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A Framework for
mental health research
December 2017
Contents 1
Contents
Foreword2
1. Executive summary 4
2. Mental health of the UK population 10
2.1 Mental health in the UK 10
2.2 Mental health of children and young people in the UK 11
2.3 Cost of mental health problems to the UK 12
2.4 The Five Year Forward View of Mental Health and the role of research
and innovation in driving change 12
2.5 Process of framework development 13
3. Why mental health research matters 15
3.1 Mental health research in the UK – the opportunity for improvement 15
3.2 Case studies 16
4. Public involvement and making research matter 19
4.1 Involvement in research 19
5. Working group summaries: mental health research opportunities 21
5.1 Introduction 21
5.2 Basic science 21
5.3 Translational research 22
5.4 Population and health services 22
5.5 Children and young people 23
6. Barriers and opportunities 24
6.1 Life-course approach 24
6.2 Patient and public involvement 24
6.3 Mental and physical health 25
6.4 Co-ordination and infrastructure 25
6.5 Data, informatics and virtual populations 26
6.6 Flexible funding 27
6.7 Emerging interventions and alternative settings 28
6.8 Industry engagement 28
6.9 Regulation and governance 29
6.10 Capacity building 30
7. Conclusion and recommendations 32
8. Annexes 37
8.1 Steering group and working group membership 37
8.2 Contributors 40
8.3 Recent reports and reviews 41
8.4 Research priority setting in mental health 41
9. References 43
10. Acknowledgments 51
2 A framework for mental health research
Foreword
more work needed to increase the funding We are grateful for the contributions of
available, involve more people in the research everyone who has joined in the development
process, and ensure that new knowledge of this Framework. We are optimistic that the
is accessible to people delivering and using UK can make substantial short, medium and
services. This will require close collaboration long-term advances in research leading to the
between researchers, funders, voluntary essential transformation in mental health.
sector, and the government. As always,
people with experience of mental health
problems must be involved at every stage of
the process.
This Framework for Mental Health Research Developing a mental health problem at
has been developed in response to a a young age can have life-long adverse
recommendation in the Five Year Forward consequences, affecting emotional and social
View for Mental Health published in February development, educational achievement and
2016 by the independent Mental Health chances of employment.
Taskforce. It offers a collective view of Section 3 ‘Why mental health research
how mental health research should move matters’ emphasises the importance of
forward over the next decade. The UK research in driving innovation in mental health
needs to consider how research can take care and in bringing hope for the future.
advantage of exciting new developments Research improves our understanding of
in medicine, science and technology in the the causes and risk factors for mental health
coming years to make a real difference to problems, supports promotion and prevention
people’s lives. Implementation of research initiatives helping people to stay well,
evidence is another important issue – greater underpins the development and evaluation of
implementation would accelerate progress. new forms of support (psychological, social,
Development of the Framework was co- cultural and pharmacological), and provides
ordinated by the Department of Health evidence on how innovative approaches can
between February 2016 and November 2017. be put into practice in the healthcare system
This report and its recommendations reflect and in wider settings. Case studies in this
the discussions of the steering group, working section illustrate the UK’s strengths in mental
groups, stakeholder workshops and wider health research and the difference UK-based
engagement and builds on previous mental research has already made.
health research prioritisation work. Details of The importance of involving people with
contributors are provided in Annex 8.2. mental health problems at all stages
Mental health problems are widespread of research is the focus of Section 4.
in the UK and affect people throughout Involvement improves research, for example
the life-course. Section 2 describes the by increasing recruitment, improving study
impact mental health problems can have design and ensuring the use of the most
on individuals, and the wider societal and relevant outcome measures. This is an
economic consequences. It considers area where the UK has made advances,
some of the socioeconomic factors which and there is an opportunity for our mental
increase the risk of developing a mental health research community to continue to
health problem. It also recognises the lead in developing and establishing best
need for research to focus on children and practice. There is scope to increase diversity
young people; three-quarters of mental in involvement, increase co-production and
health problems start before the age of 18. user-lead research, and to promote greater
1. Executive summary 5
includes local authorities and education all life-science funding applications and
providers, workplaces, social care and the reporting in final reports and institutional
voluntary sector. reviews.
Recommendation 2: Patient and public •• Routine capture of mental health outcome
involvement (PPI) measures in studies of physical health
Stakeholders: Research funders, HRA, including prevention research (and the
INVOLVE, Universities, Charities. converse, routine capture of physical
outcome measures in mental health
Patient and public involvement in mental research).
health research should continue to be
strengthened and systematically embedded •• Research which spans physical and
throughout research regulation, ethics mental health such as: understanding
and governance, shaping and determining mechanisms behind the mortality gap
research questions, assessment of research in severe mental illness; side-effects of
proposals and research evaluation. medication; ethnicity; immunology and
mental health; addictions/compulsive
User-led research as an emerging discipline, disorders and physical health.
generating new knowledge and investigating
things that matter on a day to day basis to Recommendation 4: Co-ordination
people experiencing mental health problems, and infrastructure
should continue to be strengthened. So too Stakeholders: Research funders, PHE, NHSE,
should co-production in research, combining Industry, Universities, Voluntary sector,
expertise of practitioners, healthcare National Audit Office.
commissioners, service users, carers, policy Greater co-ordination and leadership of
makers and researchers together within multi- mental health research activity is needed
disciplinary research teams. across the UK between public research
There is a need to make involvement more funders, universities, industry, charities and
representative particularly by increasing the wider voluntary sector.
inclusion of children and young people Initially, building on the existing work of MQ, a
and people with protected characteristics. portfolio review of UK mental health research
Involvement in basic research should funders, including the Medical Research
be strengthened and requirements for Council (MRC) and National Institute for
involvement harmonised across research Health Research (NIHR) should be published
funders. and made openly available with a gap
Recommendation 3: Mental and analysis to inform future investment.
physical health This should lead to better alignment of mental
Stakeholders: Research funders, PHE, health infrastructure and resources including:
NHSE, Industry. capacity for investigation of animal models,
Strengthening the connections between translation of basic neuroscience, deep
physical and mental health research should phenotyping, informatics and bio-banking.
be a priority. This should include: The mental health components of national
research resources should be progressively
•• Routine assessment by applicants, strengthened, including through the use of
reviewers and funding committees of the web-based and mobile record linkages.
relevance of research to mental health in
1. Executive summary 7
treatment of children and young people with 1. Research into mental disorder
depression, £32 of savings in overall public prevention, mental health promotion,
costs of care could be achieved.53 and interventions in children, adolescents,
and young adults
2.5 The Five Year Forward View 2. Focus on the development and causal
for Mental Health and the role mechanisms of mental health symptoms,
syndromes, and wellbeing across the
of research and innovation in lifespan (including older populations)
driving change 3. Develop and maintain international and
interdisciplinary research networks and
The Five Year Forward View for Mental Health shared databases
(5YFVMH) was published in February 2016.54
This report, from the independent Mental 4. Develop and implement better
Health Taskforce to the NHS in England, set interventions using new scientific and
out a series of recommendations to improve technological advances
the experiences and outcomes of those with 5. Reduce stigma and empower service
mental health needs in England. It built on the users and carers in decisions about
Future in Mind report, which in the previous mental health research
year had articulated how access to high
6. Establish health-systems and social-
quality mental health care could be made
systems research that addresses
easier for children and young people.55
quality of care and takes into account
The 5YFVMH indicated the ‘delivering sociocultural and socioeconomic contexts
better care to more people … requires and approaches
the development of new ways to improve
The 5YFVMH recommended that the
the quality and productivity of services.’
Department of Health should publish a report
Also highlighted was the crucial role of
in one year setting out a 10-year strategy for
the community and voluntary sector in
mental health research.58
supporting groups currently underserved by
existing services, e.g. children and young In January 2017, the Government’s
people, older people, lesbian, gay, bisexual response to the 5YFVMH accepted this
and transgender people, black, Asian and recommendation.59 Development of this
ethnic minority communities.56 document was led by the Department of
Health to provide a framework for mental
The 5YFVMH recognised the importance of
health research, taking into consideration
research and innovation in driving change,
UK-wide issues and proposing a set
and the taskforce had heard support
of recommendations. This work was
for ‘more research involving experts-by-
developed with patient and public groups
experience, looking at what matters most
(see section 8.2), mental health charities and
to people in relation to prevention and care
foundations, academic experts and major
or support.’ It stated that mental health
research funders.
research should follow the roadmap set out
in the ROAMER project,57 which identified the
following priorities:
14 A framework for mental health research
3.1 Mental health research in the be put into practice, in the healthcare
system and in community, workplace and
UK – an opportunity for improving domestic settings.
our current leadership The UK itself is recognised internationally
as a leader in MH research, and has driven
Research provides the evidence to make a
notable developments in discovery, methods,
real difference to people’s lives and health
measurements and analysis. The UK leads in
outcomes. It provides hope that better
efforts in understanding mental health from
understanding and support can and will be
the perspectives of those with experience
found. All the remarkable major advances
of mental health problems through our
in health that have led to current improved
investment in processes supporting patient-
physical health and longevity have been
public involvement (PPI) in research. UK
based on multiple strands of basic and
strengths include genetics, longitudinal
applied research. The UK is making mental
cohorts and other epidemiological studies,
health a priority and this Framework’s
bioinformatics, neuroscience, neuroimaging,
ambition is to accelerate understanding
computational biology, psychological,
of mental health and support for people
behavioural and cognitive research,
with mental health problems through major
co‑produced and user-led research and
advances in science.
development of social interventions, and
Research and innovation in mental clinical studies and trials – both large
health can: and small.
•• improve understanding of the causes and The NHS is a unique resource for research –
risk factors for mental health problems, both as a source of research data (including
helping the population to stay well, NHS England’s Improving Access to
building emotional resilience and coping Psychological Therapies Programme (IAPT)64
strategies for managing poor mental and NHS Digital’s Mental Health Services
health; Data Set (MHSDS))65 and as a setting in
•• develop and evaluate social, prevention, which new interventions can be studied.
psychological, pharmacological and Its potential for the study of mental health
biological interventions, treatments and problems and population wellbeing must
supports for people with mental health be fully realised. The MRC, the NIHR and
problems; UK‑based foundations and charities including
the Wellcome Trust are among the world’s
•• determine how innovative treatments, leading funders of internationally-leading
support and management, including research. The National Institute of Health
self-help and digital, can most effectively and Care Excellence (NICE) is a further UK
16 A framework for mental health research
•• Take a strengths based, person centred •• Brief interventions in schools can reduce
approach to recovery.81 symptoms of depression, anxiety and
Research is helping to unpick how these conduct disorder in young people. Brief
relate to each other and how people affected CBT may be effective in reducing general
by mental health problems can, with the right symptom severity in young people.88
support and actions, thrive and lead the lives 3.2.3 Data save lives
they want to.82 A commitment to the collection of health
3.2.2 Improving psychological treatments data, whether routinely within the NHS (e.g.
The development of evidence-based IAPT, Hospital Episode Statistics (HES),
psychological treatments has been one of the MHSDS, Public Health England Profile
major mental health research achievements of Data), directly from clinicians (e.g. the
the past 50 years. The Improving Access to National Confidential Inquiry into Suicide
Psychological Treatments (IAPT) initiative has and Homicide) or via cohort studies (such as
delivered unprecedented access to therapies the Millennium Birth Cohort or Generation
such as cognitive behavioural therapy (CBT).83 Scotland) has resulted in the establishment
CBT is amongst the most effective treatments of world-leading data resources in the UK.
for conditions where anxiety or depression is Researchers use these data to learn more
the main problem. about mental health problems, to study
how healthcare is provided, and to drive
UK researchers are now exploring new improvements in healthcare.
ways to improve and extend psychological
treatments including: In the case of mental health problems, data
are enabling us to:
•• Better targeting of psychological and
pharmacological treatments for people •• Understand the course of mental health
with depression leading to better problems throughout the life cycle and
outcomes and more effective use of understand the efficacy of the range of
resources.84 interventions currently on offer.
Care Concordat, and research on what This work is showing how the adolescent
works for whom in suicide prevention may brain differs from the adult brain and
clarify ways in which we can end these suggests that there may be specific
tragic losses.92 windows of risk as well as opportunities for
3.2.4 Insights from genetic studies intervention during adolescence. We now
need a more precise understanding of how
Fast-moving technology has made it brain development during this period relates
possible to study the genetics of mental to increased vulnerability to mental health
health problems in large populations. UK problems, and a better understanding of
researchers are leading programmes of how we might redesign our approaches
work and making key contributions to an to address the mental health problems
international effort through the Psychiatric of adolescents. Such research will be
Genomics Consortium (PGC) which has critical if we are to prevent the longer-term
already identified over 128 genetic risk factors consequences of mental health problems.
for mental health problems.93 Some of these
risk factors are shared by people with bipolar
disorder, major depressive disorder and
schizophrenia.
Findings from PGC studies confirm that
genetics are only part of a complex set of
factors that interact across the lifespan,
affecting a person’s vulnerability to mental
health problems. These results are leading
the research community to think in new ways
about the biological factors that increase
vulnerability to mental health problems, and
providing tangible pathways for work towards
better treatments.94
3.2.5 The importance of brain
development in adolescence
Adolescence is the time of development
in which social relationships and the
environment have a strong influence on brain
and behaviour. It is also the time when mental
health problems often emerge. Scientists
in the UK are part of a growing group of
researchers studying normal structure,
function and development processes of the
adolescent brain95,96 – research that will help
us better understand how disturbances in
these processes might lead to the emergence
of mental health problems.97
4. Public involvement and making research matter 19
•• Bureaucratic obstacles that currently young adults. It could extend its positive
hamper mental health research, animal influence to research governance, the
research and clinical and experimental legal framework for translational research
medicine studies could also be and ethical matters (see section 4).
significantly reduced by a reappraisal •• Combined with research infrastructure
of current thinking and practice (see supplying very detailed information
section 6.9). on large groups of people with and
without mental health problems (as
5.3 Translational research happens for other illnesses), and on
their environments, the UK can be world
Translational mental health research beating in translational mental health
investigates how discoveries can help research (see section 6.4).
to improve prevention, produce better •• The NHS provides a unique opportunity
treatments or promote mental health and to translate innovations into help for
wellbeing. It uses evidence from clinical the people who need them. Improved
trials, epidemiology and basic science in two coverage, quality and use of routinely
directions to understand the mechanisms collected health service data will
for making these improvements: the cycle of release huge potential for large-scale
forward- and back- translation. experimental (including trials) and
Key points: observational studies (see section 6.5).
•• The UK has strong discovery sciences; •• Challenges include effective collaboration
these encompass psychological therapies across many different industries, and
(talking and digital), social factors in securing funding arrangements flexible
mental health, the life/physical sciences, enough to allow integration across
psychopharmacology, and fields such as disciplines, organisations and research
statistics, informatics and computation. approaches (see section 6.6).
The UK is excellent in many aspects of
the translational fields of epidemiology, 5.4 Population and health
psychology, imaging genetics, and
experimental studies into the mechanisms services research
of new treatments.
Population and health services research
•• There are opportunities for greater provides an evidence base for primary
utilisation of new technology including, and secondary prevention of mental health
internet, tablet and mobile phone problems and the delivery of the most
apps and wearable technologies for effective services for people with established
assessment and delivery of treatments for mental health problems. Our health systems
mental health problems. and data sources provide an ideal test-bed
•• Patient and Public Involvement (PPI) in to develop a robust evidence base on the
UK translational mental health research is prevention of mental health problems.
second-to-none. It improves the research Key points:
focus and process, and highlights
problems such as the artificial divide •• A step change in prevention could
between research on teenagers and be achieved with research platforms
which focus on critical time periods
5. Working group summaries 23
(e.g. pregnancy and birth, adolescence) in children and young people. There
and provide efficient means to recruit are considerable opportunities to make
large numbers of participants for both significant strides in mental health research
observational and interventional research in children and young people within the next
(see section 6.1). decade. This also has positive implications
•• There are many strengths in UK for improving mental health throughout the
population and health services research, subsequent life-course.
including a commitment to Patient and Key points:
Public Involvement (PPI), co-production •• A digital data platform could be
and user-led research, strong inter- established in the relatively short-term
disciplinary working, digital capability and (2-3 years) and some developments have
excellence in cohorts, trials and mental already taken place.118 This could provide
health informatics (see section 4). immediate cross-sectional and short-
•• There are numerous opportunities to span longitudinal data relevant for CYP’s
leverage these strengths to accelerate mental health research. (see section 6.5).
progress in the short to medium term, •• This platform could also enable on-
especially by providing mechanisms going longitudinal data collection and
to assist mental health researchers could be used to set-up ‘virtual cohorts’
to work effectively together and pool to provide longitudinal data with deep
resources. National infrastructures are phenotyping measures, vastly increasing
needed to deliver PPI; to expand research our understanding of mechanisms of
informatics infrastructure; and to raise emerging mental health problems and
the profile of mental health to ensure it is resilience (see section 6.5)
always considered when national medical
research investments are made (see •• Systematic implementation and evaluation
section 6.4). There is also a need to focus of alternative treatments and delivery
efforts on sustaining an interdisciplinary models could also be achieved, enabling
research workforce (see section 6.10). assessment of their efficacy in reducing
mental health problems and public health
•• Research on services and prevention also costs (see section 6.7).
needs to take account of the changing
landscape of service delivery, with •• Implementation research, together with
more interventions provided by the third research into causes and maintenance
sector. There is a need to build research of stigma, could deliver improved
expertise and provide research tools in understanding of barriers to treatment
such settings (see section 6.7). seeking and acceptability of services (see
section 6.10).
5.5 Children and young people •• It is also possible to achieve a significant
improvement in CYP patient and public
With the majority of mental health problems involvement, including a more diverse
having their roots in childhood, research is set of CYP in PPI representation and
needed to understand the causal risk factors research agenda setting (section 4).
that precipitate the development of mental ill
health and identify and develop interventions
that prevent and treat mental health problems
24 A framework for mental health research
mental health in national informatics 5.8% of the research spend across all health
initiatives. categories.147
•• Digital data and platforms: The digital era The majority of public and charity mental
offers new opportunities for facilitating health research funding in the UK (82.6% in
data collection, supporting mental 2014) comes from three major funders, the
health promotion strategies including National Institute for Health Research (NIHR),
self-management, enabling early the Medical Research Council (MRC) and the
diagnosis, improving treatment and Wellcome Trust. The remainder is provided by
facilitating access to ongoing support other Research Councils, Government bodies
for people with mental health problems. and the charity sector.148,149 The growth of
Approaches including social media or new charities dedicated to funding mental
wearables can make research more health research such as MQ and McPin, is
accessible (especially for younger people most welcome.
and people in rural areas). However, It has been reported that the extent of
digital approaches can risk excluding charitable funding of mental health research
some groups, for example those with in the UK is well below that for conditions
poor digital literacy, learning difficulties, (including cancer and cardiovascular disease)
differences in cultural interpretation where general public donations more than
or limited access. Effort is needed to match government investment.150 Yet, support
ensure participation and subsequent for a transformation in mental health care is
engagement is as inclusive as possible.145 growing; targeted government action and
•• Dataset linkage: Understanding of mental mental health awareness campaigns are
health problems and their social and changing the public’s perception of mental
environmental aspects will require greater health.151 The increase needed in public
linkage of diverse datasets, including funding will only come about if the stigma
across health, education, social care, associated with mental health continues to be
welfare and justice systems. There is a challenged.
need for greater harmonisation across There are also concerns around the
data sets to enable linkage. Careful withdrawal of pharmaceutical investment
consideration must be given to ensure from this field and the consequent impact on
consent for data sharing. industrial-academic support and collaboration
for mental health research in the UK (see
6.6 Flexible funding section 6.8).
More broadly, there is a need for initiatives
Analysis by the UK clinical research and partnerships between funders to
collaboration (UKCRC) has shown that, in promote interdisciplinary, translational and
contrast to many other disease areas, the basic-clinical research studies. There is also
proportion of research spending on mental a need for a diversity of funding to build the
health in the UK is below the relative burden evidence base around holistic and alternative
of disease.146 The overall annual spend by approaches to mental health and wellbeing.
major public and charitable UK funders on Innovative funding schemes need to be
research related to mental health in 2014 explored for research into mental health.
was calculated at £112.3 million, around
28 A framework for mental health research
•• New targets derived from genetic the Home Office in accordance with
discoveries and improved human and the Animals (Scientific Procedures)
animal stem cell models. Act 1986.160 There is concern from the
•• Investigation of the potential repurposing research community that the current
of drugs. regulatory process in the UK – which
is principally intended for the important
•• Increased support for industry- aim of ensuring animal welfare – has in
academic posts (including post-doctoral practice become disproportionate and
Fellowships) to develop capacity. unduly bureaucratic. This may place
The digital sector has an increasingly the UK at international disadvantage in
important role to play, both in enabling new basic research, and may also act as a
means of data collection for research as disincentive to early career researchers,
well as driving the development of forms of although it is not an issue unique to
virtual support.154 This is an area of potential mental health.
growth. Academic collaborations with digital •• In relation to translational research in
and computing companies and national data health, social care and educational
research infrastructure including the Alan settings, researchers view governance
Turing Institute155 will be important to support procedures as onerous and rate-limiting,
digital sector engagement in mental health. despite work to streamline processes.
For example, difficulties in establishing
6.9 Regulation, governance all approvals not only significantly delays
research, but may make some unfeasible
and ethics and untimely. The new UK policy
framework for health and social care
Regulatory and governance barriers across
research sets out the principles of good
the research pathway can delay progress:
practice in the management and conduct
•• Research in human psychopharmacology, of health and social care research and
which is seeking to understand the its intention is to remove unnecessary
action or potential therapeutic uses of bureaucracy for researchers.161
psychoactive drugs (such as opiates,
•• There is concern that NHS Research
benzodiazepines and serotonergics and
Ethics Committees (RECs)162 are unduly
novel mechanisms) is difficult to conduct
cautious in the mental health field, for
due to the need for compliance with
example, in relation to studies addressing
multiple regulations.156 These include
suicidal thoughts, intent or plans
the Misuse of Drugs Act (1971),157 the
despite systematic review evidence that
European Clinical Trials Regulations,158 the
asking such questions has no effect on
requirements of medicines regulators and
subsequent risk.163 Greater involvement of
ethical review. The recent Psychoactive
mental health clinicians and people with
Substances Act (2016) may add further
experience of mental health problems on
complexity.159 Each in isolation has a
RECs is a potential means of developing
logic but the combined effect is greater
relevant expertise and supporting
in some areas of mental health than for
decision-making. Access to independent
physical health.
ethical review requires streamlining for
•• Research involving protected species research conducted outside academic
of animals is regulated in the UK by and clinical institutions, e.g. voluntary
30 A framework for mental health research
sector led research. The informal be drawn in from other medical specialities
requirement of many RECs that research and a diverse range of other disciplines such
participants in mental health research as: anthropologists, data scientists, chemists,
studies must be recruited through a engineers, statisticians, geographers,
care co-ordinator, rather than directly, is psychologists, sociologists, economists,
a further barrier to initiation of research criminologists, educationalists, clinical trialists,
studies and needs review. population scientists, improvement scientists.
•• As the potential for greater dataset linkage The mental health research community
expands, consent around the collection, can also be built through the increased
use, confidentiality and security of data involvement of service-user researchers,
relating to mental health is a key concern people with experience of mental health
of research participants. Transparency problems, and those within voluntary and
about how information is collected, community groups.
shared, used and ultimately destroyed is There are significant barriers in the clinical
essential. Equally, barriers to data access academic career pathways in mental health
can delay or prevent research, and there research. Points in these pathways where
is a need for a proportionate approach greater support is needed to maintain
and clear governance. Recent progress capacity include post-doctoral research
in this area includes new provision for fellowships, the transition to academic
follow up in the recent Adult Psychiatric clinical lecturer and establishment at senior
Morbidity Survey (APMS).164 lecturer level. Established academics have
In the longer term, there is need to ensure an important role in supporting capacity
that any novel ethical considerations relevant building by acting as role models and
to mental health research that arise are providing mentoring and support to attract
addressed, for example, how ethical review is and retain students and trainees. There
approved in interdisciplinary research. are particular concerns about capacity in
academic psychiatry, including a lack of
psychiatrists with complementary training in
6.10 Capacity building basic sciences such as the neurosciences,
psychopharmacology, informatics,
The UK’s capacity to deliver mental health epidemiology, genetics etc.166,167 There is also
research is constrained by the current scale a need to promote service user research
of its workforce.165 There is a need to expand leadership and research leadership in
the research community in terms of both the wider mental health and primary care
size and diversity, and to strengthen it by workforce, e.g. mental health nursing, social
attracting researchers from a broader pool work and general practice.
of expertise and encourage focus from more
of the total life-science research capacity on More can also be done to strengthen
mental health. In addition, there is a need to research awareness, literacy and participation
improve the recognition of the importance amongst healthcare practitioners and
of research to service users, carers and those supporting people with mental health
clinicians and their engagement and problems (including general practitioners,
involvement with research in any capacity. nurses, health visitors, midwives,
occupational therapists social workers,
In addition, researchers from a wide variety pharmacists, psychologists, public health
of disciplines are required. Expertise should practitioners, relatives and carers).
6. Barriers and opportunities 31
Recommendation 2: Patient and public •• Routine capture of mental health outcome
involvement (PPI) measures in studies of physical health
Stakeholders: Research funders, HRA, including prevention research (and the
INVOLVE, Universities, Charities. converse, routine capture of physical
outcome measures in mental health
Patient and public involvement in mental research).
health research should continue to be
strengthened and systematically embedded •• Research which spans physical and
throughout research regulation, ethics mental health such as: understanding
and governance, shaping and determining mechanisms behind the mortality gap
research questions, assessment of research in severe mental illness; side-effects of
proposals and research evaluation. medication; ethnicity; immunology and
mental health; addictions/compulsive
User-led research as an emerging discipline, disorders and physical health.
generating new knowledge and investigating
things that matter on a day to day basis to Recommendation 4: Co-ordination
people experiencing mental health problems, and infrastructure
should continue to be strengthened. So too Stakeholders: Research funders, PHE, NHSE,
should co-production in research, combining Industry, Universities, Voluntary sector,
expertise of practitioners, healthcare National Audit Office.
commissioners, service users, carers, policy Greater co-ordination and leadership of
makers and researchers together within multi- mental health research activity is needed
disciplinary research teams. across the UK between public research
There is a need to make involvement more funders, universities, industry, charities and
representative particularly by increasing the wider voluntary sector.
inclusion of children and young people Initially, building on the existing work of MQ, a
and people with protected characteristics. portfolio review of UK mental health research
Involvement in basic research should funders, including the Medical Research
be strengthened and requirements for Council (MRC) and National Institute for
involvement harmonised across research Health Research (NIHR) should be published
funders. and made openly available with a gap
Recommendation 3: Mental and analysis to inform future investment.
physical health This should lead to better alignment of mental
Stakeholders: Research funders, PHE, NHSE, health infrastructure and resources including:
Industry. capacity for investigation of animal models,
Strengthening the connections between translation of basic neuroscience, deep
physical and mental health research should phenotyping, informatics and bio-banking.
be a priority. This should include: The mental health components of national
research resources should be progressively
•• Routine assessment by applicants, strengthened, including through the use of
reviewers and funding committees of the web-based and mobile record linkages.
relevance of research to mental health in
all life-science funding applications and
reporting in final reports and institutional
reviews.
34 A framework for mental health research
8. Annexes
The lists below include many of the •• Mrs Joy Todd, Strategic Lead for Health
contributors who agreed to be named. We & Human Behaviour Research, Economic
apologise for any errors or omissions. and Social Research Council
•• Dr Kathryn Adcock, Head of
8.1 Steering and working Neurosciences & Mental Health, Medical
group members Research Council
•• Dr Giovanna Lalli, Acting Head of
Steering group Neuroscience and Mental Health,
•• Professor Chris Whitty (Chair), Chief Wellcome Trust
Scientific Adviser, Department of •• Dr Raliza Stoyonova, Senior Portfolio
Health (DH) Developer, Neuroscience & Mental
•• Professor Tim Kendall, National Clinical Health, Wellcome Trust
Director for Mental Health, NHS England •• Dr Andrew Welchman, Head of
•• Professor Steve Pilling, Professor Neuroscience and Mental Health,
of Clinical Psychology & Clinical Wellcome Trust
Effectiveness, University College London •• Professor Trevor Robbins, Chair, Working
& NHS England Group 1, Basic Science
•• Mr Gregor Henderson, Director of •• Dr Thomas Kabir, Co-chair, Working
Wellbeing & Mental Health, Public Health Group 1, Basic Science
England
•• Professor Peter Jones, Chair, Working
•• Mr Paul Farmer CBE, Chief Executive Group 2, Translational Research
Officer, Mind
•• Ms Delphine van der Pauw, Co-chair,
•• Ms Cynthia Joyce, Chief Executive Working Group 2, Translational Research
Officer, MQ
•• Professor Matthew Hotopf, Chair, Working
•• Professor Sir Simon Wessely, President, Group 3, Population and Health Services
Royal College of Psychiatry
•• Ms Clare Dolman, Co-Chair, Working
•• Dr Vanessa Pinfold, Chair, Alliance of Group 3, Population and Health Services
Mental Health Research Funders
•• Professor Essi Viding, Chair, Working
•• Professor Clair Chilvers, Founding Group 4, Children and Young People
Trustee, Mental Health Research UK
•• Ms Matilda Simpson, Co-Chair, Working
Group 4, Children and Young People
38 A framework for mental health research
•• Mrs Joy Todd, Strategic Lead for Health •• Mr Ian Bradshaw, The McPin Foundation
& Human Behaviour Research, Economic
and Social Research Council Observers:
•• Ms Cynthia Joyce, Chief Executive
4. Children and young people Officer, MQ
•• Professor Essi Viding (Chair), Professor •• Mrs Joy Todd, Strategic Lead for Health
of Developmental Psychopathology, & Human Behaviour Research, Economic
University College London and Social Research Council
•• Ms Matilda Simpson (Dep Chair), National
Young People’s Mental Health Advisory
Group 8.2 Contributors
•• Dr Dickon Bevington, Medical Director,
Anna Freud National Centre for Children Stakeholder Workshops
and Families Facilitated by Date Location
•• Professor Lucy Bowes, Leverhulme Early Mind 22/02/17 Cardiff
Career Fellow & Associate Professor of Mental Health 24/02/17 The
Experimental Psychology, University of Foundation Manchester
Oxford Centre for
•• Professor Cathy Creswell, Professor Women’s
of Developmental Clinical Psychology, Mental Health,
University of Reading Manchester
University
•• Dr Andrea Danese, Clinical Senior
Mind 01/03/17 Cambridge
Lecturer, King’s College London
Mental Health 03/03/17 London
•• Professor Neil Humphrey, Professor of Foundation
Psychology of Education, The University
Academy 15/03/17 Academy
of Manchester
of Medical of Medical
•• Professor Eamon McCrory, Professor Sciences Sciences
of Developmental Neuroscience and
Psychopathology, University College Additional Contributions:
London, •• Members of the National Survivor User
•• Professor Elizabeth Meins, Professor of Network
Psychology, University of York •• Alliance of Mental Health Research
•• Professor Emily Simonoff, Head of Funders
Department of Child and Adolescent •• Cllr Jacqui Dyer, Vice-Chair Mental
Psychiatry, King’s College London Health Taskforce
•• Professor Ilina Singh, Professor of •• Emily Antcliffe, Deputy Director,
Neuroscience & Society, University of MH Policy, DH
Oxford
•• Ricks Llewellyn-Davies, MH Policy
•• Professor Anita Thapar, Clinical Professor, Lead, DH
Division of Psychological Medicine and
Clinical Neurosciences, Cardiff University
8. Annexes 41
•• Lyn Romeo, Chief Social Worker for 8.3 Recent research reports
Adults, DH
and reviews
•• Sarah Yiannoullou, National Survivor User
Network MRC Delivery Plan 2016-2020 (2016).173
•• Dr Andrew Welchman, Head of Mapping UK mental health research funding
Neuroscience and Mental Health, and its contribution to global funding (2016).174
Wellcome
What Research Matters for Mental Health
•• Professor Louise Howard, NIHR Research Policy in Scotland (2015).175
Professor in Maternal Mental Health
UK Mental Health Research Funding (2015).176
•• Professor James Nazroo, Professor of
Sociology and Director of the Cathy Implementing Bamford: Knowledge from
Marsh Centre for Census and Survey Research (2011).177
Research at the University of Manchester. Review of Mental Health Research – Report
•• Professor Kamaldeep Bhui, Centre of the Strategic Review Group 2010 (2010).178
Lead for Psychiatry, Wolfson Institute Strategic Analysis of UK Mental Health
of Preventive Medicine, Barts & The Research Funding (2005).179
London School of Medicine & Dentistry. MRC’s Strategy for Lifelong Mental Health
Queen Mary, University of London Research (2017).180
•• Zoë Gray, Director of INVOLVE Widening cross-disciplinary research for
•• Julia Gault, Deputy Director Family Policy, mental health (2017).181
Department for Work and Pensions
•• Dr Neil Ralph, Health Education England 8.4 Research priority setting in
•• Annette Bramley & Sarah Hobbs, EPSRC mental health
•• Elly De Decker, Big Lottery
A number of programmes in Europe and the
•• Professor Miranda Wolpert, Anna Freud UK have sought to identify research priorities
Centre, UCL in mental health. These include:
•• Professor Ian Young, Chief Scientific •• The Roadmap for Mental Health
Advisor, Northern Ireland Research in Europe (ROAMER)
•• Professor Andrew Morris, Chief Scientist, programme. Founded in 2011 to establish
Scotland an agenda for mental health research
in Europe, the programme identified six
•• Professor Jon Bisson, Director Health and overarching priorities.182,183,184
Care Research, Wales
•• The James Lind Alliance (JLA) brings
patients, carers and clinicians together
in priority setting partnerships (PSPs)
to identify and prioritise the top ten
unanswered questions, about the effects
of treatments in a specific research
area.185 A series of PSPs in mental health
research have considered: Schizophrenia
42 A framework for mental health research
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10. Acknowledgments 51
10. Acknowledgments