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Dec
7
2017

A framework for mental health research – what next?
by

We have been involved over the past 18 months in the development of a 10 year strategy for mental health research in the UK. Developing such a strategy was one of the recommendations in the 2016 Five Year Forward View for Mental Health report.  Full of optimism we engaged with the process, sitting on committees and recommending experts to consult. In particular, we recommended experts from experience to join working groups: basic science, translational research, health services and population research, and children and young people. What we learnt very early on was this wasn’t going to be an easy process. Difficult and complicated issues needed to be discussed. Indeed it was decided to produce a ‘framework’ rather than a strategy.   It was also clear mental health research needed substantial development – particularly to build a diverse community engaging beyond the traditional mental health sector.

Young people are a particular priority in this Department of Health led research framework, with a focus on work that helps with early intervention and prevention. Given that a green paper has recently been launched on children and young people’s mental health (consulting to 2 March 2018) it is perhaps not difficult to see why.  We asked people to submit their questions about young people’s mental health as part of a McPin led project called ‘Right People Right Questions’. We had over 5500 questions submitted to us from just about 2600 people. We quickly saw that there were a lot of questions coming through to which there simply isn’t answer right now. But there seems to be a strong desire to change this.

The idea behind the mental health framework for research is to improve co-ordination and build capacity. In other words to foster more people working in mental health research. And to encourage more organisations and individuals to work together in new and creative ways.  This is needed to improve the UK science base and accelerate discoveries that can meaningfully progress improvements in prevention and care across the life span.

It does not have all the answers. It does not suggest which research topics should be researched. It does not promise that more resources will be available, indeed there is no mention of money in it at all. It is a call to action that mental health research could, and should, do much more to improve the health of our communities everywhere.

One recommendation is to strengthen connections between mental and physical health research. If the framework leads to significant progress on the join up of research around mental health and physical health that will be a huge achievement. If it pushes forward the mental health prevention agenda and helps us all stay well, or stay better for longer, with the support of new knowledge and translation of research into practice, it will save lives, reduce distress in families, support workplaces, schools and communities to thrive.  It must also address inequalities in how some groups are disproportionately affected by mental health problems, and develop innovative solutions that are population and context specific. We are pleased that there are several references to Public and Patient involvement (PPI) and co-production in the framework.  There is an encouraging call to improve involvement in more ‘basic’ research. This is research that might be carried out in laboratories for example. Involvement of people with experience of mental health issues in such research has long been lacking. There is an opportunity to address this.

The framework contains nine overarching recommendations, and we wouldn’t disagree with any of the headlines. These are ‘basic foundations’ necessary to accelerate discoveries. The main question we have, however, is how will change happen in practice? Where are the sticks and carrots to ensure better co-ordination of mental health research, when academic communities are naturally very competitive?

  1. Mental health research should take a ‘life course approach’
  2. Patient and Public Involvement (PPI) should be strengthened and developed. Different funders have differing requirements for PPI in research they fund. These requirements should be more consistent
  3. Connections between physical and mental health research should be strengthened
  4. Greater co-ordination and leadership of mental health research activity is needed
  5. Better use of data / informatics, digital technologies and linkage of national data sets
  6. Flexible funding arrangements
  7. Promote development and evaluation of new and alternative approaches to prevent mental health problems or support people with them.
  8. Engage with industry (digital, engineering, design technology and pharmaceutical).
  9. Streamline research regulation, ethics, and governance

 

The framework encourages collective efforts to drive change. This is an ambitious agenda. Expertise is currently concentrated geographically in a few places across the country. We found the same in our analysis of mental health research activity in NHS Trusts. This needs to change. Mental health research funders will have a key role to play. The Alliance of Mental Health Research Funders www.amhrf.org.uk), that I chair, is yet to consider its own response and will do so in due course. We are very interested in your reaction to the framework – please let us know what you think.