A study exploring the relationships between cognitive and sensory disorders and experiences of abuse and discrimination

Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.

Objective for processing

This is an application for an extension of Pseudonymised Adult Psychiatric Morbidity Survey (APMS) data used has been requested under this Agreement by UCL. University College London (UCL). The data requested is already held by the applicant. UCL. The extension is was intended to allow further time for analysis, and to respond to reviewer comments on papers that are at the submission stage. It will also allow for two further planned papers to be written by UCL MSc students. The sole data controller and processor is University College London. [1 paragraph unchanged] This study has already explored how and why sensory impairments might be [8 words unchanged] of psychotic symptoms has changed over time. In future, it will explore how common mental disorders have changed over time and how they related to physical comorbidities and to substance use; and how health and social disadvantages might increase the risk of experiencing abusive [61 words unchanged] hearing loss alone affecting a third of people aged 65 and over. The APMS survey data was transferred to the UCL data safe haven, [14 words unchanged] and conference posters, and no participant would be identifiable from these publications. The sole data controller and processor is University College London. No other organisations are involved in the data analysis. [1 paragraph unchanged] The purpose of the project is to conduct secondary analysis of the [111 words unchanged] by UCL in discussion with NatCen and the wider APMS writing group. The group have a successful track record of published analyses using the 2014 data exploring the relationship of sensory impairment to suicidal ideation, psychosis and common mental disorders. They plan to extend this work as discussed above, to extend understandings of the inter-relationships between mental disorders, impairments and social contexts. This work is not independently funded and will be carried out by [28 words unchanged] psychiatry. No organisations other than UCL are involved in the planned data analysis: all those involved in the processing of the data are substantive employees of UCL, or students on UCL MSc courses under the supervision of UCL substantive employees. No elements of the work will take place outside the UK. analysis. All UCL students are expected to undertake annual training on handling highly confidential information. The processing of the data is justified under Article 6(1)(e) of the GDPR (processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller), because participants in the APMS gave consent for their data to be analysed for the purpose of improving understanding of mental health and illness in the population. Under Article 9(2)(j) (processing is necessary for archiving purposes in the public interest, scientific or historical research purposes or statistical purposes), the data subjects have given explicit consent for data to be analysed in the public interest to further health research. Trainees/students register for and complete NHS Digital’s Data Security Awareness (NHSD) course provided by e-Learning for Health. The course covers data security awareness, the law, threats to data security, breaches and incidents, and the General Data Protection Regulation. Completion of the course is sufficient evidence of basic information governance training to handle highly confidential information under the SLMS Information Governance Training Policy. Trainees'/ students up-to-date training is recorded in the SLMS IG training register. The processing of the data is justified under article 6(1)(e) of the GDPR, because participants in the APMS gave consent for their data to be analysed for the purpose of improving understanding of mental health and illness in the population. Under article 9(2)(j), the data subjects have given explicit consent for data to be analysed in the public interest to further health research.

Processing activities

The 2014 APMS dataset is held on behalf of NHS Digital by the UK Data Service (UKDS) (www.ukdataservice.ac.uk ) (www.ukdataservice.ac.uk) and UKDS are responsible for dissemination under direction by NHS Digital. UCL already holds the whole dataset; there is no facility to select individual variables. They UCL will be able to download the dataset from UKDS for the period [48 words unchanged] of individuals being able to identify anyone taking part in the survey. [4 paragraphs unchanged] Data transfers out of UCL will only be in the form of [17 words unchanged] with the HES-Analysis guide. Data will not be accessed outside the UK. All those processing the data are substantive employees of University College London. The data NHS Digital supplies will be stored within the Data Safe Haven. The data will not be linked or compared (matched) with other data sets. There will be no attempts to try and re-identify or re link to identifiable record level patient data. NHS Digital reminds all organisations party to this agreement of the need to comply with the Data Sharing Framework Contract requirements, including those regarding the use (and purposes of that use) by “Personnel” (as defined within the Data Sharing Framework Contract ie: employees, agents and contractors of the Data Recipient who may have access to that data) No organisations other than UCL are involved in the planned data analysis: all those involved in the processing of the data are substantive employees of UCL, or students on UCL MSc courses under the supervision of UCL substantive employees. No elements of the work will take place outside the UK. All UCL students are expected to undertake annual training on handling highly confidential information. Trainees/students register for and complete NHS Digital’s Data Security Awareness (NHSD) course provided by e-Learning for Health. The course covers data security awareness, the law, threats to data security, breaches and incidents, and the General Data Protection Regulation. Completion of the course is sufficient evidence of basic information governance training to handle highly confidential information under the SLMS Information Governance Training Policy. Trainees'/ students up-to-date training is recorded in the SLMS IG training register. The data NHS Digital supplies will be stored within the Data Safe Haven. The data will not be linked or compared (matched) with other data sets. There will be no attempts to try and re-identify or re-link to identifiable record level patient data. NHS Digital reminds all organisations party to this Agreement of the need to comply with the Data Sharing Framework Contract requirements, including those regarding the use (and purposes of that use) by “Personnel” (as defined within the Data Sharing Framework Contract i.e.: employees, agents and contractors of the Data Recipient who may have access to that data)

Expected output

The following papers have already been published or are in press in peer-reviewed journals: UCL will disseminate findings through peer reviewed journal papers, supported by UCL media press release where findings are likely to be of widespread national interest. 1. A paper exploring the relationship between sensory impairment and common mental illness and social functioning as a possible mediator of this relationship, as well as the 'treatment gap' for people with sensory impairments relative to those without. The following papers have already been published: 2. 1. A paper exploring the relationship between sensory impairment and psychotic symptoms, common mental illness and social functioning as a possible mediator of this relationship. relationship, as well as the 'treatment gap' for people with sensory impairments relative to those without. This paper was published in BJPsych Open in November 2019. The following is a list of planned papers that are in the final stages of editing prior to submission for publication; it is anticipated these will be published by February 2021: 2. A paper exploring the relationship between sensory impairment and psychotic symptoms, and social functioning as a possible mediator of this relationship. This paper has been published in Schizophrenia Research, and has been available online since September 2019. 3. A paper exploring how sensory impairment is associated with suicidal ideation and any mediators of an association association. This paper has been published in BMJ Open in February 2021. 4. A paper exploring whether prevalence of psychotic symptoms in the population of England has changed over time, and correlates of experiencing psychotic symptoms symptoms. This paper was published in Schizophrenia Research, and was the subject of a press release and newspaper article in 2020. The following is a list of planned papers nearing readiness for publication in submission peer reviewed journals; it is anticipated these will be published by February 2022: [1 paragraph unchanged] The following are planned papers; it is anticipated that these would be published by February 2023: [2 paragraphs unchanged] Target journals include British Journal of Psychiatry and BJPsych Open, Lancet Psychiatry, Schizophrenia Research, BMJ Open, and International Psychogeriatrics. The papers are intended of the scientific community, as well as interested members of clinical professions and the public. The applicant organisation has collaborated with the Alzheimer͛s society on previous press releases. 8. A paper exploring trends in antidepressant prescribing and Common Mental Disorder (CMD) symptoms over time. All outputs published will be in the form of aggregated outputs with small numbers suppressed (as is in line with the HESAnalysis guide). 9. A paper exploring the association between common mental disorder and menopausal symptoms and status. v4 update (Dec 2020): 10. A paper investigating prevalence, predictors, and treatment receipt in social phobia. Work on the other papers proposed as future outputs in the last iteration of this agreement will also be worked on, and the research team also plan outputs exploring the following questions: 11. A paper exploring the association between incontinence and common mental disorder symptoms. 1. How trends in psychotropic prescriptions and common mental disorder symptoms compare. 12. A paper exploring trends in Generalised Anxiety Disorder (GAD) prevalence over time and relation to demographic variables. 2. What predicts whether people who are experiencing symptoms of CMD have received a professional diagnosis. 13. A paper exploring associations between ketamine use and comorbidities in the population. 3. How treatment receipt (counselling, psychology, medication etc) differs between those who do and do not report receiving a diagnosis; the student may also explore this in relation to whether participants self-identify as having a mental disorder. 14. A paper exploring prevalence and correlates of CMD symptoms in illicit drug users compared to the general population 15. A paper exploring associations between ability to trust in others and CMD symptoms and mental wellbeing. Target journals include British Journal of Psychiatry and BJPsych Open, Lancet Psychiatry, Schizophrenia Research, BMJ Open, Acta Psychiatrica Scandinavica, and International Psychogeriatrics. The papers are intended of the scientific community, as well as interested members of clinical professions and the public. The applicant organisation has collaborated with the Alzheimer’s society on previous press releases. All outputs published will be in the form of aggregated outputs with small numbers suppressed (as is in line with the HES Analysis guide).

Expected measurable benefits

There is a lack of research currently on the mental health of people with sensory impairment in the UK, which is why UCL wishes to explore the proposed work plan. Previous work carried out by this group of researchers has raised awareness of the mental health needs of older people: it is expected that this research will allow for increased scientific knowledge of how cognitive and sensory impairments might impact on the likelihood of experiencing abuse or discrimination. There is a lack of research currently on the impact of menopause on women’s mental health in the UK. There is also a lack of up-to-date research on population prevalence of social phobia, GAD, and ketamine use at the population level. Addressing these gaps can raise awareness of these issues, and support clinicians in understanding of how these issues interlink with mental health. Previous work carried out by this group of researchers has raised awareness of the mental health needs of older people: it is expected that this research will allow for increased scientific knowledge of how cognitive and sensory impairments might impact on the likelihood of experiencing abuse or discrimination. The benefit of exploring the mental health of people with sensory impairment [42 words unchanged] knowledge can be disseminated as relevant information to a variety of people. The employees of UCL involved in this research project are well placed to disseminate knowledge directly into mental health services through a number of channels; 1. Via professional work as clinical psychiatrists. The research can be disseminated directly to colleagues, and discussed/used in continuing professional development forums to improve the standard of health care for people with sensory impairment in the UK. If the researchers are able to understand to what extent and how people with sensory impairments, for example, are at greater risk of mental disorder, how this will inform targeting/planning of future talking therapies, and adaptation to remove barriers to this population accessing mental health services. mental health services through a number of channels; 2. The applicant is also the lead on the Alzheimer͛s Society Centre of Excellence ʹIndependence at Home which is based at University College London. Any findings that are directly related to patients affected by Alzheimer͛s can be disseminated via the work here ʹto inform future work programmes that can address any inequalities identified in the analysis, and to help improve the standard of healthcare given to those who have sensory or cognitive impairments. 1. Via professional work as clinical psychiatrists. The research can be disseminated directly to colleagues, and 3. They are well placed and connected with a variety of Third Sector Organisations (Charities). Any findings that are directly relevant to the older generation can be disseminated to Age UK to inform future targeted work programmes again to address the inequalities discovered through the research to help better the healthcare provision for those with cognitive and sensory impairments, and to remove the barriers that this population may face when accessing mental health services. discussed/used in continuing professional development forums to improve the standard of health care for people with sensory impairment in the UK. If the researchers are able to understand to what extent and how people with sensory impairments, for example, are at greater risk of mental disorder, how this will inform targeting/planning of future talking therapies, and adaptation to remove barriers to this population accessing mental health services. 2. The applicant is also the lead on the Alzheimer’s Society Centre of Excellence Independence at Home which is based at University College London. Any findings that are directly related to patients affected by Alzheimer’s can be disseminated via the work here to inform future work programmes that can address any inequalities identified in the analysis, and to help improve the standard of healthcare given to those who have sensory or cognitive impairments. 3. They are well placed and connected with a variety of Third Sector Organisations (Charities). Any findings that are directly relevant to the older generation can be disseminated to Age UK to inform future targeted work programmes again to address the inequalities discovered through the research to help better the healthcare provision for those with cognitive and sensory impairments, and to remove the barriers that this population may face when accessing mental health services. [1 paragraph unchanged] It is anticipated that all the work stated above should will be completed by the end of 2022 with the exploration of the new research questions potentially taking more time to produce results. 2024.

Benefits reported

Secondary analyses of the writing groups 2007 APMS have already been widely cited. The 2014 APMS report, published by NHS Digital, cites the contribution of UCL's previous work in this area and its influence on the 2014 survey that UCL are requesting as follows:͞ published by NHS Digital, cites the contribution of UCL's work in this area and its influence on the 2014 survey that UCL are requesting as follows: [1 paragraph unchanged] A paper (listed on previous page as paper 1) that used the APMS data to explore the relationship between sensory impairment and common mental illnesses, and assessed social functioning as a mediator of this relationship as well as the 'treatment gap', was published in BJPsych Open in November 2019. Earlier work (Shoham et al, 2019) has also explored the relationship between sensory impairment and depressive and anxiety symptoms, and how social functioning might be an important mediator, indicating a potential future point for intervention. A second paper, listed above as paper two, is in press in Schizophrenia Research, and has been available online since September 2019. Additional yielded benefits are expected to come from further analysis of the data. The papers listed as papers 3 and 4 above are undergoing final editing after which they will be submitted for publication. Paper 4 has been submitted as a conference abstract for the Royal College of Psychiatrists International Congress 2020. v4 update (Dec 2020): Of the two papers that were listed previously as being in the final stages of editing, one is in press and one is being revised for resubmission to BMJOpen after they requested revisions, these papers are: Shoham, N et al (in press, Schizophrenia Research) Temporal trends in psychotic symptoms: repeated cross-sectional surveys of the population in England 2000-14. Kurana et al. The association between sensory impairment and suicidal ideation and attempt: a cross-sectional analysis of nationally representative English household data. The team also have: - 2 Successful MSc dissertations both using the APMS data. - A Poster Presentation at the Royal College of Psychiatrists General Adult Psychiatry faculty conference titled: Is the Prevalence of Psychosis in England Increasing?

Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.

Expected output

UCL will disseminate findings through peer reviewed journal papers, supported by UCL media press release where findings are likely to be of widespread national interest. [7 paragraphs unchanged] 5. A paper exploring what predicts whether people who are experiencing symptoms of common mental disorder self-diagnose or receive a professional diagnosis diagnosis, and how this relates to receipt of treatment. [2 paragraphs unchanged] Target journals include British Journal of Psychiatry and BJPsych Open, Lancet Psychiatry, [21 words unchanged] clinical professions and the public. The applicant organisation has collaborated with the Alzheimer’s Alzheimer͛s society on previous press releases. All outputs published will be in the form of aggregated outputs with small numbers suppressed (as is in line with the HES-Analysis HESAnalysis guide). v4 update (Dec 2020): Work on the other papers proposed as future outputs in the last iteration of this agreement will also be worked on, and the research team also plan outputs exploring the following questions: 1. How trends in psychotropic prescriptions and common mental disorder symptoms compare. 2. What predicts whether people who are experiencing symptoms of CMD have received a professional diagnosis. 3. How treatment receipt (counselling, psychology, medication etc) differs between those who do and do not report receiving a diagnosis; the student may also explore this in relation to whether participants self-identify as having a mental disorder.

Expected measurable benefits

There is a lack of research currently on the mental health of [54 words unchanged] sensory impairments might impact on the likelihood of experiencing abuse or discrimination. The benefit of exploring the mental health of people with sensory impairment in the UK is so that more information is available to a variety of clinicians and organisations to make better decisions in the provision of health care regarding those affected. With the results derived from the statistical analysis undertaken, this extra scientific knowledge can be disseminated as relevant information to a variety of people. The benefit of exploring the mental health of people with sensory impairment in the UK is so that more information is available to a variety of clinicians and organisations to make better decisions in the provision of health care regarding those affected. With the results derived from the statistical analysis undertaken, this extra scientific knowledge can be disseminated as relevant information to a variety of people. [2 paragraphs unchanged] 2. The applicant is also the lead on the Alzheimer’s Alzheimer͛s Society Centre of Excellence – Independence ʹIndependence at Home which is based at University College London. Any findings that are directly related to patients affected by Alzheimer’s Alzheimer͛s can be disseminated via the work here – to ʹto inform future work programmes that can address any inequalities identified in the [6 words unchanged] standard of healthcare given to those who have sensory or cognitive impairments. [2 paragraphs unchanged] It is anticipated that all the work will stated above should be completed by the end of 2020. 2022 with the exploration of the new research questions potentially taking more time to produce results. So far, two papers were completed ahead of the previous target date of February 2020, and two have not been completed by this date due to competing commitments of the authors. These two papers are expected to be submitted for publication within two months.

Benefits reported

Secondary analyses of the writing groups 2007 APMS have already been widely [19 words unchanged] and its influence on the 2014 survey that UCL are requesting as follows: follows:͞ “Analyses Analyses of APMS 2007 data indicated that white people were the ethnic group [64 words unchanged] to have requested mental health treatment but not received it than other groups.” groups. [2 paragraphs unchanged] The papers listed as papers 3 and 4 above are undergoing final [14 words unchanged] as a conference abstract for the Royal College of Psychiatrists International Congress 2020 2020. v4 update (Dec 2020): Of the two papers that were listed previously as being in the final stages of editing, one is in press and one is being revised for resubmission to BMJOpen after they requested revisions, these papers are: Shoham, N et al (in press, Schizophrenia Research) Temporal trends in psychotic symptoms: repeated cross-sectional surveys of the population in England 2000-14. Kurana et al. The association between sensory impairment and suicidal ideation and attempt: a cross-sectional analysis of nationally representative English household data. The team also have: - 2 Successful MSc dissertations both using the APMS data. - A Poster Presentation at the Royal College of Psychiatrists General Adult Psychiatry faculty conference titled: Is the Prevalence of Psychosis in England Increasing?

Unchanged: Objective for processing, Processing activities.

Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.

Objective for processing

The applicant has published previously on the 2000 and 2007 APMS datasets. The 2014 dataset is the first of this recurring survey, the first of which took place in 1993, to be helped by NHS Digital. The survey is undertaken by NatCen, supported by a writing group of academics (including the applicant) from several Universities including UCL who undertake secondary data analyses, that have contributed a significant body of knowledge on mental wellbeing in the UK over the past 25 years. UCL are requesting access to the 2014 APMS Data Set for the purposes of a study instigated by a clinical reader at the UCL Division of Psychiatry. This is an application for an extension of Adult Psychiatric Morbidity Survey (APMS) data used by UCL. The data requested is already held by the applicant. The extension is intended to allow further time for analysis, and to respond to reviewer comments on papers that are at the submission stage. It will also allow for two further planned papers to be written by UCL MSc students. The sole data controller and processor is University College London. This study will explore how and why cognitive and sensory impairments might be associated with worse mental health; and how health and social disadvantages might increase the risk of experiencing abusive and discriminatory experiences. The UK Department of Health defines abuse as “a violation of an individual's human and civil rights by another person(s)" (2). Abuse is defined by the impact, rather than intention of actions or inactions on an individual. Hearing and visual loss are very common, with hearing loss alone affecting a third of people aged 65 and over. Sensory impairments can present barriers to social engagement, and people who experience sensory impairments are more likely to require help from others in Activities of Daily Living. Sensory impairments might therefore be a risk factor for experiencing abuse and discrimination, although this has not been studied before. The applicant has published previously on the 2000 and 2007 Adult Psychiatric Morbidity Survey (APMS) datasets. The 2014 dataset is the most recent iteration of this recurring survey, the first of which took place in 1993. The survey is undertaken by NatCen, supported by a writing group of academics (including the applicant) from several Universities including UCL who undertake secondary data analyses, which have contributed a significant body of knowledge on mental wellbeing in the UK over the past 25 years. The APMS survey data would be transferred to UCL data safe haven, where it would be analysed. The only outputs would be for publication in research journals, and no participant would be identifiable from these publications. No other organisations are involved in the data analysis. This study has already explored how and why sensory impairments might be associated with worse mental health; and how prevalence of psychotic symptoms has changed over time. In future, it will explore how health and social disadvantages might increase the risk of experiencing abusive and discriminatory experiences, and how cognitive impairment might be associated with other aspects of mental health. The UK Department of Health defines abuse as “a violation of an individual's human and civil rights by another person(s)" (2). Abuse is defined by the impact, rather than intention of actions or inactions on an individual. Hearing and visual loss are very common, with hearing loss alone affecting a third of people aged 65 and over. The APMS survey data was transferred to the UCL data safe haven, where it was analysed. The only outputs would be for publication in research journals and conference posters, and no participant would be identifiable from these publications. No other organisations are involved in the data analysis. [1 paragraph unchanged] The purpose of the project is to conduct secondary analysis of the [96 words unchanged] to publish findings in an open access scientific journal. The secondary analysis wok work was initiated by UCL in discussion with NatCen and the wider APMS writing group. This work is not independently funded and will be carried out by [28 words unchanged] psychiatry. No organisations other than UCL are involved in the planned data analysis, analysis: all those involved in the processing of the data are substantive employees [14 words unchanged] employees. No elements of the work will take place outside the UK. [3 paragraphs unchanged] The processing of the data is justified under article 6(1)(e) of the GDPR, because participants in the APMS gave consent for their data to be analysed for the purpose of improving understanding of mental health and illness in the population. Under article 9(2)(j), the data subjects have given explicit consent for data to be analysed in the public interest to further health research.

Processing activities

All organisations party to this agreement must comply with the Data Sharing Framework Contract requirements, including those regarding the use (and purposes of that use) by “Personnel” (as defined within the Data Sharing Framework Contract i.e.: employees, agents and contractors of the Data Recipient who may have access to that data). The 2014 APMS dataset is held on behalf of NHS Digital by the UK Data Service (UKDS) (www.ukdataservice.ac.uk ) and UKDS are responsible for dissemination under direction by NHS Digital. UCL already holds the whole dataset; there is no facility to select individual variables. They will be able to download the dataset from UKDS for the period specific within the DSA and they must securely destroy all local copies of the dataset when the DSA expires and notify DARS in line with standard procedures. This 2014 version of the dataset available via DARS has been redacted on Disclosure Control Procedure advice to minimise the likelihood of individuals being able to identify anyone taking part in the survey. The 2014 APMS dataset is held on behalf of NHS Digital by the UK Data Service (UKDS) (www.ukdataservice.ac.uk ) and UKDS are responsible for dissemination under direction by NHS Digital. UCL will get the whole dataset; there is no facility to select individual variables. They will be able to download the dataset from UKDS for the period specific within the DSA and they must securely destroy all local copies of the dataset when the DSA expires and notify DARS in line with standard procedures. This 2014 version of the dataset available via DARS has been redacted on Disclosure Control Procedure advice to minimise the likelihood of individuals being able to identify anyone taking part in the survey. The pseudonymised APMS data is stored and accessed within the Data Safe Haven. This is UCL's data service for storing, handling and analysing identifiable data. It has been certified to the ISO27001 information security standard and conforms to NHS Digital's Information Governance Toolkit. Once an active data sharing agreement is in place, UKDS will transfer the pseudonymised APMS data to UCL. It will be transferred and accessed within the Data Safe Haven. This is UCL's data service for storing, handling and analysing identifiable data. It has been certified to the ISO27001 information security standard and conforms to NHS Digital's Information Governance Toolkit. [1 paragraph unchanged] Analysis of the data will be undertaken using statistical software, in order to understand the mental health needs of those with sensory impairment. All analyses software. Analyses will be performed using data weighted to take account of the complex [7 words unchanged] to ensure that the results are representative of the British Household population. Conceptual models developed that seek to explain abuse consider: victim vulnerability, abuser stress, psychopathology or impairment, intra-individual dynamics and societal attitudes. The research team at UCL have based the hypotheses of the research project on this model, hypothesising that those who are more vulnerable due to cognitive or sensory impairments are at greater risk of worse mental health and suicidal ideation, abusive or discriminatory experiences, and that this increased risk may be due to dependence on others for care and relative isolation from protective social support The data will not be stored, processed or in any other way accessible by a third party organisation. The data will be held on, held, and only analysed analysed, on a UCL computer within the UCL Division of Psychiatry. [1 paragraph unchanged] NHS Digital reminds all organisations party to this agreement of the need to comply with the Data Sharing Framework Contract requirements, including those regarding the use (and purposes of that use) by “Personnel” (as defined within the Data Sharing Framework Contract ie: employees, agents and contractors of the Data Recipient who may have access to that data)

Expected output

[1 paragraph unchanged] The following is a list of planned papers for publication in peer reviewed journals; it is anticipated these will be published by February 2020: The following papers have already been published or are in press in peer-reviewed journals: 1. A paper exploring the relationships relationship between sensory impairment and common mental health illness and social functioning as a possible mediators mediator of this relationship, as well as the 'treatment gap' for people with sensory impairments relative to those without. 2. A paper exploring the relationships relationship between cognitive sensory impairment and mental health psychotic symptoms, and social functioning as a possible mediators mediator of this relationship relationship. The following is a list of planned papers that are in the final stages of editing prior to submission for publication; it is anticipated these will be published by February 2021: [1 paragraph unchanged] 4. A paper exploring what predicts whether people who are experiencing symptoms of common mental disorder self-diagnose or receive a professional diagnosis 4. A paper exploring whether prevalence of psychotic symptoms in the population of England has changed over time, and correlates of experiencing psychotic symptoms 5. A paper exploring sensory impairment and psychosis and possible mediators of any association. The following is a list of planned papers for publication in peer reviewed journals; it is anticipated these will be published by February 2022: Target journals include British Journal of Psychiatry, Lancet Psychiatry, International Psychogeriatics. The papers are intended of the scientific community, as well as interested members of clinical professions and the public. The applicant organisation has collaborated with the Alzheimer’s society on previous press releases. 5. A paper exploring what predicts whether people who are experiencing symptoms of common mental disorder self-diagnose or receive a professional diagnosis 6. A paper exploring the relationships between cognitive impairment and mental health and possible mediators of this relationship 7. A paper exploring predictors of abuse in older people Target journals include British Journal of Psychiatry and BJPsych Open, Lancet Psychiatry, Schizophrenia Research, BMJ Open, and International Psychogeriatrics. The papers are intended of the scientific community, as well as interested members of clinical professions and the public. The applicant organisation has collaborated with the Alzheimer’s society on previous press releases. [1 paragraph unchanged]

Expected measurable benefits

There is a lack of research currently on the mental health of [25 words unchanged] of researchers has raised awareness of the mental health needs of older people It people: it is expected that this research will allow for increased scientific knowledge of [69 words unchanged] knowledge can be disseminated as relevant information to a variety of people. [4 paragraphs unchanged] Target Dates It is anticipated that all work will be completed by the end of 2020. So far, two papers were completed ahead of the previous target date of February 2020, and two have not been completed by this date due to competing commitments of the authors. These two papers are expected to be submitted for publication within two months.

Benefits reported

Secondary analyses of the writing groups 2007 APMS have already been widely cited. The 2014 APMS report, published by NHS Digital Digital, cites the contribution of UCL's previous work in this area and its influence on the 2014 survey that UCL are requesting as follows: [1 paragraph unchanged] A paper (listed on previous page as paper 1) that used the [17 words unchanged] as a mediator of this relationship as well as the 'treatment gap', has now been submitted for publication. was published in BJPsych Open in November 2019. A second paper, listed above as paper two, is in press in Schizophrenia Research, and has been available online since September 2019. The papers listed as papers 3 and 4 above are undergoing final editing after which they will be submitted for publication. Paper 4 has been submitted as a conference abstract for the Royal College of Psychiatrists International Congress 2020

Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.

Objective for processing

[5 paragraphs unchanged] This work is not independently funded and will be carried out by [42 words unchanged] those involved in the processing of the data are substantive employees of UCL. UCL, or students on UCL MSc courses under the supervision of UCL substantive employees. No elements of the work will take place outside the UK. All UCL students are expected to undertake annual training on handling highly confidential information. Trainees/students register for and complete NHS Digital’s Data Security Awareness (NHSD) course provided by e-Learning for Health. The course covers data security awareness, the law, threats to data security, breaches and incidents, and the General Data Protection Regulation. Completion of the course is sufficient evidence of basic information governance training to handle highly confidential information under the SLMS Information Governance Training Policy. Trainees'/ students up-to-date training is recorded in the SLMS IG training register.

Unchanged: Processing activities, Expected output, Expected measurable benefits, Benefits reported.