University of Nottingham research in the field of recovery has had a
major influence on changes in mental health policy. It has led to a new
model of service provision both in the UK (including through NICE guidance
and the NHS's outcomes framework) and internationally (including in
Western Europe, Scandinavia, Canada, Australia and Asia). The work has
contributed to a reduction in the use of mainstream services and has
enhanced the quality of life enjoyed by people with mental health
problems. It has also been central to the Department of Health's
Implementing Recovery through Organisational Change programme, which has
pioneered the use of Recovery Colleges and peer support workers in mental
health care in the UK.
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.
Our research has had a direct influence on policy makers', commissioners'
and practitioners' understanding of the value of peer led self-help groups
and the potential of citizen/service user researchers for driving service
improvements grounded in lived experience. That impact is reflected in:
This case study concerns a body of research by Dr Julie Ridley, Dr Helen Spandler and Dr Karen
Newbigging into Self-directed Support (SDS) and Direct Payments (DPs), which examines
perspectives and experiences of policies to promote choice, control and flexibility in social care,
and provides a critique distinguishing between rhetoric and reality. Early qualitative and action
research focused specifically on mental health, including work for the Scottish Executive (Ridley)
and the Department of Health (Spandler), leading to cutting-edge policy critiques (Spandler),
engagement with the field to distil key implementation themes (Newbigging) and later, to broader
based evaluation of SDS policy implementation in Scotland. Collectively and over time, this work
has had a direct influence on social care policy and law across the UK, as outlined below.
Impact resulted from the unit's sustained research in the field,
including the leadership of a large EU Framework 6 action project `EMILIA'
- the Empowerment of Mental Illness Service Users: Lifelong Learning,
Integration and Action, and the follow up project, PROMISE. The findings
identified how to reduce social exclusion among people with serious mental
illness through lifelong learning and by improving participation in
service delivery, education and training, as well as paid employment. The
research recommendations were included in a joint EU/WHO policy statement
and subsequently rolled out across European Union Member States. The
research impacted on the development of European and national policies
regarding mental health service users and, through further knowledge
transfer activities and the incorporation of the recommendations by a
network of providers in 43 countries, also impacted on the profession and
mental health service users directly.
King's College London (KCL) researchers developed and disseminated the
Camberwell Assessment of Need (CAN) which provides a scientifically
rigorous and flexible approach to assessing the mental health and social
needs of people with a wide range of disorders. Mental Health services
around the world are striving to increase the patient-centeredness of
their care. The CAN supports this needs-led care planning to help
transform mental health policy and practice. KCL work has resulted in CAN
being the most internationally recognised and researched assessment tool
available. The CAN is widely used in mental health policies and locally
adapted versions are routinely used in clinical practice within both
statutory mental health services and nongovernmental organisations in the
UK and around the world.
The Centre For Community Mental Health (CCMH) is a research team within
the Centre for Health
and Social Care (CHSCR). CCMH develops and supports research that reduces
stigma and social
exclusion and which empowers people with mental health problems to lead
fulfilling lives in their
own communities. The impact of this research has challenged prevailing
beliefs and practices and
led directly to changes in practice, organisational processes and service
design across the world.
Our studies of voice hearing, in adults and children, have shown that it
may not always be
associated with mental illness and that cognitive behavioural therapy is
effective for many people.
Our work has led to the development of the Hearing Voices Movement and the
Hearing Voices Network, which now spans 22 countries and which enables
people who hear
voices to find bespoke solutions and lead normal lives.
The impact of our work on community-based approaches to the management of
acute and long
term mental ill health led, first, to the development of assertive
outreach and crisis resolution teams
that reduced hospital admissions by treating people at home; second, our
work has led directly to
service redesign in many different countries.
Our studies of special and underserved social groups in relation to
mental ill health have
demonstrated the multiple barriers to services that many people
experience. The impact of these
studies has included changes in organisational practices to promote
greater engagement with
Alternatives to acute admission in mental health are crucial, not least
because of the high cost of inpatient care. We have carried out a major
research programme that includes the only randomised controlled evaluation
of crisis resolution teams and the only major UK study of crisis houses,
which are community-based, residential alternatives to hospital admission.
This programme demonstrated the efficacy of community treatment and has
significantly influenced decision making at a local and national policy
level, including commissioning guidance and three sets of NICE guidelines.
This has contributed to changes in the way acute services for severely
mentally ill adults are configured in the NHS, and internationally.
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.
Our research has directly informed the development of services that are
supporting recovery from mental ill health by enabling mental health
service users to: