Opinion: When my child is in psychosis, the pediatric health care system can’t help us

I am sitting in a firm recliner with a wipeable surface during a two-day hospital admission for testing at our local children’s hospital. The chair is designed for durability, not sleep. The pillow beneath my head is flat and smells faintly of disinfectant. A thin hospital blanket scratches against my arms as I shift, unsuccessfully, trying to rest. The room is dim but never quiet. Monitors beep. Machines hum. Footsteps pass the door. Hospital noise does not fade. It embeds itself in the nervous system.

My 13-year-old is finally asleep. His thin body is curled beneath a blanket identical to mine. One shoulder peeks out, bruised from repeated injections of calming medication. A neon orange bandage marks the most recent one, given about an hour ago. I watch his chest rise and fall and allow myself a brief moment of relief.

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Commercial or industrial use of mental health data for research: primer and best-practice guidelines from the DATAMIND patient/public Lived Experience Advisory Group

BackgroundRoutinely collected health data, such as that held by United Kingdom (UK) national health services (NHS), has important research uses. However, its use requires public trust and transparency. Access by commercial/industrial organisations is especially sensitive for the public, as is mental health (MH) data. Although existing MH data science guidelines emphasise patient/public involvement (PPI), they do not cover commercial uses specifically.ObjectivesTo develop patient- and public-led guidelines for the commercial and industrial use of MH data for research. Though UK-focused, their principles may apply internationally.MethodsA PPI Lived Experience Advisory Group (LEAG) was created within DATAMIND, a UK data hub for MH informatics. Initial discussion yielded a requirement for definitions and explanations of concepts relating to MH data research, developed iteratively. Subsequently, the LEAG developed guidelines via a qualitative quasi-Delphi approach. The agreed scope excluded data provided for research with informed consent, data processing arrangements (e.g. companies hosting electronic systems on the instruction of health services), and compliance with legal minimum requirements. The scope included the use of routinely collected MH data for research by commercial/industrial organisations without explicit consent, and aspects of industry-led MH data collection conducted with consent.ResultsAlongside the primer in MH data research concepts, the LEAG provide best-practice guidelines relating to commercial/industrial research use of MH data, for organisations controlling MH data (such as NHS bodies) and for commercial applicants seeking access. Core principles include transparency, patient rights, meaningful PPI, stringent governance, and statistical disclosure control. The guidelines recommend a risk–benefit approach to assessing data access applications, within limits that include avoiding the export of unconsented patient-level data outside NHS-controlled secure data environments, and not providing commercial applicants with access to unconsented free-text MH data. Further recommendations for NHS executive and regulatory bodies relate to public choice and transparency, clarity of guidance to research-active NHS organisations, and support for de-identification.ConclusionsMH data research requires patient/public involvement and understanding. These guidelines reflect the views of people with personal or family experience of mental ill health. We hope they are useful to the MH research community and increase public transparency and trust.