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Schizophrenia, a severe and disabling mental disorder, affects about 285,000 people in the UK. It is associated with a progressive course, poor social and occupational functioning, a high suicide rate, premature death from physical illness and high use of health services including in-patient beds. Medication is the preferred treatment but response is limited. Prior to the publication of research carried out by Professor Stephen Pilling and colleagues at UCL there was uncertainty about the effectiveness of psychological interventions. This work established the case for psychological interventions in NICE guidelines and psychological interventions for schizophrenia are now widely available and used in the NHS.
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.
Anorexia nervosa affects 1-4% of people over their lifetime with approximately half of all adolescents with anorexia requiring inpatient treatment. A specific form of family therapy, developed at the Maudsley Hospital and evaluated by researchers at King's College London through a series of randomised controlled trials, has been widely acknowledged as the principal evidence-based treatment for adolescent anorexia nervosa. The treatment is recommended by NICE in the UK and clinical guidelines in other countries and is strongly supported by advocacy and carer groups. It has influenced service commissioning with a growing number of specialist family-oriented outpatient services being developed in the UK and abroad. The Maudsley service model has been adopted by the Department of Health's Increased Access to Psychological Treatments programme as a specialist component of Systemic Family Therapy training.
A high proportion of social work clients have alcohol or drug problems, ranging from 5% in some adults services to over 70% in children's services. Workers find this work challenging, and misuse is strongly associated with negative outcomes, including abuse and neglect. The Tilda Goldberg Centre (TGC) leads research on substance misuse in social work, that has had the effect of:
Research at Edinburgh Napier University regarding psychosocial interventions for trauma has pioneered management of mental health problems. We have developed and tested a number of individual, group and self-help interventions aimed at promoting recovery following psychological childhood and adulthood trauma. We have trained a large number of healthcare professionals on our interventions in the voluntary and statutory sectors. Our research has also informed policy regarding the management of psychological trauma. Self-help materials developed through our research are currently being used by health and social care workers in Scotland and abroad, making an impact on the wellbeing of survivors of trauma.
Improving outcomes for children, young people and families focuses on supporting the development of health and social care initiatives to promote social inclusion and improve quality of life, family cohesion, and health outcomes for `troubled', at risk, and disadvantaged families, demonstrating the following impact:
The pioneering work undertaken at UCL has had a major impact on clinical practice for the treatment of self-harming, suicidal patients with a diagnosis of borderline personality disorder and the techniques have been drawn on in extensions to other common mental disorders including eating disorder, substance misuse, and antisocial personality disorder. This treatment, known as mentalisation based therapy or MBT, has since been applied in a range of clinical settings including inpatient and outpatient work in the UK and internationally. This case study presents two areas in particular where our research has been applied: the treatment of personality disorders, and in work with troubled adolescents.
Brunel research evaluated the first UK adaptation of an innovative American model for managing child care proceedings in court cases of parental drug and alcohol misuse. This evaluation provided the UK evidence base for the `Family Drug and Alcohol Court model' (FDAC); this has created impacts with national significance and international reach. Impacts for health and welfare for families were demonstrated through improved health and welfare outcomes such as reduced parental substance misuse, higher family reunification rates or, if required, swifter alternative placement for children; impacts for practitioners and professional services were achieved for social workers, lawyers, children's guardians and judges through the development of new understanding, enhanced inter-professional working and the delivery of more integrated practice with potential cost savings; impacts on public policy, law and services were achieved through raising political awareness, legislative debate, as well contributing to the international adoption of the model.
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.
This case study details an impact relating to health and welfare in which educational practices regarding the dissemination of responsible drinking messages has been influenced, and on public policy and services where this evidence has stimulated policy debate. Specifically, research led to (i) the withdrawal of the Drinkaware Trust's 5-year flagship campaign, Why let the good times go bad? (WLGTGB), and (ii) a recommendation from an independent review to a) involve academics in future campaign development and evaluation, and b) implement changes to the current campaign based on our findings.