The Mental Health Research Network Peter Huxley March 05

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The Mental Health Research NetworkPeter
Huxley March 05
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Why is mental health a big issue?

• World Health Report (WHO, 2001)
• Mental Health accounts for more than one third
  global disability
• Top three diagnoses are mental health issues
• Suicide leading cause of death in young men

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The cost of mental health to the exchequer

• Direct care costs 12.5 billion
• Cost to UK society of more than 77 billion
• USA direct care costs for severe mental illness
  is 40 billion
• Around one in six of the population suffers from
  anxiety and or depression
• At least 1 in 4 GP consultations for mental ill
  health

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Current state of Mental Health research

• Less than 5 of the trials on the Cochrane
  database indexed under mental disorder
• Literature dominated by
• Short term trials
• Hospital based
• Medication studies

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What is the problem for mental health research?

• Too few studies
• Lack of funding or lack of creativity or capacity
  or all three
• Studies too small
• Often take place only in a hospital

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Size does matter2000 Schizophrenia Trials

• 3 could have detected a clinically important
  change in mental health
• Too small to detect many of the risks of
  treatment
• Too small to detect whether there were
  differences between sub-groups

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UK MHRN

• Established to provide the NHS infrastructure
  for clinical trials and other well designed
  studies

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The MHRN is

• A structure to provide admin support
• research governance and contracting procedures
• Monitor and maintain recruitment rates
• Shift or change recruitment sites
• Expand partnerships to develop relevant
  researchable questions
• Service users, clinicians, scientists

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Structure of the UK MHRN
UKCRNCC
Advisory Board
Adoptions Committee
Operational Group
Research Groups
SURGE
Eight Hubs
Clinical Component Secondary, primary and social
care
Research Component
Clinical Component
Linked sites
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Where are the Research Hubs?

North East Hub Universities of Durham Newcastle

Heart of England Hub Universities of Birmingham,
Central England, Leicester, Warwick,
Wolverhampton

North West Hub University of Manchester
University of Liverpool

East Midlands Hub Universities of Nottingham
Lincoln

West Hub Universities of Bristol, Bath, West of
England, Peninsula Medical School

Cambridgeshire and Norfolk Hub Universities of
Cambridge East Anglia

South London Hub Institute of Psychiatry South
London Maudsley NHS Trust

North London Hub Imperial College University
College London
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What the MHRN can do

• Coordinating centre
• Contracts and Finances
• IT - Secure Data Entry System DES
• Progress Mapping
• Regularly monitoring of project progress and
  recruitment rates
• Emphasis on identifying problems early and
  problem solution.
• MHRN Hubs
• Administration - Honorary contracts, LREC
  approval, RD Approval
• Recruitment
• Social Care and Primary Care services
• Clinical Studies Officers
• Communications
• Publicity
• Site Implementation Group
• Project Meetings

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The Network So Far
20 Universities 37 NHS Trusts Covering a
population of 29.7 million Approx 60 population
of England 25 studies already on the network
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MHRN social themes/inclusion (23)

• Outcomes of Involuntary Hospital admissions
• Mental health professionals Information Sharing
  practices with carers
• The impact of treatment foster care on the
  outcomes for young people looked after by the
  authorities
• Improving social recovery in early affective
  non-affective psychosis
• Alternatives to in-patient care
• BECCA befriending and the costs of caring

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? Possible social outcomes/social inclusion

• Evaluating the development and impact of early
  intervention services in the West Midlands (EDEN)
• Feasibility study of enhanced relapse prevention
  by key workers for people with bipolar disorder
• SuperEden Early Intervention for psychosis
  services
• Antidepressant drug therapy versus a
  community-based psychosocial intervention
• Early Intervention for adolescents with bulimia
  nervosa web based CBT intervention
• Eval. of cog. remediation supported employment
  to improve outcome for people with schizophrenia

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Research groups

• Early intervention in psychosis
• Self Help
• Treatment for depression
• Scoping exercises to identify priorities for
• Childrens research
• Social Care
• Elderly research

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UK MHRN

• Social research scoping exercise
• Jerry Tew (Social Perspectives Network)
• Nick Gould (SCIE/NIMHE Fellow)
• Peter Huxley (MHRN Managing Partnership)
• Jenny Secker (APU)

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Social Research Scoping

• Results of previous exercises
• Social research priority topics (social
  inclusion)
• Capacity Issues
• Methodology issues

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Social Research Scoping

• E-mail consultation exercise topics (social
  inclusion)
• Project specification meetings
• Writing group(s)
• Project bid(s) to run on MHRN
• Report to MHRN
• Dissemination of findings

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Social Research Scoping

• Capacity issues
• Research funding for social research
• Research training (ALSSS Report Great
  Expectations)
• National Coordinating Centre for Research
  Capacity Development
• NCC RCD AWARDS SCHEME
• (Career Scientist Personal Award Scheme Post
  Doctoral Awards)

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Methodological issues

• Government Social Research Unit
• GSRU policy research studies
• GCSRO research training (GCSRO seminars)
• The Magenta Book (www.policyhub.gov.uk)
• Campbell Collaboration (social welfare group)
• ESRC (NCRM) (www.ncrm.ac.uk)

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Methodological issues

• NCRM at University of Southampton
• Nodes from April 2005
• MLM Bristol
• Qualitative Cardiff
• Bayesian Imperial
• Synthesis methods Inst of Education
• Statistical modelling Lancaster/Warwick
• Multi-dimensional methods for real life research
  - Leeds

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MHRN

• Contact details for the social research scoping
  exercise
• Peter.huxley_at_kcl.ac.uk