A Framework For Mental Health Research

Chapter heading
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
One in four of us experience mental Currently expertise is concentrated

health problems but many do not receive geographically, and we must support a major
the support they need. There are stark push to spread this more widely. We must
inequalities; people living in poverty, in be bold in setting clear goals to improve the
poor physical health, and from minority prevention and treatment of mental illness,
communities are disproportionately affected. challenge the scientific community to deliver
As public attitudes begin to improve, and the tools for these goals, and then support
stigma starts to reduce, the need to prioritise them to do so. The potential is enormous
mental health in the research community has – research has already led to remarkable
never been clearer. reductions in death and disability from many
Despite the urgency and scale of this major physical health conditions.
challenge, mental health research has lagged This Framework has been developed to
behind many other areas in terms of priority, improve co-ordination and focus on areas
funding, and therefore discoveries. This where mental health research is likely to
means that improvements in prevention and translate into significant health benefits. It has
care are progressing too slowly. been developed in collaboration with people
The Mental Health Taskforce laid out the who have mental health problems, academics
immediate steps that should be taken to in mental health research and research
improve support and make the most of our funders. They have come together to identify
existing knowledge. However, accelerating the barriers that need to be overcome and
mental health research and creating a strong opportunities that we must seize. They found
ambition for change is essential to achieve that basic foundations need to be laid so that
parity between mental and physical health in mental health research can flourish.
the longer term. There have been major initiatives to reach a
There is great, and justifiable, optimism that consensus on the most pressing scientific
the UK can and should do better in mental priorities in mental health, in particular the
health research. We are world-leaders in ROAMER collaboration. This Framework does
peer research and patient involvement, digital not seek to replicate these. Instead, it makes
development, neuroscience and functional a number of recommendations which include
imaging, epidemiology, and research with increasing the capacity and diversity of the
children. Research led programmes have mental health research community, promoting
shown the effectiveness of large scale access innovative research in a wider range of
to talking therapies (IAPT), and anti-stigma settings, and strengthening patient and public
programmes (Time to Change). We must involvement.
build on these strengths to achieve change We cannot underestimate the challenge
but we must also increase our ambition. ahead. This is a first step, but there is much
Foreword 3
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.
Jeremy Hunt, Secretary of Paul Farmer, Chris Whitty,

State for Health Chief Executive of Mind Chief Scientific Adviser
1. Executive summary
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
consistency in involvement requirements could be improved are identified, as is the

across UK research funders. need to expand the size and diversity of the
Four working groups supported the research community.
development of the Framework. Each The Framework concludes in Section 7 with
focused on an area of mental health research ten recommendations to address the barriers
(basic science; translational research; and opportunities identified in Section 6.
population and health services research; Implementation of these recommendations
research on children and young people). will require collaborative action from
Section 5 summarises the views from each stakeholders across the UK’s mental health
group, in particular highlighting areas of UK research community over the next decade
strength, and suggestions for how the UK’s and beyond. The recommendations are
mental health research system could be intended to improve coordination and
improved. strengthen the focus on areas where mental
Section 6 reviews the current barriers health research is likely to translate into
to mental health research in the UK and significant health benefit for the UK and
identifies future research opportunities. The worldwide.
importance of taking a life-course approach
to mental health research is emphasised, RECOMMENDATIONS
and the value of involving of people with
mental health problems in research is again Recommendation 1: Life-course approach
highlighted. The need for securing closer Stakeholders: Research funders, PHE, NHSE,
integration of mental and physical health NHS Digital.
research to maximise research capacity,
and for improved alignment in national Mental health research needs to take a
research infrastructure (including cohorts and life-course approach with an emphasis on
biobanks) to support mental health research prevention and early intervention at all stages
is outlined. of life, understanding how and why mental
health problems emerge and improving
The full potential of data collection and treatment and support.
informatics for mental health research has
yet to be realised. The digital era offers vast Funding programmes should encourage
opportunity, but there is a need for greater research at the periods during which
consensus on outcome measures, increased mental health problems can be prevented
use of NHS data and wider dataset linkage (particularly in the perinatal period and during
beyond healthcare settings. childhood and adolescence) and encourage
understanding of the causes and progression
Research funding mechanisms must be of mental health problems. The use of a
sufficiently flexible to promote translational range of methods to address questions
research and interdisciplinary studies, and around social inequality as well as standard
must enable innovative research in a range approaches, such as cohorts, should be
of settings. Renewed support is important encouraged.
to ensure the engagement of not only the
pharmaceutical and digital sectors, but all In adopting a truly life-course approach
industries relevant to mental health, such to mental health research, there is a
as care home providers. Ways in which the need to involve organisations beyond
regulatory and governance requirements traditional mental health services. This
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
Recommendation 5: Data, informatics Funding mechanisms should:

and virtual populations •• Be sufficiently flexible to enable forward
Stakeholders: Research Funders PHE, NHSE, and back translation of findings within
NHS Digital, HRA, Industry, Universities. a single programme (for example
Informatics projects should be established programmes should span pre-clinical and
and supported by investments to expand clinical research and/or social research).
the use and linkage of digital data in mental •• Promote collaboration between
health research. These should build on the disciplines and across sectors
potential of the Clinical Record Interactive (e.g. education, housing, voluntary sector).
Search (CRIS) and of electronic health Funders should also consider novel
records (EHRs). Links with national datasets processes to bridge support for existing
across sectors including social care, research programmes to reduce delay across
education, welfare and justice should be translational interfaces.
promoted.
Recommendation 7: Emerging
Digital technologies such as social media, interventions and alternative settings
wearable sensors, smart phone apps, virtual
reality and artificial intelligence should enable Stakeholders: Research funders, PHE,
new approaches to generate research data Department for Education, Home Office,
and provide supportive interventions: DWP, DCMS, Local Authorities, Voluntary
Sector, research academics.
•• Virtual/digital recruitment platforms
for mental health research should Funding programmes should promote
be established drawing from research to enable the development and
routine healthcare, educational evaluation of new and alternative approaches
and crowd‑sourced data providing to prevent mental health problems or support
populations for observational and people with them. There should be increased
experimental studies. focus on interventions in children’s centres,
schools, workplaces, prisons, care homes
•• Platform(s) should support the and voluntary and/or community-led centres
identification of risk factors and high-risk (e.g. refuge/crisis centres).
populations and should develop new
methods to generate targeted/enriched New research methods must be developed
cohorts focused on specific risk factors, and a more diverse research community
health problems or age periods. established to facilitate research in
such settings. As interventions may not
Recommendation 6: Flexible funding immediately transfer across or between
Stakeholders: Research funders. settings, systematic implementation research
Novel, seamless funding mechanisms should be encouraged to enable local
should be established to stimulate linked adaptation and adoption.
programmes of mental health research
across the translational interfaces. This
includes adopting novel trial procedures
(e.g. adaptive trials) that also allow or test for
patient preferences.
Recommendation 8: Industry engagement mental health clinicians in reviewing mental

Stakeholders: Research funders, health research studies.
Industry, BEIS. Recommendation 10: Capacity building
Industry engagement in mental health Stakeholders: Research funders, NHSE,
research should be encouraged across the academic research community. Universities
pharmaceutical, digital, engineering, design and their linked teaching Trusts, NHS Trusts,
and technology sectors through a suite of Voluntary & Community sector.
initiatives including: Sustained effort is required to progressively
•• Increased incentives to re-invigorate expand UK mental health research
industry loans of research tools (including capacity and make this a more diverse
drug libraries and other molecules such and representative workforce, particularly
as positron emission tomography (PET) at senior levels. A greater focus on mental
ligands). health research should be encouraged across
•• Funding schemes to support academic the total life-science research workforce and
collaboration with micro, small and other relevant disciplines.
medium-sized enterprises (SMEs) and Initiatives should include:
the involvement of patients to focus on •• Recruiting wider multidisciplinary
experimental medicine approaches and research expertise (from other medical
to develop, tools, standards and quality specialities and groups such as:
of health related products. These should anthropologists, data scientists, chemists,
facilitate research tool donation and engineers, statisticians, geographers,
intellectual property (IP) agreement. sociologists, economists, criminologists,
•• A focus on research with sectors educationalists, clinical trialists, population
emerging as important to mental health scientists, improvement scientists).
such as care home providers and the •• Strengthening clinical–academic
data analytic sector. research capacity across the mental
Recommendation 9: Regulation, health professions (including in academic
ethics and governance psychiatry, nursing, clinical psychology,
Stakeholders: Research Funders, Home social work).
Office, HRA, RECs, MHRA/EMA, Local •• Expanding the existing mental health
Authorities, Universities. research community through practical
Procedures for the regulation, governance measures to build the careers of service
and ethical oversight of mental health users as researchers and, increase and
research should be streamlined to expedite maintain the involvement of people with
studies. There should be a focus on experience of mental health problems,
streamlining the regulation, ethics and carers and those within voluntary and
governance of: animal research, experimental community groups.
medicine, clinical trials, population research •• Fostering research fellowships partnered
and observational research involving large with industry sectors.
datasets. Research ethics committees should •• Strengthening research awareness
have mental health specific expertise on their and participation amongst healthcare
panels and involve experts by experience and practitioners and those supporting
people with mental health problems

(including general practitioners, nurses,
health visitors, midwives, occupational
therapists social workers, pharmacists,
psychologists, public health practitioners,
relatives and carers).
•• Encouraging Universities and their
linked teaching hospital Trusts to grow
their mental health research portfolios,
challenging stigma at an institutional level.
•• Increasing support for mental health
researchers throughout their careers
(including mentoring schemes for early
career researchers, and incentives
for Universities to invest in senior
investigators).
•• Encouraging funders and researchers
to include within all life-science
research outcome measures relevant to
mental health.
2. Mental health of the UK population
2.1 Mental health in the UK Improvements in the prevention and

treatment of mental health problems have
Mental health problems are widespread in the been much slower than in other common
UK population and affect people throughout health conditions, including cardiovascular
the life-course.1 In the most recent national disease (heart disease and stroke) and
household survey one in six adults (17%) in cancer. The remarkable progress in other
England – about one woman in five, and one disease areas has been built on a very
man in eight – reported they had a common strong, science-driven, evidence base.
mental problem within the last week.2 There is already evidence that scientific
Almost half of adults in England (35.2% of discovery can similarly lead to improvements
men and 51.2% of women, 43.5% total) in mental health outcomes.12 For example, a
also reported that, in their lifetime, they have recent cost-effectiveness review of services
had a diagnosable mental health problem.3 to promote mental health and wellbeing
There were over 6,000 deaths from suicide identified eight evidence based areas of
in the UK in 2015, and suicide is now the work.13 The UK government has therefore
leading cause of death for young men.4,5 The prioritised mental health including research
extent of mental health problems is broadly into the prevention and treatment of mental
similar across the UK, although there are health problems.
minor national variations (Table 1). People Mental health problems are varied and
from lower income groups are more likely to often disabling. In 2013, the Chief Medical
develop mental health problems.6,7 Officer’s report on public mental health
Table 1: National Survey data on recognised ‘mental illness... as the largest
mental health single cause of disability’ which ‘represents
28% of the national disease burden in the
England 17% of adults reported they UK’.14 There are indications of a continued
had a common mental health growth in the impact of mental health
problem within the last week.8 problems; for example the rates of common
Northern 17% of respondents showed mental disorders in women in England
Ireland signs of a possible mental have increased steadily since 2000.15 The
health problem.9 extent of mental health problems in the UK
Scotland 16% of adults exhibited signs of is also part of a wider global picture; mental
a possible psychiatric disorder.10 health problems are one of the main causes
Wales 13% of adults were found to be of global disease burden now accounting
currently receiving treatment for for a fifth (21.2%) of years lived with
a mental health problem.11 disability worldwide.16
The impact of a particular mental health 2.2 Socio-economic factors

problem on an individual’s overall health
and life will vary considerably. However, There is evidence of significant inequalities
some outcomes are widely recognised. between different groups in the population in
For example: relation to mental health.26 It is accepted that
•• People with severe mental health exposure to unfavourable social, economic
problems have a life expectancy that is, and environmental circumstances, inter-
on average, 20 years less for men and related with gender, increases the risk of
15 years less for women, than the general developing mental health problems.27,28
population.17 This has been described For example:
as an ‘unacceptably large premature •• Socioeconomic disadvantage (e.g. low
mortality gap’ and ‘one of the greatest education, unemployment, poverty or
health inequalities in England’.18,19 There is deprivation) is associated with increased
potential to reduce this excess mortality risk of mental health problems.29
through improvements in both mental and
physical health care.20 •• People in marginalised groups are at
greater risk of mental health problems,
•• Mental and physical health problems including people from black, Asian and
interact. Research by the King’s Fund other minority ethnic backgrounds,
found that 46% of people with a mental lesbian, gay, bisexual and transgender
health problem had a long-term physical people, disabled people and people who
health problem, and conversely that have had contact with the criminal justice
30% of people with a long-term physical system, among others.30 Research has
health problem also had a mental health found that Black Caribbean and African
problem.21 adults are estimated to be twice as likely
•• Alcohol and/or drug misuse often to experience psychotic disorders.31
co‑exist with mental health problems. It •• Having a stable place of residence is
has been estimated that 75% of users important to maintaining good mental
of drug services and 85% of users of health and can support recovery
alcohol services experience mental health from mental health problems. 80% of
problems.22 People with co-existing homeless people surveyed in England
substance misuse and mental health in 2014, reported that they had mental
problems face significant barriers in health issues, with 45% having been
accessing mental health and or drug and diagnosed with a mental health
alcohol services, sometimes requiring condition.32 Population surveys have
both services simultaneously.23,24 found that social isolation is associated
•• Employment is lower among people with depression and anxiety.33
with mental health problems. Only 43% In 2014, the World Health Organization
of people with mental health problems described the need to ‘raise the priority given
are in employment, compared to 74% of to the prevention of mental disorders and to
the general population (in the UK aged the promotion of mental health through action
16‑64).25 on the social determinants of health’.34
Whilst there is evidence that public of depression in adulthood.46 Family

knowledge and attitudes have become circumstances and quality of parenting have
less negative towards people with a mental a significant impact on risk of developing
health problem in the UK in recent years, mental as well as physical health problems.
people with mental health problems, and In contrast, interventions in childhood can
also their carers and families, continue prevent the development of mental health
to experience inequality, social exclusion problems in adults, for example, effective
and discrimination.35,36 . Negative attitudes treatment of conduct disorders in children
towards mental health problems can also reduces the incidence of adult mental
extend to the perception of the research health problems.47
and provider communities, making mental
health care and research a less attractive 2.4 Costs of mental health
career choice.37,38
problems to the UK
2.3 Mental health of children and Alongside personal consequences, and
young people in the UK the direct costs of health and social care
service provision, mental health problems
It has been estimated that half of lifetime have wider economic impact across the
cases of diagnosable mental health problems UK through loss of productivity, sickness
begin by 14 years of age and 75% of absence and the need for provision of welfare
mental health problems start before the age support. Costs are also incurred within the
of 18.39,40 Developing a mental health problem education system.48
at a young age can have life-long adverse Estimates indicate that the total economic
consequences, affecting emotional and social and social costs of mental health problems
development, educational achievement and range between £70-£100 billion annually
later chances of employment.41 (~ 4.5% of gross domestic product) with
The most recent national surveys of child and some estimates as high as £105 billion and
adolescent mental health, in 1999 and 2004, given the rise in prevalence, these costs are
found that 10% of children and young people set to rise.49,50 In 2015, mental health-related
(aged 5-16 years) had a clinically diagnosable issues were found to lead to approximately
mental health problem, which equates to 2-3 17.6 million days’ sick leave, or 12.7% of the
children in every class.42 A more recent report total sick days taken in the UK.51
from the Office for National Statistics found In 2013, two-thirds of adult recipients of
that one in eight children surveyed in 2011‑12 Employment and Support Allowance (ESA),
and aged between 10 and 15, reported a form of welfare support provided to people
symptoms of mental health problems.43 who are ill or disabled to support them to
Adverse conditions in early life, including child work, or to meet the costs of ill health for
maltreatment and neglect, are associated those unable to work, were recorded as
with a high risk of mental health problems having a common mental health problem.52
later in life, greater severity of mental health Conversely, effective early treatment can
problems, increased recurrence across the reduce economic impacts of mental health
life-course, and poor treatment response.44,45 problems. For example, a recent analysis
There is consensus that childhood trauma found that for every pound invested in the
is significantly involved in the development
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:
2.6 Process of Framework –– Implementing Bamford: Knowledge

from Research.63
development
–– Research priority setting programmes
2.6.1 Steering group and working groups for mental health research (see
section 8.4).
Development of the Framework was overseen
by a steering group chaired by the Chief The draft framework and emerging
Scientific Adviser for the Department of recommendations were also reviewed
Health. The steering group was supported by through a series of independent
four expert working groups which generated stakeholder events (see section 8.2).
the Framework’s interconnecting themes and
recommendations. Each group focused on
an area of mental health research and was
co-led by a clinical academic professor and
service user research expert:
•• Basic science;
•• Translational research;
•• Population and health services research;
•• Children and young people.
The membership of the steering and working
groups is set out in Section 8.1.
2.6.2 Further input and review
Development of the Framework was
informed by input from a range of additional
stakeholders and sources, including:
•• Discussion with stakeholders conducted
by working group members and the
secretariat (see section 8.2).
•• Relevant publications (see section 8.3)
including:
–– Widening cross-disciplinary research
for mental health (2017).60
–– MRC Strategy for Lifelong Mental
Health Research (2017).61
–– What Research Matters for Mental
Health Policy in Scotland (2015).62
3. Why mental health research matters
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
strength which has led to global recognition 3.2 Case studies

of the UK as a leader in evidence review
and evidence-based care.66 Rigorous and The UK’s strengths in mental health research
objective analysis of evidence will continue to span the research pathway from basic
be essential in driving improvement in mental scientific discovery to the implementation of
health treatments and outcomes. novel treatments.
Translation of research findings into 3.2.1 The importance of social support
meaningful advances in treatment and and interventions
support is a vital stage of the research
pathway. Better interventions are clearly Mental health problems have many causes,
needed to make substantive and meaningful and they change people’s lives in different
change for future generations. UK research ways.67 They impact on relationships with
strengths, coupled with important advances family and friends, opportunities in education
in technology, represent a huge opportunity and work, access to housing and how
for the UK to continue to lead globally in communities respond. There is also a need to
mental health research, and expand on avoid discrimination, paternalistic relationships
current scope and ambition. At the same and prejudice towards people with mental
time it is important to recognise that the UK health problems and against other identity
mental health research base, whilst of high characteristics, including sexuality, ethnicity
quality, is relatively small and geographically and age and race and migrant status and
concentrated compared to many other areas educational level; for example, learning
of medicine, with a limited number of people disability.
trained in both research and psychiatry The UK is a leader of the field in using
or related disciplines. This puts a limit on epidemiological studies to understand
the speed at which expansion of research variations in the incidence of mental health
can occur whilst maintaining excellence in problems68 and follow up with social
some important areas. Strengthening and programmes such as those tackling bullying
broadening the skill base, and encouraging in childhood69 and social isolation.70,71 We are
the wider life-science community to invest also leading methodological developments
in mental health research is essential. It is a for co-produced studies72 and survivor
goal of this Framework to provide a vision research.73
for what we can achieve together, and a
Advances in understanding and addressing
route to improving mental health research
social inequalities and multiple disadvantages
infrastructure in the UK that will support this
include work in the UK to:
sector to thrive.
•• Reduce discrimination.74
•• Tackle domestic violence.75
•• Reduce violence victimisation, particularly
in young people.76,77
•• Address poverty, childhood abuse and
neglect.78,79
•• Develop mental health employment
support programmes.80
•• 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.
•• Reducing the impact of treatment •• Tackle early mortality in severe mental

resistant depression through combination illness: people with severe mental health
treatment: Adding CBT to antidepressant problems have a lower life expectancy
treatment may reduce symptoms and than otherwise healthy adults.89 This
improve quality of life.85 evidence has underpinned work in NHS
Trusts to improve health outcomes for
•• Psychological therapies for young people those with severe mental health problems
with eating disorders: An enhanced form with an initial focus on checks for
of CBT, already known to be effective for diabetes, heart disease and cancer.
adults with eating disorders, has similarly
been found to be effective for young •• Prevent suicide and self-harm: People
people.86 with a history of self-harm, suicide
attempts or under the care of mental
•• CBTp for psychosis, developed in the health services are most vulnerable in
UK, can improve outcomes, led to NICE the first three months post-discharge
guidelines and is now implemented from hospital.90,91 Studies suggest that a
across the world.87 stronger focus around crisis care, such as
the measures recommended in the Crisis
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
4. Public involvement and making

research matter
4.1 Involvement in research early.109,110 Involvement also supports the

ethical design and conduct of research,
Involvement of people with mental health and tools have been developed to enhance
problems, including many with experience the quality of reporting patient and public
of mental health services, in mental health involvement.111,112,113 Likewise, programmes
research has increased in the UK with such as the James Lind Alliance in the UK,
‘substantial advances being made in a that are built upon co-production principles,
relatively short time’.98,99 It is now an area have been established to involve patients,
in which the UK has perhaps the most carers and practitioners in identifying
systematic approach world-wide. It includes research questions around particular mental
involving members of the public in all stages health topics of direct relevance and potential
of the research process, in activities such as benefit to them (see section 8.4).114
priority setting, defining research outcomes, We need to strengthen the evidence base
selecting research methodology, recruiting of the effectiveness, outcomes and impact
participants, interpretation of research of patient involvement for each stage of the
findings and dissemination of results.100,101 research process and put measures in place
There is also increasing co-produced and to ensure quality and appropriate involvement
user-led research which underlines the strategies are delivered in practice.115
significance of people’s expertise through
experience, and encourages collaboration The National Institute for Health Research
and a commitment to shared principles and (NIHR) has recently set out a national vision
values.102,103,104,105,106,107 This is an area for for the involvement of people in research as
further development. ‘a population actively involved in research to
improve health and wellbeing for themselves,
The value and importance of involvement their family and their communities’.67
is supported by evidence that it improves
research, for example by increasing This vision gives the UK mental health
recruitment, improving study design and research community an opportunity to lead in
ensuring the use of relevant outcome developing and establishing best practice in
measures.108 There is evidence that mental mental health research. Including the need, in
health research studies which involve patients mental health research, for:
and the public throughout the research •• Greater involvement of children and
process are more successful; for example young people, and men;
they are likely to reach recruitment targets •• Greater involvement of people with
and impact is more likely to be achieved protected characteristics, including
where patient and public involvement people from black, Asian and other
is well-planned and people are involved minority ethnic backgrounds;
•• Inclusion of wider community

perspectives;
•• Greater public involvement in basic
science relating to mental health;
•• Greater involvement in translational mental
health research to ensure implementation
of the knowledge generated;
•• Greater co-produced and survivor
research/user-led research;
•• Greater consistency of requirement for
PPI involvement across research funders.
5. Working group summaries 21
5. Working group summaries
5.1 Introduction at mental health problems in great detail

(‘deep-phenotyping’ studies). This research
The remit of the working groups was to look will also help us to reappraise the utility of
at the overall system for undertaking and psychiatric diagnosis classification schemes
delivering mental health research in the UK into research into underlying mechanisms in
and how it could be improved. Key points mental health.
are summarised here under the headings of Key points:
the four working groups. The full discussion
papers produced by the working groups will •• The availability of better animal models,
be made available on-line. The four working including approaches involving
group summaries are not designed to be behavioural, genetic, viral transduction,
linear or priority ordered. immunological and patient-derived stem
cell methods, requires a more multi-
disciplinary approach, more closely
5.2 Basic science integrated with clinical studies. This
is essential to enable their effective
Basic science research uses hypothesis- evaluation, translation into treatments, and
driven experimental designs to determine the the search for effective predictive markers
causal mechanisms behind the functioning of illness.
of the human body in health and illness.116
In relation to mental health problems, it •• Basic research is an area where
includes laboratory studies with cell cultures, Patient and Public Involvement (PPI)
animal studies, using systems and circuit is underdeveloped, and there are
neuroscience and cellular-molecular based inconsistent requirements for PPI
methods, to increase our ability to understand amongst research funders (see section 4).
the mechanisms that underlie mental •• The withdrawal of some of the
health conditions. pharmaceutical industry from the field of
The explosion of knowledge and mental health research117 has removed
understanding in basic science, as well as in investment (with potential drugs for
‘big data’ and psychiatric genetics presents mental health conditions having higher
huge opportunities over the next decade. failure rates) and reduced career
The UK has strengths in many key research opportunities for young researchers.
areas including imaging, animal models and With investment, significant progress
molecular biology. There are also promising could be made within the next decade
ways that research could capitalise on to encourage re-engagement by industry
discoveries in psychiatric genetics. These (see section 6.8).
include research that attempts to look
•• 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
6. Barriers and opportunities
Continued delivery of world-leading mental and biological explanations for mental

health research across the UK over the next health problems to be integrated.
decade will require opportunities to be taken •• It can help to identify chains of risk that
and current barriers to be overcome. can be broken and particular times when
intervention may be especially effective.124
6.1 Life-course approach This may be during key life transitions (e.g.
during exam periods, when leaving home,
The UK has led in the adoption of a life- starting work, having children or retiring).
course approach in physical and mental A life-course approach is also essential for
health and there is a significant opportunity to the development of preventative approaches
capitalise on UK investments in this area.119,120 to mental health problems and population
This approach involves studying physical wellbeing. It is recognised that preventive
and social risks during gestation, childhood, public mental health interventions should
adolescence, young adulthood, midlife and begin in pregnancy and ‘efforts to understand
old age that affect subsequent health.121 and alleviate mental disorders of adulthood
This approach is based on understanding must take into account a life-course
that there are critical periods of growth and perspective’.125
development when environmental exposures
have a greater impact on health, and on long-
term health outcomes, than at other times.122 6.2 Patient and public
In addition, there is evidence of sensitive involvement
stages in childhood and adolescence when
social and cognitive skills, habits, coping There are opportunities for the UK mental
strategies, attitudes and values – that can health research community to continue
strongly influence health in later life – are to develop best practice, seeking to
more easily acquired.123 establish new models for patient and public
A life-course approach is particularly valuable involvement in studies from basic science
in mental health research as: to public health research. Known barriers
include funding to pay for involvement at
•• The wider determinants of mental health the research proposal stage, time required
problems are diverse, including adversity to do involvement well across the research
in childhood (such as physical, sexual pathway, and training of people with diverse
and emotional abuse or neglect) as expertise to get involved in research.126
well as socio-economic context, social Embedding PPI appropriately in all mental
relationships and health behaviours. A health research studies is the objective. (see
life-course approach allows both social Section 4).
6.3 Mental and physical health 6.4 Co-ordination and

infrastructure
Mental and physical health are closely
dependent on each other (see section 2.1).127 Although the UK has research strengths
However a disconnect between mental in many underlying topics, disciplines and
and physical health is evident not only approaches relevant to mental health,
across healthcare service provision and progress is currently limited by the lack
commissioning, but also in the public health of integration across the breadth of the
and research sectors. research community. This includes a lack of
Mental ill health also contributes to health flexible funding mechanisms to enable multi-
inequality as it is also associated with the disciplinary approaches in mental health,
risk of heart disease, stroke, cancer and for example, joint clinical-basic studies and
premature mortality. Physical health problems studies across the health and social care
in people with mental health problems can interface. A lack of infrastructure to support
result from cardio-metabolic side effects of joint working means that investigators, groups
drug treatments, lifestyle factors, and possibly and centres tend to collaborate on an ad
factors common to mental and physical illness hoc basis, around particular programmes
risk, such as inflammatory processes.128 or grants, rather over the longer term. There
By the same token, individuals with chronic are both cultural and practical challenges in
medical conditions such as diabetes, heart establishing long-standing collaborations.
failure, and chronic obstructive pulmonary In addition, national infrastructure for mental
disease have double the rate of depression of health research needs strengthening and
the general population. 129,130 greater alignment to address particular
In the health services, separation in the research questions (‘horizontal alignment’)
approaches and location of treatment can and to achieve translation (‘vertical
result in poorer physical health outcomes alignment’).
for people with mental health problems, and •• Cohorts: The UK has a strong tradition
conversely in poorer mental health outcomes of epidemiological research including
for people with physical illnesses, particularly national surveys and birth cohort
for those with long-term conditions.131 studies.133,134 More modern UK birth
Targeting of the Improving Access to cohorts, such as ALSPAC are now
Psychological Therapies (IAPT) programme moving into the period of life-course
towards people with long-term conditions is where mental health outcomes are
one step towards overcoming this divide.132 becoming apparent, so their full mental
Separation in research is evident in that health research value has yet to be
mental health outcomes are too frequently realised.135 Cohorts such as Born in
overlooked in physical health research. This Bradford, with inter-agency record
can be a consequence of data being held linkage, will be extremely informative.136
in separate systems (i.e. in mental health Existing cohorts and those potentially
trusts). There is a significant opportunity to available in future, through capture
help expand mental health research capacity of routine NHS and other data sets,
by encouraging routine collection of some need strategic planning and public
mental health outcome measures in studies confidence to better enable mental
of physical health. health research. There is also scope for
greater harmonisation of mental health •• Routine outcome measures: Consistently

measures between existing cohorts collected outcome and experience
and other population resources. Such measures enable research and have
harmonisation may also contribute to been shown to drive improvement in
greater reproducibility of mental health the quality of healthcare in areas such
research findings. as cardiovascular disease and stroke.
•• Access to tissues: Alongside access However, only one sector of mental
to data (see section 6.5), mental health health services (the Improving Access
research depends on the availability of to Psychological Therapies (IAPT)
biological samples such as blood, brain services139) has to date adopted and
imaging scans and genetic material, mandated the use of a set of routine,
often from large numbers of participants. patient-rated outcome measures. In
Routine brain scanning and blood other mental health services there is little
sampling in the mental health context is agreement as to which measures should
not yet in place across the NHS. This is a be routinely used, and debate continues
lost opportunity. around the use of condition-specific
and/or general measures. In addition,
•• Bio-banking: Research capacity has measures mandated for mental health
been limited by a lack of dedicated service commissioning (e.g. Health of the
mental health biobanks accessible to Nation Outcome Scales, HoNOS140) may
the NHS, and because national research be unsuited to either clinical or research
infrastructure such as UK Biobank, communities. Research on new, simple
which has in time assembled important outcome and experience measures is
resources relevant to mental health, have underway and should build towards
tended to engage later in this field.137 adoption of core sets which can be used
both for healthcare and research across
6.5 Data, informatics and the lifespan.141,142
virtual populations •• Clinical informatics: Mental health services
have been leaders in the use of digital
The full potential and opportunity of data data and there have been important
collection and informatics for mental health advances in the use of electronic mental
research has yet to be realised. Across all health records in research active trusts,
forms of collection there is a need to ensure together with new means of collating and
that data sets are harmonised and inclusive using information (such as the Clinical
of a broad range of demographics (including Record Interactive Search (CRIS) and
consistency of coding across all protected the Dementia Clinical Record Interactive
characteristics) so that inequality and multiple Search (D-CRIS)143,144). However, there
disadvantage can be pro-actively addressed. remains potential for far greater use of
Careful consideration needs also to be ‘live’ NHS data streams. The separation
given to consent and data sharing issues, of mental health and physical health
recognising the need for greater access to secondary care services, and a lack of
diverse datasets for a wider audience of wider awareness of excellence in mental
mental health researchers.138 health informatics, can result in missed
opportunities around the inclusion of
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
6.7 Emerging interventions and of research methods. For example, action

research, ethnography, quality improvement
alternative settings programmes, qualitative studies and
participatory research methods may all be
Asset based community development appropriate for addressing critical research
approaches recognise the importance questions in a reasonable timescale within
of social capital resources found within real world settings. Strengthening the
communities for promoting population implementation of research evidence and
level wellbeing and good mental health for good practice into a range of settings where
everyone.152 New approaches to supporting people seek support is equally important.
people with mental health problems are There needs to be greater emphasis on
also emerging including community based service delivery staff being supported to
peer support.153 This requires undertaking be research literate and in making research
research within ordinary communities, taking findings accessible and relevant for local
studies beyond academic and healthcare implementation.
settings into everyday spaces, and driving
understanding of people’s support needs
in environments representative of their 6.8 Industry engagement
experience. This includes settings such
as schools, places of worship, sports Active academic-industrial collaboration
clubs, workplaces, prisons, voluntary and/ across a number of sectors (including
or community-led centres, shelters for the pharmaceutical, digital, engineering, design
homeless and crisis/refuge centres (including and technology) will be essential to maximise
those for women) and care homes for the frail UK potential to develop new forms of
elderly. There are also important opportunities treatment and support for people with mental
to research and develop innovative forms of health problems.
support for use during critical time-periods The pharmaceutical sector has undergone
within existing health and care services, for significant change with many larger
example low-intensity interventions which can companies scaling back mental health
provide initial support for people on mental research portfolios. However, there are
healthcare waiting lists. important opportunities to build on the
Community and voluntary groups are an ongoing activity of small and medium
invaluable source of support for people with sized pharmaceutical and biotechnology
mental health problems. These groups can companies as well as to stimulate large scale
act as leaders in providing innovative and re-investment. These include:
culturally relevant support to communities •• Initiatives to invigorate loans of research
and warrant further research. However, tools (including drug libraries and other
practical barriers to research in these settings molecules such as positron emission
may mean that such approaches are less tomography (PET) ligands).
likely to be systematically evaluated. In turn
this can delay wider scale implementation of •• New partnerships between academic,
new models of support. industrial and regulatory partners to
develop more sensitive measurement
To facilitate research in a broader range of tools and biomarkers for use in clinical
settings there is a need for the continued studies and trials.
development and uptake of a wider range
•• 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
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).
Discrimination is still encountered by people

with mental health problems, their carers
and families. It can act as a barrier to mental
health research. One of the consequences
of discrimination is that, just as people with
mental health problems can delay seeking
access to support and treatments, they can
also be reluctant to engage with research.
This can make it difficult for researchers to
recruit and retain study participants, making
research harder to conduct and the field
overall seem less attractive. Indeed, stigma
may also deter some people from becoming
mental health researchers.
Mental health discrimination intersects with
stigma and discrimination experienced
by other groups. There are important
opportunities through the media, and
through campaigns such as ‘Time to change’
(which focuses on reducing mental health
discrimination) and ‘OK to ask’ (which
encourages people to ask about their
research opportunities) to promote increased
participation in mental health research.168,169
7. Conclusion and recommendations
The UK is internationally recognised as a community over the next decade and

research leader, with a proven track-record beyond.
in mental health research. By harnessing Recommendation 1: Life-course
developments in science and technology, our approach
mental health research community has a real
opportunity to play a leading role in driving Stakeholders: Research funders, PHE, NHSE,
forward innovation and making a significant NHS Digital.
difference to millions of people. Mental health research needs to take a
We must aspire to: life-course approach with an emphasis on
prevention and early intervention at all stages
•• Make significant progress in addressing of life, understanding how and why mental
mental health inequalities, bringing parity health problems emerge and improving
with physical health closer; treatment and support.
•• Accelerate the pace of change in the Funding programmes should encourage
development of innovative forms of research at the periods during which
prevention and support for people with mental health problems can be prevented
mental health problems, and in the rate (particularly in the perinatal period and during
that these are implemented; childhood and adolescence) and encourage
•• Enable the development of innovative understanding of the causes and progression
research methodologies and widen the of mental health problems. The use of a
range of settings in which mental health range of methods to address questions
research takes place; around social inequality as well as standard
•• Ensure greater diversity within the approaches, such as cohorts, should be
mental health research community, encouraged.
enabling more people to contribute their In adopting a truly life-course approach
experience and knowledge to deliver to mental health research, there is a need
change. to involve organisations beyond traditional
This framework has been developed to mental health services. This includes
improve coordination and strengthen focus local authorities and education providers,
on areas where mental health research is workplaces, social care and the voluntary
likely to translate into significant health benefit. sector.
Its implementation will require collaboration
from stakeholders across the UK’s mental
health and wider life-sciences research
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.
Recommendation 5: Data, informatics Funding mechanisms should:

and virtual populations •• Be sufficiently flexible to enable forward
Stakeholders: Research Funders PHE, NHSE, and back translation of findings within
NHS Digital, HRA, Industry, Universities. a single programme (for example
Informatics projects should be established programmes should span pre-clinical and
and supported by investments to expand clinical research and/or social research).
the use and linkage of digital data in mental •• Promote collaboration between
health research. These should build on the disciplines and across sectors (e.g.
potential of the Clinical Record Interactive education, housing, voluntary sector).
Search (CRIS) and of electronic health Funders should also consider novel
records (EHRs). Links with national datasets processes to bridge support for existing
across sectors including social care, research programmes to reduce delay across
education, welfare and justice should be translational interfaces.
promoted.
Recommendation 7: Emerging
Digital technologies such as social media, interventions and alternative settings
wearable sensors, smart phone apps, virtual
reality and artificial intelligence should enable Stakeholders: Research funders, PHE,
new approaches to generate research data Department for Education, Home Office,
and provide supportive interventions: DWP, DCMS, Local Authorities, Voluntary
Sector, research academics.
•• Virtual/digital recruitment platforms
for mental health research should Funding programmes should promote
be established drawing from routine research to enable the development and
healthcare, educational and crowd- evaluation of new and alternative approaches
sourced data providing populations for to prevent mental health problems or support
observational and experimental studies. people with them. There should be increased
focus on interventions in children’s centres,
•• Platform(s) should support the schools, workplaces, prisons, care homes
identification of risk factors and high-risk and voluntary and/or community-led centres
populations and should develop new (e.g. refuge/crisis centres).
methods to generate targeted/enriched
cohorts focused on specific risk factors, New research methods must be developed
health problems or age periods. and a more diverse research community
established to facilitate research in
Recommendation 6: Flexible funding such settings. As interventions may not
Stakeholders: Research funders. immediately transfer across or between
Novel, seamless funding mechanisms settings, systematic implementation research
should be established to stimulate linked should be encouraged to enable local
programmes of mental health research adaptation and adoption.
across the translational interfaces. This
includes adopting novel trial procedures
(e.g. adaptive trials) that also allow or test for
patient preferences.
Recommendation 8: Industry engagement mental health clinicians in reviewing mental

Stakeholders: Research funders, health research studies.
Industry, BEIS. Recommendation 10: Capacity building
Industry engagement in mental health Stakeholders: Research funders, NHSE,
research should be encouraged across the academic research community. Universities
pharmaceutical, digital, engineering, design and their linked teaching Trusts, NHS Trusts,
and technology sectors through a suite of Voluntary & Community sector.
initiatives including: Sustained effort is required to progressively
•• Increased incentives to re-invigorate expand UK mental health research
industry loans of research tools (including capacity and make this a more diverse
drug libraries and other molecules such and representative workforce, particularly
as positron emission tomography (PET) at senior levels. A greater focus on mental
ligands). health research should be encouraged across
•• Funding schemes to support academic the total life-science research workforce and
collaboration with micro, small and other relevant disciplines.
medium-sized enterprises (SMEs) and Initiatives should include:
the involvement of patients to focus on •• Recruiting wider multidisciplinary
experimental medicine approaches and research expertise (from other medical
to develop, tools, standards and quality specialities and groups such as:
of health related products. These should anthropologists, data scientists, chemists,
facilitate research tool donation and engineers, statisticians, geographers,
intellectual property (IP) agreement. sociologists, economists, criminologists,
•• A focus on research with sectors educationalists, clinical trialists, population
emerging as important to mental health scientists, improvement scientists).
such as care home providers and the •• Strengthening clinical–academic
data analytic sector. research capacity across the mental
Recommendation 9: Regulation, ethics health professions (including in academic
and governance psychiatry, nursing, clinical psychology,
Stakeholders: Research Funders, Home social work).
Office, HRA, RECs, MHRA/EMA, Local •• Expanding the existing mental health
Authorities, Universities. research community through practical
Procedures for the regulation, governance measures to build the careers of service
and ethical oversight of mental health users as researchers and, increase and
research should be streamlined to expedite maintain the involvement of people with
studies. There should be a focus on experience of mental health problems,
streamlining the regulation, ethics and carers and those within voluntary and
governance of: animal research, experimental community groups.
medicine, clinical trials, population research •• Fostering research fellowships partnered
and observational research involving large with industry sectors.
datasets. Research ethics committees should •• Strengthening research awareness
have mental health specific expertise on their and participation amongst healthcare
panels and involve experts by experience and practitioners and those supporting
people with mental health problems

(including general practitioners, nurses,
health visitors, midwives, occupational
therapists social workers, pharmacists,
psychologists, public health practitioners,
relatives and carers).
•• Encouraging Universities and their
linked teaching hospital Trusts to grow
their mental health research portfolios,
challenging stigma at an institutional level.
•• Increasing support for mental health
researchers throughout their careers
(including mentoring schemes for early
career researchers, and incentives
for Universities to invest in senior
investigators).
•• Encouraging funders and researchers
to include within all life-science
research outcome measures relevant to
mental health.
8. Annexes 37
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
•• Ms Alison Tingle, Research Liaison •• Professor David Porteous, Chair of

Officer, DH SRED Human Molecular Genetics & Medicine,
•• Dr Laura Boothman, Science Writer, DH The University of Edinburgh
SRED •• Professor Angela C Roberts, Professor of
Behavioural Neuroscience, University of
Working groups Cambridge
1. Basic Science •• Professor Trevor Smart, Schild Professor
•• Professor Trevor Robbins (Chair), of Pharmacology, University College
Professor of Cognitive Neuroscience and London
Experimental Psychology, University of
Cambridge Observers:
•• Dr Thomas Kabir (Co-chair), The McPin •• Dr Kathryn Adcock, Head of

Foundation Neurosciences & Mental Health, Medical
Research Council
•• Dr Chris Chatterton, Independent
Researcher, Cardiff University •• Dr Sophie Dix, Director of Research, MQ
•• Professor Jeff Dalley, Professor of •• Dr Raliza Stoyanova, Senior Portfolio

Behavioural and Molecular Neuroscience, Developer, Neuroscience & Mental
University of Cambridge Health, Wellcome Trust
•• Professor Peter Dayan, Director, Gatsby 2. Translational research

Computational Neuroscience Unit,
University College London •• Professor Peter Jones (Chair), Professor
of Psychiatry, University of Cambridge
•• Dr Neil Harrison, Wellcome Clinician
Scientist and Reader in Neuropsychiatry, •• Ms Delphine van der Pauw (Co-chair),
Brighton and Sussex Medical School Research & Information Manager,
Epilepsy Research UK
•• Professor Paul Harrison, Professor of
Psychiatry, University of Oxford •• Professor Ed Bullmore, Head of the
Department of Psychiatry, University of
•• Professor Heidi Johansen Berg, Head Cambridge
of FMRIB and Professor of Cognitive
Neuroscience, University of Oxford •• Professor Tamsin Ford, Professor of Child
and Adolescent Psychiatry, University of
•• Dr Matt Jones, Reader in Cognitive Exeter Medical School
Neurophysiology, University of Bristol
•• Professor Jeremy Hall, Director and
•• Professor David Nutt, The Research Theme Lead, Neurosciences &
Edmond J Safra Chair in Mental Health Research Institute, Cardiff
Neuropsychopharmacology, Imperial University
College London
•• Professor Nav Kapur, Professor of
•• Professor Mike Owen, Director of MRC Psychiatry & Population Health, The
Centre for Neuropsychiatric Genetics and University of Manchester
Genomics, Cardiff University
•• Professor Martin Knapp, Professor of
Social Policy and Director of the Personal
Social Services Research Unit at the
8. Annexes 39
London School of Economics and •• Professor Kam Bhui, Professor of Cultural

Political Science Psychiatry & Epidemiology, Queen Mary
•• Dr Belinda Lennox, Associate Professor University of London
and Senior Clinical Lecturer, University of •• Dr Richard Dobson, Senior Lecturer and
Oxford Head of Bioinformatics, King’s College
•• Professor Karina Lovell, Professor London
of Mental Health, The University of •• Professor Simon Gilbody, Director of the
Manchester Mental Health and Addictions Research
•• Professor Martin Orrell, Director, Institute Group, University of York
of Mental Health, The University of •• Professor Sonia Johnson, Professor
Nottingham of Social and Community Psychiatry,
•• Professor Barbara Sahakian, Professor University College London
of Clinical Neuropsychology, University of •• Professor Glyn Lewis, Professor of
Cambridge Psychiatric Epidemiology, University
•• Professor Dame Til Wykes, College London
Professor of Clinical Psychology & •• Professor Paul McCrone, Professor of
Rehabilitation, King’s College London Health Economics, Kings College London
•• Dr Paul Moran, Reader in Psychiatry,
Observers: University of Bristol
•• Dr Kathryn Adcock, Head of •• Mr Michael Parsonage, Chief Economist,
Neurosciences & Mental Health, Medical Centre for Mental Health, London
Research Council
•• Professor Anne Rogers, Professor
•• Dr Giovanna Lalli, Acting Head of of Health Systems Implementation,
Neuroscience and Mental Health, University of Southampton
Wellcome Trust
•• Professor Diana Rose, Professor of User-
•• Dr Vanessa Pinfold, Chair, Alliance of Led Research, King’s College London
Mental Health Research Funders
•• Professor Alan Simpson, Professor of
3. Population and health Collaborative Mental Health Nursing, City
services research University London
•• Professor Matthew Hotopf (Chair), •• Dr Geraldine Strathdee, Consultant
Professor of General Hospital Psychiatry Psychiatrist, Oxleas NHS FT
at the Institute of Psychiatry, Psychology
and Neuroscience, King’s College London Observers:
•• Ms Clare Dolman (Co-Chair), King’s •• Mr Gregor Henderson, Director of
College London, Vice-Chair Maternal Wellbeing & Mental Health, Public Health
Mental Health Alliance, Vice-Chair Bipolar England
UK, Action on Post-Partum Psychosis. •• Dr Vanessa Pinfold, Chair, Alliance of
•• Professor Louise Arseneault, Professor of Mental Health Research Funders
Developmental Psychology, Kings College
London.
•• 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
(2011),186 Depression: ARQ (2016),187

Bipolar priority setting (2016)188 and
Autism (2016).189 Further PSPs are
underway considering psychological
treatments, digital technologies for mental
health and mental health in children and
young people.190
•• ‘Have your say’ conducted in 2016 to
inform the priorities for mental health
related research sponsored by the
Economic and Social Research Council
(ESRC).191
•• ‘New Mind Network’ – Work to support
the Development of the New Mind
Research Roadmap by the Engineering
and Physical Sciences Research Council
(EPSRC).192
The public engagement findings of the

5YFVMH taskforce were published in
September 2015.193 The engagement findings
indicated that:
•• People wanted mental health research to
be equitably funded, and to have parity
with other areas of health research.
•• There should be ‘much more research led
by experts by experience looking at what
matters most to people in relationship to
prevention and treatment’.
•• There were calls for more research
into the long-term effects of psychiatric
medication.194
The taskforce also concluded that:
•• Understanding the causes of mental ill
health, including social and psychological
factors, was considered a priority for
research funding.195
9. References 43
9. References
1
The Mental Health Task Force (2016) The Five Year statistics/2016/160622-welsh-health-survey-2015-
Forward View for Mental Health. A report from the health-status-illnesses-other-conditions-en.pdf
independent Mental Health Taskforce to the NHS 12
ROAMER: a roadmap for mental health research in
in England. Europe. Key project aims. http://www.roamer-mh.
2
McManus S, Bebbington P, Jenkins R, Brugha org/index.php?page=1_1
T (eds.) (2016) Mental health and wellbeing in 13
McDaid D, Park AL, Knapp M (2017)
England: Adult Psychiatric Morbidity Survey 2014. Commissioning Cost-Effective Services for
Leeds: NHS Digital. Promotion of Mental Health and Wellbeing and
3
McManus S, Bebbington P, Jenkins R, Brugha Prevention of Mental Ill-Health. London: Public
T. (eds.) (2016) Mental health and wellbeing in Health England. https//www.gov.uk/government/
England: Adult Psychiatric Morbidity Survey 2014. publications/mental-health-services-cost-effective-
Leeds: NHS Digital. As cited in Mental Health commissioning
Foundation (2016) Fundamental facts about mental 14
Annual Report of the Chief Medical Officer 2013
health. (2014) Public Mental Health Priorities: Investing in
4
Office for National Statistics (2016) Suicides in the the Evidence. https://www.gov.uk/government/
UK: 2015. registrations. uploads/system/uploads/attachment_data/
5
The Mental Health Task Force (2016) The Five Year file/413196/CMO_web_doc.pdf
Forward View for Mental Health. A report from the 15
McManus S, Bebbington P, Jenkins R, Brugha
independent Mental Health Taskforce to the NHS T (eds.) (2016) Mental health and wellbeing in
in England. England: Adult Psychiatric Morbidity Survey 2014.
6
Wilkinson R & Pickett K (2017) Inequality and Leeds: NHS Digital.
mental illness. The Lancet Psychiatry, 4(7):512-513. 16
Vos, T et al. (2013) Global, regional, and national
7
Riberio W et al. (2017) Income inequality and incidence, prevalence, and years lived with
mental illness-related morbidity and resilience: disability for 301 acute and chronic diseases and
a systematic review and meta-analysis. Lancet, injuries in 188 countries, 1990–2013: a systematic
4(7):554-562. analysis for the Global Burden of Disease Study.
8
McManus S, Bebbington P, Jenkins R, Brugha The Lancet, 386 (9995): 743-800.
Wahlbeck, K, Westman, J, Nordentoft, M, Gissler,
England: Adult Psychiatric Morbidity Survey 2014. M, & Laursen, TM (2011) Outcomes of Nordic
Leeds: NHS Digital. mental health systems: Life expectancy of patients
9
Corrigan, D & Scarlett, M (2017) Health with mental disorders. British Journal of Psychiatry,
Survey Northern Ireland: First Results 2016/17. 199(6), 453–458.
Department of Health, Social Services and Public 18
Davies, SC (Sep 2014) Annual Report of the
Safety. https://www.health ni.gov.uk/sites/default/ Chief Medical Officer 2013, Public Mental Health
files/publications/health/hsni-first-results-16-17.pdf Priorities: Investing in the Evidence. London:
10
Bromley, C et al. (2014) The Scottish Health Department of Health.
Survey: 2013 edition, volume 1, main report. 19
The Mental Health Task Force (2016) The five year
[online] Edinburgh: The Scottish Government. forward view for mental health. A report from the
http://www.gov.scot/Resource/0046/00464858. independent Mental Health Taskforce to the NHS
pdf in England.
11
The Welsh Government. (2016) Welsh
Health Survey 2015. http://gov.wales/docs/
20
Annual Report of the Chief Medical Officer 2013 33
World Health Organization and Calouste
(2014) Public Mental Health Priorities: Investing in Gulbenkian Foundation (2014) Social determinants
the Evidence. https://www.gov.uk/government/ of mental health. Geneva, World Health
uploads/system/uploads/attachment_data/ Organization.
file/413196/CMO_web_doc.pdf 34
Ibid.
21
Naylor C, Parsonage M, McDaid D, Knapp M, 35
Henderson C, Robinson E, Evans-Lacko S,
Fossy M, Galea A (2012) Long term conditions and Corker E, Rebollo-Mesa I, Rose D, Thornicroft G.
mental health – the cost of co-morbidities. The (2016) Public knowledge, attitudes, social distance
King’s Fund and Centre for Mental Health. and reported contact regarding people with mental
22
Weaver T et al. (2003) Comorbidity of substance illness 2009–2015. Acta Psychiatr Scand, 134
misuse and mental illness in community mental (Suppl. 446): 23–33.
health and substance misuse services. British 36
Corker E, Hamilton S, Robinson E, Cotney J,
Journal of Psychiatry, 183(4)304-313. Pinfold V, Rose D et al. (2016) Viewpoint survey
23
Turning Point (2016) Dual Dilemma: The impact of mental health service users’ experiences
of living with mental health issues combined with of discrimination in England 2008–2014. Acta
drug and alcohol misuse http://www.turning-point. Psychiatr Scand, 134 (Suppl. 446): 6–13.
co.uk/media/1138757/dual_dilemma.pdf 37
Royal College of Psychiatrists (2012) Recruitment
24
PHE (2014) Co-existing alcohol and drug misuse Strategy 2011-2016. http://www.rcpsych.ac.uk/pdf/
with mental health issues: guidance to support Recruitment%20Strategy%20-%2010092013.pdf
local commissioning and delivery of care. http:// 38
Gaebel W, Zäske H, Zielasek J et al. (2015)
www.nta.nhs.uk/uploads/ceadmmhi-consultation- Stigmatization of psychiatrists and general
draft-180116.pdf practitioners: results of an international survey. Eur
25
Department of Work and Pensions (2015) Labour Arch Psychiatry Clin Neurosci, 265: 189.
Force Survey analysis of disabled people by https://doi.org/10.1007/s00406-014-0530-8
region and main health problem. https://www. 39
Kessler RC, Amminger GP, Aguilar-Gaxiola S,
disabilityrightsuk.org/news/2015/february/labour- Alonso J, Lee S, & Ustün TB (2007) Age of onset
force-survey-analysis-disabled-people of mental disorders: a review of recent literature.
26
Wilkinson R & Pickett K (2017) Inequality and Current Opinion in Psychiatry, 20(4), 359–364.
mental illness. The Lancet Psychiatry, 4(7):512-513. 40
Kim-Cohen J, Caspi A, Moffitt TT, Harrington HL,
27
World Health Organization and Calouste Milne BJ, Poulton R (2003) Prior Juvenile
Gulbenkian Foundation. (2014) Social determinants Diagnoses in Adults With Mental Disorder
of mental health. Geneva, World Health Developmental Follow-Back of a Prospective-
Organization. Longitudinal Cohort Arch Gen Psychiatry,
28
Mental Health Foundation (2016) Fundamental 60(7):709-717.
Facts about Mental Health 2016. https://www. 41
MQ transforming mental health (2016) The MQ
mentalhealth.org.uk/publications/fundamental- manifesto for young people’s mental health.
facts-about-mental-health-2016 https://www.mqmentalhealth.org/articles/mq-
29
Pickett K, Oliver J, & Wilkinson R (2006) Income manifesto-for-young-peoples-mental-health
inequality and the prevalence of mental illness: 42
Green H, McGinnity A, Meltzer H, Ford T and
A preliminary international analysis. Journal of Goodman, R (2005) Mental health of children and
Epidemiology and Community Health, 60, 646– young people in Great Britain, 2004. [online] NY:
647. Palgrave Macmillan.
30
The Mental Health Task Force (2016) The Five Year 43
ONS (2015) Insights into children’s mental
Forward View for Mental Health. A report from the health and well-being. https://backup.ons.gov.
independent Mental Health Taskforce to the NHS uk/2015/10/20/insights-into-childrens-mental-
in England. health-and-well-being/
31
Kirkbride JB et al. (2008) Psychoses, ethnicity 44
World Health Organization and Calouste
and socio-economic status. The British Journal of Gulbenkian Foundation. (2014) Social determinants
Psychiatry. 193(1), pp.18–24. of mental health. Geneva, World Health
https://bjp.rcpsych.org/content/193/1/18.abstract Organization.
32
Homeless Link (2014) The unhealthy state of
homelessness: Health audit results 2014.
9. References 45
45
Vachon DD, Krueger RF, Rogosch FA et al. 57
Wykes T, Haro JM, Belli SR, Obradors-Tarragó C,
(2015) Assessment of the harmful psychiatric Arango, C, Ayuso-Mateos JL et al. (2015) ‘Mental
and behavioral effects of different forms of child health research priorities for Europe’ The Lancet
maltreatment. JAMA Psychiatry, 55455(11): 1135– Psychiatry, vol 2, no. 11, pp. 1036–1042.
1142. 58
The Mental Health Task Force (2016) The Five Year
46
Negele A, Kaufhold J, Kallenbach L & Leuzinger- Forward View for Mental Health. A report from the
Bohleber M (2015) Childhood Trauma and Its independent Mental Health Taskforce to the NHS
Relation to Chronic Depression in Adulthood. in England. Recommendation 26.
Depression Research and Treatment. https://www. 59
HM Government (2017) The Government’s
ncbi.nlm.nih.gov/pmc/articles/PMC4677006/#B23 response to the Five Year Forward View for Mental
47
Dodge K et al. (2015) Impact of Early Intervention Health.
on Psychopathology, Crime and Well-Being at Age 60
The Research Councils (AHRC, BBSRC, EPSRC,
25. American Journal of Psychiatry, 172:1, 59-70. ESRC, MRC, NERC and STFC) (2017) Widening
48
Knapp M et al. (2015) How do child and adolescent cross-disciplinary research for mental health
mental health problems influence public sector (August 2017) http://www.rcuk.ac.uk/documents/
costs? Interindividual variations in a nationally documents/cross-disciplinary-mental-health-
representative British sample. The Journal of Child research-agenda-pdf/
Psychology and Psychiatry, 56: 667–676. 61
Medical Research Council (2017) Strategy for
49
Davies SC (Sep 2014) Annual Report of the Lifelong Mental Health Research
Chief Medical Officer 2013, Public Mental Health 62
The Scottish Government (2015) What Research
Priorities: Investing in the Evidence. London: Matters for Mental Health Policy in Scotland.
Department of Health. 63
The Health & Social Care Research and
50
Centre for Mental Health (2009) The economic and Development Division of the Public Health Agency
social costs of mental health problems in 2009/10, (2011) Implementing Bamford: Knowledge from
1–4. London, UK Research.
51
ONS (2016) UK Labour Market: July 2016. ons.gov. 64
NHSE – Improving Access to Psychological
uk/employmentandlabourmarket/peopleinwork/ Therapies Programme. https://www.england.nhs.
employmentandemployeetypes/bulletins/ uk/mental-health/adults/iapt/
uklabourmarket/july2016 65
NHS Digital – Mental Health Services Data Set
52
McManus S, Bebbington P, Jenkins R, Brugha, http://content.digital.nhs.uk/mhsds
https://www.nice.org.uk/
England: Adult Psychiatric Morbidity Survey 2014. 67
Stilo SA et al. (2017) Further evidence of a
Leeds: NHS Digital. As cited in Mental Health cumulative effect of social disadvantage on risk of
Foundation (2016) Fundamental facts about mental psychosis. Psychological Medicine, 47 (5): 913-
health. 924.
53
Khan L et al. (2015) Investing in children’s mental 68
Kirkbride JB et al. (2012) Incidence of
health report: A review of evidence on the costs Schizophrenia and Other Psychoses in England,
and benefits of increased service provision. 1950–2009: A Systematic Review and Meta-
Centre for Mental Health, London. https://www. Analyses. PLoS ONE, 7(3): e31660. https://doi.
centreformentalhealth.org.uk/investing-in-children- org/10.1371/journal.pone.0031660
report 69
Arseneault L. Bowes L & Shakoor S (2010) Bullying
54
The Mental Health Task Force (2016) The Five Year victimization in youths and mental health problems:
Forward View for Mental Health. A report from the ‘Much ado about nothing’? Psychological
independent Mental Health Taskforce to the NHS Medicine, 40 (5): 717-729.
in England. 70
Cable N et al. (2013) Friends are equally important
55
Department of Health; NHS England (2015) Future to men and women, but family matters more for
in mind Promoting, protecting and improving our men’s well-being. Journal of Epidemiology and
children and young people’s mental health and Community Health, 67 (2) http://jech.bmj.com/
wellbeing. content/67/2/166.short
56
The Mental Health Task Force (2016) The five year
forward view for mental health. A report from the
independent Mental Health Taskforce to the NHS
in England.
71
Webber M et al. (2015) Enhancing social networks: 81
Leamy M et al. (2011) Conceptual framework for
a qualitative study of health and social care personal recovery in mental health: systematic
practice in UK mental health services. Health and review and narrative synthesis. British Journal of
Social Care in the Community, 23(2):180-9 http:// Psychiatry, 199(6):445-52.
clok.uclan.ac.uk/11394/ 82
Webber M et al. (2015) Enhancing social networks:
72
Gillard S, Simons L, Turner K, Lucock M and a qualitative study of health and social care
Edwards C. (2012) “Patient and Public Involvement practice in UK mental health services. Health and
in the Co-production of Knowledge: Reflection on Social Care in the Community, 23(2):180-9.
the Analysis of Qualitative Data in a Mental Health 83
Clark DM (2011) Implementing NICE guidelines
Study”, Qualitative Health Research, Vol. 22, No. 8, for the psychological treatment of depression
pp. 1126-1137. and anxiety disorders: the IAPT experience.
73
Faulkner A (2004) The ethics of survivor research. International Review of Psychiatry, (Abingdon,
https://www.jrf.org.uk/report/ethics-survivor- England), 23(4), 318–27. http://doi.org/10.3109/095
research-guidelines-ethical-conduct-research- 40261.2011.606803
carried-out-mental-health 84
DeRubeis RJ, Cohen ZD, Forand NR, Fournier JC,
74
Evans-Lacko S et al. (2014) Effect of the Time to Gelfand LA et al. (2014) The Personalized
Change anti-stigma campaign on trends in mental- Advantage Index: Translating Research on
illness-related public stigma among the English Prediction into Individualized Treatment
population in 2003–13: an analysis of survey data. Recommendations. A Demonstration. PLoS
The Lancet Psychiatry, 1: 121–28 http://www. ONE, 9(1): e83875. https://doi.org/10.1371/journal.
thelancet.com/journals/lanpsy/article/PIIS2215- pone.0083875
0366(14)70243-3/fulltext 85
Wiles NJ, Thomas L, Turner N, Garfield K, Kounali
75
Rose D et al. (2010) Barriers and facilitators of D, Campbell J et al. (2016) Long-term effectiveness
disclosures of domestic violence by mental health and cost-effectiveness of cognitive behavioural
service users: qualitative study. British Journal of therapy as an adjunct to pharmacotherapy for
Psychiatry, 198(3):189-194. http://bjp.rcpsych.org/ treatment-resistant depression in primary care:
content/198/3/189.full-text.pdf+html follow-up of the CoBalT randomised controlled
76
Danese A, & McCrory E. (2015) Child trial. The Lancet Psychiatry, 3(2):137-44.
Maltreatment. In: Rutter’s Textbook of Child & 86
Dalle Grave R, Calugi S, Sartirana M & Fairburn,
Adolescent Psychiatry, 6th Edition. Wiley-Blackwell, CG (2015) Transdiagnostic cognitive behaviour
London, UK. therapy for adolescents with an eating disorder
77
Macmillan HL, Wathen CN, Barlow J, Fergusson WHO are not underweight. Behaviour Research
DM, Leventhal JM & Taussig HN (2009) and Therapy, 73, 79–82. http://doi.org/10.1016/j.
Interventions to prevent child maltreatment and brat.2015.07.014
associated impairment. Lancet, 373(9659):250-66. 87
NICE (2015) Psychosis and Schizophrenia in
78
Bywaters P, Bunty L, Davidson G, Hanratty J, Adults. Quality Standard https://www.nice.org.
Mason W, McCartan C, Steils N ( 2016) The uk/guidance/qs80/chapter/quality-statement-2-
Relationship between poverty, child abuse and cognitive-behavioural-therapy
neglect: an evidence review. Joseph Rowntree 88
O’Leary-Barrett M, Topper L, Al-Khudhairy N,
Foundation. Pihl RO, Castellanos-Ryan N, Mackie CJ &
79
Radford L, Corral S, Bradley C & Fisher HL (2013) Conrod PJ (2013) Two-year impact of personality-
The prevalence and impact of child maltreatment targeted, teacher-delivered interventions on youth
and other types of victimization in the UK: Findings internalizing and externalizing problems: A cluster-
from a population survey of caregivers, children randomized trial. Journal of the American Academy
and young people and young adults. Child abuse of Child and Adolescent Psychiatry, 52(9), 911–920.
& neglect, 37(10), 801-813. http://doi.org/10.1016/j.jaac.2013.05.020
80
Burns T et al. (2015) A randomised controlled trial 89
Chang CK, Hayes RD, Perera G, Broadbent MTM,
of time-limited individual placement and support: Fernandes AC, Lee WE et al. (2011) Life
IPS-LITE trial. British Journal of Psychiatry, expectancy at birth for people with serious mental
207(4):351-6. illness and other major disorders from a secondary
mental health care case register in London. PloS
One, 6(5), e19590. http://doi.org/10.1371/journal.
pone.0019590
9. References 47
90
Dougall N, Lambert P, Maxwell M, Dawson A, 103
Sweeney A et al. (2012) Hearing the voices of
Sinnott R, McCafferty S et al. (2014) Deaths by service user researchers in collaborative qualitative
suicide and their relationship with general and data analysis: the case for multiple coding. Health
psychiatric hospital discharge: 30-Year record Expectations, 16, pp.e89–e99.
linkage study. British Journal of Psychiatry, 204(4), 104
Rose D, Evans J, Sweeney A (2011) A model
267–273. http://doi.org/10.1192/bjp.bp.112.122374 for developing outcomes measures from the
91
The National Confidential Inquiry into Suicide and perspective of mental health service users.
Homicide by People with Mental Illness. Making International Review of Psychiatry, 23(1):41–46.
Mental Health Care Safer: Annual Report and 105
Sweeney A, Beresford P, Faulner A, Nettle M,
20-year Review. October 2016. University of Rose D (eds) (2009) This is survivor research. Pccs
Manchester. http://research.bmh.manchester. Books. Ross on Wye.
ac.uk/cmhs/research/centreforsuicideprevention/ 106
INVOLVE (2015) Going the Extra Mile: improving
nci/reports/2016-report.pdf the nation’s health and wellbeing through public
92
http://www.crisiscareconcordat.org.uk/ involvement in research. https://www.nihr.ac.uk/
93
Cross-Disorder Group of the Psychiatric Genomics patients-and-public/documents/Going-the-Extra-
Consortium. Identification of risk loci with shared Mile.pdf
effects on five major psychiatric disorders: a 107
4Pi National Involvement Standards (2015) https://
genome-wide analysis. (2013) Lancet, 381:1371– www.nsun.org.uk/faqs/4pi-national-involvement-
1379. standards
94
Ripke S, Neale BM, Corvin A, Walters JTR, Farh 108
Staley K (2009) Exploring Impact: Public
KH, Holmans PA, et al. (2014) Biological insights involvement in NHS, public health and social care
from 108 schizophrenia-associated genetic loci. research. INVOLVE, Eastleigh.
Nature, 0, 1–6. http://doi.org/10.1038/nature13595 109
Ennis L & Wykes T (2013) Impact of patient
95
Mills KL, Goddings AL, Herting MM, Meuwese R, involvement in mental health research: longitudinal
Blakemore SJ, Crone EA, et al. (2016) Structural study. The British Journal of Psychiatry, 203,
brain development between childhood and 381–386.
adulthood: Convergence across four longitudinal 110
Dudley L, Gamble C, Preston J, Buck D, The EPIC
samples. NeuroImage, 141, 273–281. http://doi. Patient Advisory Group, Hanley B et al. (2015) What
org/10.1016/j.neuroimage.2016.07.044 Difference Does Patient and Public Involvement
96
Giedd JN & Rapoport JL (2010) Structural MRI Make and What Are Its Pathways to Impact?
of pediatric brain development: What have we Qualitative Study of Patients and Researchers from
learned and where are we going? Neuron, 67, a Cohort of Randomised Clinical Trials. PLoS ONE,
728–734. 10(6): e0128817. https://doi.org/10.1371/journal.
97
Lee BFS, Heimer H, Giedd N, Lein ES, Šestan N, pone.0128817
Weinberger DR & Casey BJ (2014) Adolescent 111
INVOLVE & Health Research Authority (2016)
mental health — Opportunity and obligation. Impact of public involvement on the ethical aspects
Science, 346(6209), 547–549. http://doi. of research.
org/10.1126/science.1260497 112
Staniszewska S, Brett J, Mockford C, Barber R
98
Patterson S, Trite J. and Weaver T (2014) Activity (2011) The GRIPP checklist: Strengthening the
and views of service users involved in mental quality of patient and public involvement reporting
health research: UK survey. The British Journal of in research. International Journal of Technology
Psychiatry, 205(1):68-75. Assessment in Health Care, 27:4, 391–399.
99
Ennis L & Wykes T (2013) Impact of patient 113
Popay J & Collins M (2014) (eds) with the PiiAF
involvement in mental health research: longitudinal Study Group. PiiAF The Public Involvement Impact
study. British Journal of Psychiatry, 203(5):381-386. Assessment Framework Guidance. piiaf.org.uk/
100
http://www.invo.org.uk/find-out-more/what-is- documents/piiaf-guidance-jan14.pdf
public-involvement-in-research-2/ 114
http://www.jla.nihr.ac.uk/about-the-james-lind-
101
Department of Health (2006) Best Research for alliance/
Best Health. 115
Staley K (2015) ‘Is it worth doing?’ Measuring
102
Gillard S et al. (2012) Patient and Public the impact of patient and public involvement in
Involvement in the Coproduction of Knowledge: research. Research Involvement and Engagement,
Reflection on the Analysis of Qualitative Data in a 1:6.
Mental Health Study Qual Health Res, 22: 1126,
116
https://www.aamc.org/initiatives/research/334422/ 132
https://www.england.nhs.uk/mental-health/adults/
basicscience.html iapt/
117
Cressey D (2011) Psychopharmacology in crisis. 133
http://content.digital.nhs.uk/catalogue/PUB21748
Nature. http://www.nature.com/news/2011/110614/ McManus S, Bebbington P, Jenkins R, Brugha T
full/news.2011.367.html (eds.) (2016) Mental health and wellbeing in
118
https://www.mqmentalhealth.org/news-blog/post/ England: Adult Psychiatric Morbidity Survey 2014.
new-data-platform-promises-step-change-in- Leeds: NHS Digital.
young-peoples-mental-health-research 134
http://www.cls.ioe.ac.uk/Default.aspx
119
Barker DJP (1995) Mothers, Babies, and Disease 135
Avon Longitudinal Study of Parents and Children.
in Later Life. British Medical Journal, 310. https:// http://www.bristol.ac.uk/alspac/
doi.org/10.1136/bmj.310.6971.68a 136
Born in Bradford. https://borninbradford.nhs.uk/
120
Jones P, Rodgers B, Murray R, Marmot M 137
https://www.ukbiobank.ac.uk/
(1994) Child development risk factors for adult 138
Monteith, S & Glenn, T (2016) Automated decision-
schizophrenia in the British 1946 birth cohort. making and big data: concerns for people with
Lancet, 344(8934):1398-402. mental illness. Curr Psychiatry Rep, 18: 112. https://
121
WHO (2000) The Implications for training of doi.org/10.1007/s11920-016-0746-6
embracing A Life Course Approach to Health. 139
https://www.england.nhs.uk/mentalhealth/adults/
World Health Organisation/ International Longevity iapt/
Centre. 140
Wing JK, Beevor AS, Curtis RH, Park SBG,
122
Ibid. Madden S & Burns A (1998) Health of the Nation
123
Ibid. Outcome Scales (HoNOS). British Journal of
124
Ibid. Psychiatry, 172, 11-18.
125
Davies SC (2014) Annual Report of the Chief 141
Child Outcomes Research Consortium. http://
Medical Officer 2013, Public Mental Health www.corc.uk.net/
Priorities: Investing in the Evidence. London: 142
http://www.sheffield.ac.uk/scharr/sections/heds/
Department of Health. mvh/mentalhealth
126
Brett J, Staniszewska S, Mockford C, Herron-Marx 143
Perera G, Broadbent M, Callard F, Chang CK,
S, Hughes J, Tysall C, Suleman R (2012) Mapping Downs J, Dutta R et al. (2016) Cohort profile of
the impact of patient and public involvement on the South London and Maudsley NHS Foundation
health and social care research: a systematic Trust Biomedical Research Centre (SLaM
review. Health Expectations, 17, pp.637–650. BRC) Case Register: current status and recent
127
Bhugra D, Kar A & Lawton-Smith S. (2014) enhancement of an Electronic Mental Health
Integration of Mental and Physical Health Services. Record derived data resource. BMJ Open, 6:
Journal of Psychosocial Rehabilitation and Mental e008721.
Health, 1(1):15–21. 144
Werbeloff N, Chang C-K, Broadbent M, Hayes
128
Royal College of Psychiatrists (2010) No health JF, Stewart R, Osborn DPJ (2017) Readmission
without public mental health: the case for action. to acute mental health services following contact
129
National Institute for Health and Clinical with crisis resolution and home treatment teams.
Excellence (2009) Depression in Adults with a Lancet Psychiatry, 4: 49-56.
Chronic Physical Health Problem: Treatment and 145
Robotham D, Satkunanathan S, Doughty L &
Management. NICE. http://www.nice.org.uk/ Wykes T (2016) Do we still have a digital divide in
nicemedia/pdf/CG91FullGuideline.pdf mental health? Cross-sectional surveys over five
130
Egede LE (2007) Major depression in individuals years. Journal of Medical Internet Research, 18:
with chronic medical disorders: prevalence, and e309.
correlates and associates of health recourse 146
UK Clinical Research Collaboration (UKCRC)
utilisation, lost productivity and functional disability. (2015) UK Health Research Analysis 2014
General Hospital Psychiatry, 29, 409–416. https:// http://www.hrcsonline.net/sites/default/files/
doi.org/10.1016/j.genhosppsych.2007.06.002 UKCRCHealthResearchAnalysis2014%20PRINT.
131
Davies SC (2014) Annual Report of the Chief pdf
Medical Officer 2013, Public Mental Health 147
Ibid.
Priorities: Investing in the Evidence. London: 148
Ibid.
Department of Health. 149
MQ (2015) UK Mental Health Research Funding.
MQ Landscape Analysis
9. References 49
150
Ibid. 167
The Gatsby Foundation and Wellcome Trust
151
MQ transforming mental health (2016) The MQ Neuroscience Project http://rcpsych.ac.uk/
manifesto for young people’s mental health. traininpsychiatry/neuroscienceproject.aspx
152
Priebe S, Omer S, Giacco D & Slade M (2014) The 168
http://www.time-to-change.org.uk/
British Journal of Psychiatry, 204 (4) 256-261 169
http://www.nihr.ac.uk/news-and-events/support-
153
Side by Side research consortium (2017) Side by our-campaigns/ok-to-ask/
Side early findings report. London: Mind. http:// 170
Bell C & Scarlett M (2015) Health Survey Northern
mcpin.org/wp-content/uploads/Mind-Side-by- Ireland: First Results 2014/15. Department of
Side_Early-Research-findings.pdf Health, Social Services and Public Safety. health-
154
Firth J, Torous J, Nicholas J, Carney R, Pratap A, ni.gov.uk/sites/default/files/publications/dhssps/
Rosenbaum S & Sarris J. (2017) The efficacy of hsni-firstresults-14-15.pdf
smartphone-based mental health interventions 171
Bromley C et al. (2014) The Scottish Health Survey:
for depressive symptoms: a meta-analysis of 2013 edition, volume 1, main report. [online]
randomised controlled trials. World Psychiatry, Edinburgh: The Scottish Government. http://www.
16:287-298. gov.scot/Resource/0046/00464858.pdf
155
https://www.turing.ac.uk/ 172
The Welsh Government. (2016) Welsh Health
156
Nutt DJ, King LA, Nichols DE (2013) Effects of Survey 2015. http://gov.wales/statistics-and-
Schedule I drug laws on neuroscience research research/welsh-health-survey/?lang=en
and treatment innovation. Nature Reviews 173
Medical Research Council (2016). The MRC
Neuroscience, 14(8):577-85. doi: 10.1038/nrn3530. Delivery Plan 2016 – 2020. https://www.mrc.
Epub 2013 Jun 12. With follow up in Nutt, DJ, King, ac.uk/about/what-we-do/spending-accountability/
L A, & Nichols, DE (2013) New victims of current delivery-plan/
drug laws. Nat Rev Neurosci. 174
Cochrane G, Pollitt A & Wooding S (2016) Mapping
157
http://www.legislation.gov.uk/ukpga/1971/38/ UK mental health research funding and its
contents contribution to global funding. A refined analysis for
158
https://ec.europa.eu/health/sites/health/files/files/ the UK context. Rand Europe https://www.rand.
eudralex/vol-1/reg_2014_536/reg_2014_536_ org/pubs/research_reports/RR1774.html
en.pdf 175
The Scottish Government (2015) What Research
159
http://www.legislation.gov.uk/ukpga/2016/2/pdfs/ Matters for Mental Health Policy in Scotland.
ukpga_20160002_en.pdf 176
MQ Transforming Mental Health (2015) UK
160
https://www.gov.uk/guidance/research-and- Mental Health Research Funding. MQ Landscape
testing-using-animals#animals-scientific- Analysis.
procedures-act-1986 (revised in 2013) 177
The Health & Social Care Research and
161
UK policy framework for health and social care Development Division of the Public Health Agency
research (2017) https://www.hra.nhs.uk/planning- (2011) Implementing Bamford: Knowledge from
and-improving-research/policies-standards- Research.
legislation/uk-policy-framework-health-social-care- 178
Medical Research Council (2010) Review of Mental
research/ Health Research Report of the Strategic Review
162
http://www.hra.nhs.uk/about-the-hra/our- Group 2010.
committees/research-ethics-committees-recs/ 179
Mental Health Research Funders’ Group (2005)
163
Dazzi T, Gribble R, Wessely S, Fear NT (2014) Strategic Analysis of UK Mental Health Research
Does asking about suicide and related behaviours Funding.
induce suicidal ideation? What is the evidence? 180
Medical Research Council (2017) Strategy for
Psychological Medicine, 44(16):3361-3. Lifelong Mental Health Research.
164
McManus S, Bebbington P, Jenkins R, Brugha T 181
Research Councils UK (2017) Widening cross-
(eds.) (2016) Mental health and wellbeing in disciplinary research for mental health. www.rcuk.
England: Adult Psychiatric Morbidity Survey 2014. ac.uk/documents/documents/cross-disciplinary-
Leeds: NHS Digital. http://content.digital.nhs.uk/ mental-health-research-agenda-pdf
catalogue/PUB21748 182
ROAMER: a roadmap for mental health research in
165
Medical Research Council (2017) Strategy for Europe. Key project aims. http://www.roamer-mh.
Lifelong Mental Health Research. org/index.php?page=1_1
166
Academy of Medical Sciences (2013)
Strengthening academic psychiatry in the UK.
183
Haro JM, Ayuso-Mateos JL, Bitter I et al. (2014)
ROAMER: roadmap for mental health research in
Europe. Int J Methods Psychiatr Res, 23 (suppl 1):
1–14.
184
Wykes T, Haro JM, Belli SR, Obradors-Tarragó C,
Arango C, Ayuso-Mateos JL et al. (2015) ‘Mental
health research priorities for Europe’ The Lancet
Psychiatry, 2(11):1036-1042.
185
For further information see http://www.jla.nihr.
ac.uk/
186
ac.uk/priority-setting-partnerships/schizophrenia/
top-10-priorities/
187
MQ: Transforming Mental Health (January 2016)
Depression: asking the right questions.
188
ac.uk/priority-setting-partnerships/bipolar/
189
ac.uk/priority-setting-partnerships/autism/
190
For further information see: https://www.
mqmentalhealth.org/articles/psychological-
treatments-priority-setting
191
Hart A, Cameron J, Stubbs C, Heaver B &
Duncan S (2015) ‘Have Your Say’ on Mental
Health Research. eprints.brighton.ac.uk/16363/1/
Have%20Your%20Say%20Report.pdf
192
For further information see: http://www.
newmindnetwork.org.uk/
193
Mental Health Taskforce to the NHS in England
(2015) The five year forward view mental health
taskforce: public engagement findings: A report
from the independent Mental Health Taskforce to
the NHS in England.
194
Ibid.
195
The Mental Health Task Force (2016) The Five Year
Forward View for Mental Health. A report from the
independent Mental Health Taskforce to the NHS
in England.
10. Acknowledgments 51
10. Acknowledgments
The Department of Health is grateful to all

the collaborators on the steering group
and working groups and the invaluable
contributions of all stakeholders and experts
who took part in the workshops and
telephone conversations.
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CCS1117333064 December 2017
Produced by APS for the Department of Health

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Chapter heading

One in four of us experience mental Currently expertise is concentrated

Jeremy Hunt, Secretary of Paul Farmer, Chris Whitty,

1. Executive summary

consistency in involvement requirements could be improved are identified, as is the

Recommendation 5: Data, informatics Funding mechanisms should:

Recommendation 8: Industry engagement mental health clinicians in reviewing mental

people with mental health problems

2. Mental health of the UK population

2.1 Mental health in the UK Improvements in the prevention and

The impact of a particular mental health 2.2 Socio-economic factors

Whilst there is evidence that public of depression in adulthood.46 Family

2.6 Process of Framework –– Implementing Bamford: Knowledge

3. Why mental health research matters

strength which has led to global recognition 3.2 Case studies

•• Reducing the impact of treatment •• Tackle early mortality in severe mental

4. Public involvement and making

4.1 Involvement in research early.109,110 Involvement also supports the

•• Inclusion of wider community

5. Working group summaries

5.1 Introduction at mental health problems in great detail

6. Barriers and opportunities

Continued delivery of world-leading mental and biological explanations for mental

6.3 Mental and physical health 6.4 Co-ordination and

greater harmonisation of mental health •• Routine outcome measures: Consistently

6.7 Emerging interventions and of research methods. For example, action

Discrimination is still encountered by people

7. Conclusion and recommendations

The UK is internationally recognised as a community over the next decade and

Recommendation 5: Data, informatics Funding mechanisms should:

Recommendation 8: Industry engagement mental health clinicians in reviewing mental

people with mental health problems

•• Ms Alison Tingle, Research Liaison •• Professor David Porteous, Chair of

•• Dr Thomas Kabir (Co-chair), The McPin •• Dr Kathryn Adcock, Head of

•• Professor Jeff Dalley, Professor of •• Dr Raliza Stoyanova, Senior Portfolio

•• Professor Peter Dayan, Director, Gatsby 2. Translational research

London School of Economics and •• Professor Kam Bhui, Professor of Cultural

(2011),186 Depression: ARQ (2016),187

The public engagement findings of the

The Department of Health is grateful to all

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4. Public involvement and making