Log in
Psychosis devastates quality of life. Since 1995, work led by Professor David Fowler at The University of East Anglia (UEA) has made significant contributions to a series of UK and international trials which show that Cognitive Behaviour Therapy (CBT) is effective in reducing distress, emotional dysfunction and social disability in patients with chronic schizophrenia, and as part of early intervention services for first episode and at-risk patients. This work has had a major impact on mental health services as reflected in national and international mental health policy guidance, service development guidance, policy implementation guidance and training programmes for mental health workers.
Schizophrenia affects 1.1% of the adult population. It is one of the most debilitating of the psychiatric disorders, leading to costs of approximately £12Bn/year in the UK. Historically one of the major gaps in service provision has been any approach to prevention, whether primary or secondary. University of Birmingham pioneered the concept and practice of early intervention in psychosis, which is a key feature and indication of schizophrenia. This has gone on to have national and international impact on mental health care. This approach has been recommended in NICE Guidance, the Mental Health Strategy and is a requirement of the NHS Operating Framework for 2011/12. It has resulted in improved outcomes. Evaluation of this approach has found that is preferred by clients, reduces the suicide rate, reduces lost productivity due to illness and over three years the long term benefit of early intervention is between £17,427 and £36,632 per patient compared to standard care. In addition the success of early intervention in schizophrenia has impacted on wider mental health policy and practice, resulting in the development of similar approaches in other areas of mental health.
King's College London (KCL) researchers developed cognitive behaviour therapy for psychosis (CBTp), which is now a National Institute for Health and Care Excellence-recommended psychological intervention. CBTp is now part of routine NHS treatment and an estimated 25,000 patients in England and Wales receive it annually. Implementation of CBTp has been steered by KCL researchers' involvement with the Government's Increasing Access to Psychological Therapies — Severe Mental Illness initiative. The KCL model for CBTp has been used to develop clinics in Australia and the US and information on this therapy is disseminated via a KCL-led website.
Psychosis is a serious mental illness for which treatment can be aided by psychological therapies. Researchers at King's College London (KCL) demonstrated that family environment is key to recovery and developed and validated a family intervention for psychosis. Family intervention for psychosis is a recommended treatment in NICE guidelines (2009), as well as by the Patient Outcomes Research Team in the USA. The NICE guideline committee was chaired and advised by KCL researchers. Family intervention for psychosis is part of training programs for clinical staff and has changed NHS practice. The KCL-led website mentalhealthcare.org.uk disseminates this research to families of those with psychosis.
An estimated one in four people in the UK will experience depression or anxiety at some point in their lives. Cognitive behavioural therapy (CBT) is the most widely recommended non-medication- based treatment for common mental health problems, although access to this treatment is limited because of low numbers of expert practitioners. Self-help CBT resources developed by researchers at the University of Glasgow have been integrated into routine clinical practice delivered by health services and the voluntary sector in the UK, Ireland and Canada. Since 2008, these practical user-friendly resources have provided support to over 200,000 users online and an estimated 250,000 people on a one-to-one basis or within a class.
Studies conducted at Imperial College, over the last 20 years, have improved the rational, evidence-based treatment of schizophrenia. Our research has covered symptomatology, neurocognitive function, medication side effects, and comorbid substance use, and involved clinical trials of pharmacological and psychosocial treatments. We lead national quality improvement programmes supporting the implementation of psychopharmacological practice standards. Our work has impacted upon the understanding, clinical assessment and treatment of this condition in both first-episode patients and established schizophrenia, and has improved prescribing practice and the identification and assessment of side-effects.
This case study focuses on the research conducted by members of the UoA examining the services offered to service users and carers in secure settings. This includes forensic mental health services and prisons. It has had a significant impact on the development of professional practice in secure settings based on the views, experiences, and needs of service users and carers. It has established service user and carer engagement in research conducted in secure settings. It has also informed service and policy developments in the United Kingdom and internationally.
Around 28% of people worldwide will experience a sleep disorder at some point in their lives. Cognitive behavioural therapy (CBT) is an optimal treatment of choice for sleep disorders, but access to treatment is limited by the low number of expert CBT practitioners, resulting in long waiting times for CBT. University of Glasgow Sleep Centre research led to the development of an online CBT course (`Sleepio'), which has been sold online since 2010, and since September 2012 has been sold online by The Boots Company Plc. (Boots). Sleepio has been included in the NHS Health Apps Library and selected for integration with two of the best-selling fitness monitors. University of Glasgow expertise also underpinned `Sleep Matters', a year-long campaign by the UK Mental Health Foundation (MHF) which generated 300 media articles with a combined circulation of 145 million, raising awareness of and widening access to treatment for sleep disorders.
Recent NHS policy has prioritised improving access to cost-effective psychological interventions for people with mental health problems. Research by Lucock at the Centre for Health and Social Care Research (CHSCR) has contributed to meeting this challenge by developing and evaluating self-help interventions which can be provided by a range of NHS staff without professional psychotherapy or mental health training. This work has resulted in the creation of the Self-Help Access in Routine Primary Care (SHARP) initiative, a programme that gives practitioners materials and training which enable them to deliver brief self-help interventions supported by a dedicated website and a range of leaflets that recognise service users' need for easy-to-understand material. Feedback from practitioners on the website and training has been positive. There is evidence of positive impacts of the training on practitioners' confidence in their ability to deal with anxiety and depression, and in greater use of Cognitive Behaviour Therapy (CBT) approaches with patients. Evidence from testimony demonstrates impact on practice. Research also provides evidence of benefit to patients in terms of reduction of anxiety and depression and goal attainment. The research has also influenced national guidance on best practice.
Lancaster research has changed the understanding and treatment of bipolar disorder (BD) from biological models and pharmacological treatments to integrated psychosocial interventions complementary to routine medication and matched to user needs. We have developed novel psychological interventions (individual, family and group approaches), and reliable and valid ways to assess valued outcomes and underlying mechanisms of change. This research has delivered 3 major impacts. It has: fundamentally changed understanding of the condition in professional and lay audiences; changed treatment in terms of policy and practice, including NICE clinical guidelines; changed professional training delivered both nationally and internationally.