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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.
Dr Lina Gega's research has been instrumental to the development and take-up of computerised Cognitive Behavioural Therapy (cCBT) and other technology-mediated interventions for common mental health problems in the UK and internationally. Gega's adjunct on-line methods form a key foundation for the training of professionals to support cCBT, and the National Institute for Health and Care Excellence (NICE) guidelines now include cCBT for first line intervention for common mental health problems. These developments have resulted in a greater patient reach for cCBT internationally, with resultant decreases in waiting time for patients (with associated economic benefit) and improved outcomes.
Depression is a major public health problem producing substantial decrements in health and well-being, with 15% lifetime prevalence, affecting 350 million people worldwide. The Mood Disorders Centre (MDC) has improved treatment for depression by (i) understanding psychological mechanisms underpinning depression; (ii) translating this into innovative treatments and prevention interventions, evaluated in clinical trials; (iii) improving dissemination, delivery, and access to treatments. This research has improved patient care and quality of life, influenced national policy (NICE Depression Guidelines), informed national service and training provision (Improving Access to Psychological Therapies IAPT programme, with 680,000 people completing treatment 2008-2011) and achieved international impact on clinical practice.
Chronic pain, defined as pain lasting for more than 6 months, affects more than 25% of adults in developed nations. Drugs are costly, carry risks of side effects and dependence, and are of limited effectiveness in many cases. Morley, at the University of Leeds (UoL), collaborated on a series of definitive reviews and meta-analyses proving that active psychological treatments based on cognitive behavioural therapy (CBT) are effective in treating chronic pain. This led to changes in UK government and world health organization (WHO) guidelines and the adoption of CBT at specialist pain clinics, reducing patient suffering, increasing social role functioning and ensuring more cost-effective treatment.
This case study describes the impact generated by Dr Paul Flaxman's research in the Department of Psychology at City University London. Flaxman has taken a prominent role in designing a psychological skills training programme that is based on recent developments in the field of psychotherapy. The training has been adopted and utilised by a range of organisations, including Northumbria Healthcare Trust; Central Manchester Foundation Trust; Camden and Islington NHS Foundation Trust; and the South London and Maudsley Mental Health Trust. Other beneficiaries include the City and Hackney branch of Mind (the mental health charity) and nurse training providers at Middlesex University. International reach is evidenced by the adoption of the training for supporting psychiatric nurses working in Uganda. Data collected from over 600 British employees indicate that the training leads to significant and sustained improvements in people's mental health. The training has been shown to be particularly beneficial for employees experiencing a common mental health problem such as anxiety or depression.
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.
The North Atlantic Treaty Organisation (NATO)/Euro-Atlantic Partnership Council (EAPC) Guidance on "Psychosocial Care for People Affected by Disasters and Major Incidents: a Model for Designing, Delivering and Managing Psychosocial Services for People Involved in Major Incidents, Conflict, Disasters and Terrorism" is a conceptual and practical resource for: developing government policy; planning services, and providing training for health and social care staff. It was informed by underpinning research conducted in Aberdeen following the 1988 Piper Alpha oil platform disaster and evidence briefings generated from a comprehensive review of the world literature. Adopted as best practice guidance by all 28 NATO Members and Partner Nations, it has had regional, national and international impact by: enabling authorities to deliver integrated psychosocial care and mental health services; enhance training; raise awareness, and facilitate the effective utilisation of resources in responding to psychosocial/mental health needs post- incident.
This case study describes how Prof Cecilia Essau's research into emotional and behavioural problems in children and adolescents has been of benefit to children and has helped parents and schools to provide them with better support. Essau has worked with a children's charity to use her externally funded research to contribute to public understanding through providing presentations and skills training and to underpin the development and implementation of an anxiety prevention programme, Super Skills for Life (SSL), which has had a demonstrable benefit on children's wellbeing. In addition, Essau's research has been of value in informing the development of DSM-5, in introducing a specifier to the diagnosis of conduct disorder using callous-unemotional traits, and in refining the diagnosis of somatic symptom disorder. It has also contributed to policies and interventions internationally.
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.
Over the last 20 years Imperial College research on the assessment and treatment of personality disorder has led to important changes in healthcare policy and the provision of services for people with these mental disorders. Our introduction of the first reliable assessment of the severity of personality disorder made it a much better understood and accepted diagnosis and led to current plans for changing the World Health Organisation (WHO) international classification of this disorder. Our research highlighting the impact of personality disorder contributed to the development of new services and our evaluation of these services led to them becoming more widely available throughout the NHS. In contrast, our evaluation of an intensive assessment and treatment programme for a select group of offenders with personality disorder showed that it was not cost effective. This programme has now been stopped and resources have been diverted to help treat a far wider group of people with personality disorder and offending behaviour.