What do people choose to share online when they find themselves in difficult and precarious circumstances? What can we learn from this about how trust and empathy are established and maintained in online relationships? And what can all of this tell us about sharing, trust and empathy in the offline world? These questions lie at the heart of this innovative research project looking at the online relationships and behaviour of people affected by natural disasters; life-threatening or terminal disease; organ donation; emotional distress and suicidal thoughts; drug use and addiction. Why are we looking at these particular situations? This is because people in these circumstances are extremely vulnerable, and some of them may be seeking information support or help that could make the difference between life and death. That means it may be necessary to establish trust and empathy very quickly to make that difference. In these extreme contexts, people may end up over-sharing, or equally may be disadvantaged by not sharing enough. At the same time, others online need to know when they are responding to genuine distress. Understanding the way that trust and empathy works in these circumstances may help to transform the way in which resources and aid are distributed, locally and globally, and enhance individual and community resilience. But such changes may have both good and bad consequences, so working through the ethics of all this, at personal, global, institutional and governmental levels, will also be at the core of our project. The project brings together researchers from a wide range of backgrounds: sociology, international relations, computer sciences, health informatics, philosophy, media studies and bioethics. By working together we hope to produce new 'transdisciplinary' understandings of the issues of sharing, empathy and trust online - in other words, insights that would not be possible using only a single disciplinary lens. All of this will be challenging, but we have begun to exchange ideas and are confident that we will generate findings and perspectives that are genuinely novel. Several themes clearly cut across our disciplinary boundaries and this has helped us to structure our approach to the individual case studies. Our overall approach has been shaped by the notion of 'Facet Methodology'. This suggests that, like light being refracted differently through the various faces of a gemstone, we can understand more about a social problem by viewing it from a number of different angles and perspectives. As part of the research, we will be accessing online data from a wide range of sources and interacting with a variety of organisations, including UK charities, international NGOs and health providers. The charity, The Samaritans, will be directly involved as a project partner. The outputs from the research will not be aimed solely at academic audiences and we will be working hard to make them accessible and valuable to this wider set of stakeholders as well as to the general public.

VISION: Our vision is to harness the potential of digital technology to transform adolescent mental health and wellbeing and provide a safe, and supportive, digital environment to tackle the growing humanitarian crisis of unmet need arising from mental health disorders in young people (covering the definition of adolescence from age 10 up to the age of 25). THE PROBLEM: There is a youth mental health crisis; in the UK, 1.25 million (25%) of 17-19-year-olds experience significant levels of depression or anxiety; yet less than a third of these young people receive any treatment. Academic-led digital interventions exist but few, if any, have been implemented in real-world settings. Meanwhile, there are thousands of mental health and wellbeing apps, but the vast majority have no evidence-base and some may be harmful. This crisis coincides with a new 'digital environment', where being online and using social media has become integral to young people's lives. However, social media platforms are not designed to meet the mental health needs of young people. Pressing societal, public policy and research questions concern how the 'digital environment' affects young people's mental health; whether it increases the risk for mental health problems and how vulnerable young people with mental health difficulties engage with the digital environment. THE SOLUTION: Our research vision addresses two key challenges: i) RESEARCH THEME 1: DIGITAL INTERVENTIONS: How to harness digital technologies and platforms to identify those at risk and target personalised digital interventions that bridge the adolescent mental health treatment gap. This includes developing the infrastructure to collect, share, discover and analyse sensitive personal data that matches the speed of digital innovation ii) RESEARCH THEME 2: DIGITAL RISK & RESILIENCE: How engagement with the digital environment influences, and is influenced by, adolescent mental health problems, brain and cognitive development and what factors promote resilience. We aim to generate evidence-based advice to safeguard youth from harmful digital environments and design tools to promote resilience. ENGAGEMENT STRATEGY: We will bring together, through workshops, knowledge exchange events and pilot studies, an interdisciplinary community of researchers (psychiatry, psychology, neuroimaging, computer science, arts & design, humanities, education) to work with young people, parents/caregivers, clinicians, digital technology developers and policy-makers to offer vital co-ordination and research leadership in this nascent field. The collaboration builds on an outstanding track record of digital mental health research at the University of Nottingham (UoN) (NIHR MindTech Medtech Co-operative, NIHR Nottingham Biomedical Research Centre Mental Health & Technology Theme and Horizon Digital Economy Research Institute). We will engage with industry and charity partners (BBC, Xenzone, Samaritans), leading UK academic centres (Oxford, UCL, KCL, LSE) and UKRI Mental Health Networks (eNurture, Emerging Minds). YOUTH ENGAGEMENT: Young People's Advisory Group (YPAG): working in collaboration with McPin Foundation we will ensure that immersive patient and public involvement (PPI) and co-production with young people and their parents/caregivers cuts across all of our activities. Our Partners Board will facilitate knowledge exchange with healthcare, social care, education, policy-makers and industry to deliver evidence-based policy and practice solutions that can be readily implemented. OUTPUTS & IMPACT: Our proposed Engagement Award will be at the vanguard of these developments through building and sustaining new interdisciplinary research collaborations, knowledge exchange, developing early career researchers (ECRs), engaging new partners and laying out a road map for future research.

It is widely accepted that "suicide prevention is everybody's business," but most research has focused on the role of health professionals in identifying and managing suicide risk within clinical settings. Much less attention has been paid to the contribution that members of the public (with no healthcare training) can make, or the resources they need in order to do so. In a previous project funded by the MRC, we examined the role of family members and friends. We used qualitative methods to shed light on the difficulties they face in trying to interpret signs of a suicidal crisis and decide what action, if any, to take. We then formed a partnership with all the leading suicide prevention charities to develop and evaluate simple public education materials that address those difficulties. Those resources are designed for people who are concerned that someone close to them may be suicidal. We now wish to use the same approach to address a very different scenario, namely the 'Stranger on the Bridge'. This was the title of a highly-acclaimed Channel 4 documentary, broadcast in 2015, which told the story of Jonny Benjamin, who went to Waterloo bridge to take his own life and was prevented from jumping by the kindness of a passer-by. Of the 6,000 suicides that occur in the UK each year, around a third take place in a public location. Many of these involve jumping from bridges, cliffs and high buildings, or use of the railway network. Some of these deaths may be prevented by the installation of physical barriers, but human intervention will always play a vital role. This is most likely to come from a passing stranger, but few people know how to recognise someone at risk or are willing to get involved. We want to increase the number of people who are able to recognise and reach out to someone in a public place who may be contemplating suicide. First we need to gain an in-depth understanding of the Stranger on the Bridge scenario from the point of view of those who have been involved, both as 'rescuers' and 'rescued'. We will advertise for both through adverts in mainstream and social media, aiming to interview around 10 people with experience of being rescued and 20 people with experience of intervening, including some railway staff. We aim to discover: a) what signs and signals a person contemplating a suicidal act is likely to exhibit; b) how passers-by interpret those signals and understand what is happening; c) what fears people have about intervening and how they decide whether or not to do so; d) what are the core components (both verbal and non-verbal) of an effective intervention by a lay person. We will also interview some people who have no experience of this situation to find out about wider public attitudes and fears. Using the findings, we will work collaboratively with a range of non-academic partners to formulate key messages and develop a set of resources to be used in an educational campaign. We will start by developing a simple leaflet for distribution to members of the public, and an online version of the same. We will also develop a 90-minute face-to-face training session for staff at the sort of locations that are used for suicide, e.g. bridges, multi-storey car parks, rooftop restaurants, cliffs and coastal paths, and railways. We will evaluate these in a later study, and hope to go on to develop other materials using different media at a later date. Our strong project group includes academics from the University of Exeter, the documentary-maker Jonny Benjamin, who survived his own suicidal episode thanks to a stranger, together with representatives of the suicide prevention charities, Public Health England, Network Rail and the RNLI.