Conceptual framework for data harmonisation in mental health using the International Classification of Functioning, Disability and Health: an example with the R2D2-MH consortium

INTRODUCTION: Advancing research and support for neurologically diverse populations requires novel data harmonisation methods that are capable of aligning with contemporary approaches to understanding health and disability. OBJECTIVES: We present the International Classification of Functioning, Disability and Health (ICF) as a conceptual framework to support harmonisation of mental health data and present a proof of principle within the Risk and Resilience in Developmental Diversity and Mental Health (R2D2-MH) consortium. METHOD: 138 measures from various mental health datasets were linked to the ICF following the WHO's established linking rules. FINDINGS: Findings support the notion that the ICF can assist in the harmonisation of mental health data. The high level of shared ICF codes provides indications of where items may be readily harmonised to develop datasets that may align more readily with contemporary approaches to understanding health and disability. Although the linking process necessarily entails an element of subjectivity, the application of established rules can increase rigour and transparency of the harmonisation process. CONCLUSIONS: We present the first steps towards data harmonisation in mental health that is compatible with contemporary approaches in psychiatry, being more capable of capturing diversity and aligning with more transdiagnostic and neurodiversity-affirmative ways of understanding data. CLINICAL IMPLICATIONS: Our findings show promise, but future work is needed to address quantitative harmonisation. Similarly, issues related to the traditionally 'pathophysiological' frameworks that existing datasets are often embedded in can hinder the full potential of harmonisation based on the ICF.