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 Mental health research at Manchester

Mental health research at Manchester

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Mental health research at Manchester brings together psychiatrists, psychologists, epidemiologists, nurses, biostatisticians, health economists and academic researchers.

Our aim is to understand, prevent, and treat mental and co-morbid physical health problems and to enhance health and wellbeing.

We develop novel interventions for treating mental health problems, including new psychological and biological treatments. We then adapt them to work across cultures and work to ensure that they are implemented into services for people with mental health problems.

We have a large number of international collaborations and are translating much of our work into services in less developed areas in the world.

Many of our staff work closely with NHS services, charities and public health bodies as well as industry, so the work we do has a big impact on the community.

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Our strategy

We aim to deliver research growth in this area by drawing on discovery and translational research in local hospital trusts and the community in order to achieve long-term NHS goals for the early detection and treatment of severe mental health problems.

We do this in two ways:

  • Gaining a better understanding of the biological and psychological mechanisms that underpin severe mental illness.
  • Discovering, developing and delivering biological, psychological and digital interventions into practice.

Our current strategic goals include:

  • early psychosis detection;
  • understanding mechanisms that underpin suicide;
  • links between trauma and mental health;
  • tackling stigma;
  • understanding the role of inflammation, glutamate and dopamine in early psychosis;
  • improving our prediction and prevention of psychosis relapse using digital health technologies.

These goals drive our work on developing and implementing new psychological and biological treatments.

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Areas of research activity

Our work covers a range of areas, with four key areas underpinned by cross-cutting themes.

Our four key areas of research activity are:

  • suicide, risk and safety
  • understanding and treatment of mental health problems
  • primary care, population health and social care
  • youth, parenting and families

The cross-cutting themes are:

  • epidemiology
  • digital platforms
  • health economics
  • statistics
  • common measurement and outcomes
  • early detection and prevention
  • neurobiology and molecular neuroscience
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Major projects

Our researchers are involved in a number of major projects covering a wide variety of mental health issues, from pre-school autism to suicide.

Psychological treatments for suicidality

Research led by Professor Gillian Haddock, Dr Patricia Gooding and Dr Daniel Pratt is exploring how psychological treatments can be important when treating people who experience suicidal behaviours and thoughts.

The CARMS trial (Cognitive AppRoaches to coMbatting Suicidality) is evaluating a new psychological talking therapy for people who experience or have experienced psychosis and suicidal thoughts.

The project is concerned with finding out if this new therapy is effective. In order to do this, we are inviting people to join us in a study comparing two different treatments:

  • usual mental health services
  • usual mental health services plus the CARMS therapy.

Working with trauma

Mental health at Manchester is involved in research that will bring about important clinical innovation in the recognition and treatment of trauma in people with psychosis.

Dr Filippo Varese is leading the RfPB-funded EASE trial which will evaluate a trauma-focused therapy (eye movement desensitisation and reprocessing) for people with early psychosis.

Dr Varese and Professor Tony Morrison are also involved in the multi-site STAR trial.

This project will evaluate the efficacy of a cognitive behavioural therapy intervention for treating trauma in people with psychosis, and the neural and psychological mechanisms that might explain who is most likely to benefit from trauma therapy.

National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH)

As the UK’s leading research programme into suicide prevention in clinical services, NCISH has the overall aim of improving safety for all mental health patients.

Our core database is a national consecutive case series that examines the circumstances leading up to and surrounding the deaths by suicide of people under the recent care of, or recently discharged from, specialist mental health services.

Led by Professor Louis Appleby, we publish regular reports which recommend measures to reduce the number of suicides by people receiving specialist mental health care.

Mental health care providers that have adopted our recommendations have subsequently experienced lower patient suicide rates.

Children and adolescents with parental mental illness (CAPRI)

Led by Professor Kathryn Abel, this European Research Council funded project brings together epidemiology and neuroscience with the aim of identifying high-risk children living with parental mental illness and what type of targeted intervention they need.

Working with collaborators in Sweden and Australia to explore diverse population datasets, the team will also use powerful neuroimaging to discover which at-risk infants show abnormal cognitive development.

Pre-school Autism Communication Trial (PACT) 7-11 study

Led by Professor Jonathan Green and funded by the Medical Research Council, the PACT 7-11 study was a follow-up study with families who were involved in our original trial of a parent-mediated communication intervention for young children with autism.

The study’s findings were published in The Lancet.

Improving remote delivery of psychological therapy (Equity)

IAPT (Improving Access to Psychological Therapies) services support hundreds of thousands of people across the country who are experiencing anxiety and depression. Many of the psychological therapy sessions offered are delivered by telephone – a method recommended by NICE.

Many people like the idea of treatment delivered by telephone because appointments are easier to access and can be less stigmatising compared to face-to-face appointments.

However, in the NHS, many people fail to begin and complete telephone treatment, meaning that they do not receive the help that they need. The COVID-19 pandemic means that telephone and other remote delivery (such as video conference) is even more important

Through the EQUITy programme, led by Professors Penny Bee and Peter Bower, we want to improve the way psychological therapies are delivered by telephone and other remote means.

We are working with patients and professionals to deliver training and support to improve outcomes for patients. 

 

Case studies

The following case studies demonstrate the influence that our research has had on policy and practice, as well as outcomes for mental health patients.

Changing policy for early psychosis treatment

Detection and management

Our researchers have made a major impact in the area of detection and management of people with early psychosis.

Studies led by Professor Alison Yung demonstrated the possibility of identifying people at high and imminent risk of developing a psychotic disorder such as schizophrenia.

Dr Filippo Varese and Professor Alison Yung are improving prediction of psychosis in ARMS using a clinically useful prognostic tool that is co-designed by service users and NHS staff for routine use in the NHS (the IPPACT study).

The aim of the new tool is to improve the ability to detect those most at risk for transition to psychosis above the current rate of about 15-22% after 12 months.

A prospective cohort study with 12-month follow-up will be used to validate the prognostic tool.

CBT and psychosis

Research led by Professor Anthony Morrison includes the world's first clinical trial using only cognitive behavioural therapy (CBT) in the 'at risk mental state' (ARMS) group and the use of CBT in first-episode psychosis.

Professor Shon Lewis and Dr Richard Drake established a significant association between delay in treatment of the first episode of psychosis and outcomes. This demonstrated that clinical outcomes could be improved considerably if lengthy delays were reduced.

Together, this research has influenced policy and practice in the UK and abroad, including the establishment of early psychosis teams dedicated to early detection and treatment (50 in England alone).

Our findings have also influenced the development of NICE Guidelines and the NHS England Early Intervention Standard, in which detection and management of the ARMS group is mandatory.

As a result, clinicians are now required to respond urgently to a first episode of psychosis, and the use of CBT in both ARMS and first-episode psychosis are recommendations.

Digital interventions in severe mental illness

Professor Sandra Bucci and Professor Shon Lewis have led major developments in automated real-time assessment of symptoms using our smartphone app (ClinTouch) and real-time delivery of psychological therapy (Actissist).

Their aim is to develop evidence-based digital health technologies that promote self-management and improve outcomes of mental health problems.

These ground-breaking digital platforms have also formed the basis of other RCUK-funded trials in severe mental illness in the UK.

ClinTouch

Supported by funding from the Medical Research Council, ClinTouch is both a platform technology and a stand-alone app that helps people with psychosis manage their own symptoms.

It is based around a smartphone app developed by a team of service users, leading clinicians and academics, software engineers and health professionals at The University of Manchester and Manchester NHS Trusts.

The app triggers, collects and wirelessly uploads symptom data in real-time to a central server at the clinical team base. The provision of diary entries encourages service users to record information relevant to how they are feeling, leading to more informed discussions between service user and healthcare professional.

Graphical information highlighting general mood and behaviour patterns allows the service users and clinicians to track their progress and understand their experiences more clearly.

Actissist

National clinical guidelines recommend a treatment known as cognitive behavioural therapy (CBT) for people who have experienced psychosis.

Supported by Medical Research Council funding, we have developed a CBT-informed smartphone app (Actissist) for people in the early phase of psychosis to scale up access to helpful strategies in the flow of an individual’s daily life.

 

Contact

Neuroscience and Mental Health domain - Gillian Haddock

Professor Gillian Haddock
Email: gillian.haddock@manchester.ac.uk