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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.
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.
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.
Our research has directly informed the development of services that are supporting recovery from mental ill health by enabling mental health service users to:
Healthy Living Pharmacies (HLPs) represent a new concept in community pharmacy services designed to meet public health needs through a nationally agreed but locally commissioned tiered framework. The White Paper, Pharmacy in England: Building on strengths, delivering the future, published in April 2008 described the role community pharmacy could play in supporting public health: "Pharmacies will become healthy living centres: promoting and supporting healthy living and health literacy; offering patients and the public healthy lifestyle advice, support on self care and a range of pressing public health concerns; treating minor ailments and; supporting patients with long-term conditions". A national framework for HLPs was developed then ratified by the National Public Health Leadership Forum for pharmacy (PHLFP) in January 2010. This was tested in Portsmouth Primary Care Trust. Findings of the project led to the HLP concept being rolled out across England in 2012 to 20 pathfinder sites (areas, regions, site sounds like an individual pharmacy) involving 100 pharmacies. As of March 2013, there were 478 HLPs across 28 areas and presently there are 721 HLPs in over 35 areas. There are a range of impacts that can be demonstrated from this research including changes to community practice and government policy; increase in public use of pharmacies and improved patient outcomes.
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.
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.
Research undertaken at the Centre for Intellectual and Developmental Disabilities(CIDD), has significantly impacted upon:
The importance of person-centred social support has been recognised by successive governments as central to the development of effective and supportive social care services. The research led by Brunel and funded by the DoH and the Joseph Rowntree Foundation, made a substantial contribution to the enhancement of UK social care policy and practice in relation to the personalisation agenda. Parliamentary committees and policy consultation used the research to develop new social care policy. Standards of service care delivery were developed and implemented in partnership with service users; these were adopted at a policy and practice level. The development and use of evidence based practice guides, training programmes and web resources facilitated the successful adoption and implementation of person-centred support nationwide. In summary, public debate was influenced, equality and empowerment for service users was advanced, national policy and practice enhanced, health and welfare improved and economic impacts achieved.
Research at Newcastle has made a significant contribution to the public services modernisation agenda in the areas of inter-agency working and information-sharing. The research showed that effective information-sharing required not just that different information systems are made compatible with each other, but also that people from different professional cultures are enabled to work together through a common understanding of information governance issues. In active collaboration with a range of service providers, a number of processes and tools were developed for the significant benefit of service users. They have been implemented in a variety of policy settings, including children's services and adult social care, and have informed current programmes funded by the UK government.