trusts, schools and community organisations will encourage collaboration within and across systems, enabling the development of an agreed evaluation framework of best practice in arts activities. This will support streamlining access to therapeutic uses of the arts as well as scaling up and adopting the outputs from the study in the North West and beyond. Finally, we will develop and share the project outputs with our 46 non-academic national and international collaborators, making an active contribution towards tackling health inequalities that benefits the MH of CYP wherever they live.