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In the context of Law Commission reports on legislation in mental capacity, in 1999, Tony Holland published a ground-breaking review on capacity and an empirical study of the capacity of people with mental disorders. Through Holland's role as one of two expert advisers to a Parliamentary Pre-legislative Scrutiny Committee in 2003, this work directly informed the Mental Capacity Act 2005 and the Code, both of which remain current. With full implementation of the Mental Capacity Act in 2007, Holland's studies from 2008 refined concepts of capacity and best interests for clinical practice; and have examined other aspects of the Mental Capacity Act including advocacy, the Mental Capacity Act in different clinical settings, and the Deprivation of Liberty Safeguards.
Research into service user involvement in mental health care resulted in the development of an educational intervention for registered mental health nurses to deliver effective, ethically appropriate therapeutic interventions for highly distressed and disturbed patients.
The research outputs were taken up and implemented by Halikko hospital in Finland, leading to a significant change in policy and practice, including a substantial reduction in the use of coercive techniques. Following the success of this change, other psychiatric hospitals in Finland have adopted the system.
In 2008 the Philosophy Department decided to organise its impact strategy around the research activities of the Essex Autonomy Project (EAP). EAP research has been conducted in two distinct strands with different research outputs and impacts. This case study summarises the impact of our work concerning the legal concept of best interests decision-making. Through EAP public policy roundtables, EAP technical reports, and through work with public organisations and public officials, EAP research has informed professional and public discussion of the law of best interests, has had impact in the development of public policy guidelines for implementing legal requirements, and has played a role in the review and reform of existing regulatory frameworks.
The risk of having insufficient generating capacity to support demand is a critical issue in electric power system planning and market design. The 2011 Energy Act placed a duty on the Regulator (Ofgem) to produce an annual Electricity Capacity Assessment Report to the Department of Energy and Climate Change (DECC) to assess this risk looking five years ahead. This Case Study demonstrates how Dr. Chris Dent was contracted by National Grid to design technical modelling for the report based on his research, and the impact this has made in government policy and the wider public debate. Additionally it is shown how Professor Janusz Bialek provided input to the Capacity Market which forms a part of the Electricity Market Reform (EMR) due to be implemented in 2014. EMR is envisaged to stimulate estimated £110 billion of investment until 2020 while the Capacity Market itself is estimated to be worth about £1.5 billion per year.
Two research council grants were awarded to the Brunel Institute of Ageing Studies in order to: identify how health, social care and finance professionals' detect and prevent elder financial abuse and to develop and test, through a randomised controlled trial, a web-based training resource to improve workforce capacity to make decisions in this domain.
The training resource has been shown to be effective and has been advocated for member use by such organisations as the College of Occupational Therapists, the Building Societies Association and Age UK. Impacts have included raised international awareness of elder financial abuse, increased international collaborative work between stakeholders and improved professional decision-making capacity.
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.
This research stimulated debate about the treatment of people in vegetative and minimally conscious states, created new cultural representations and informed interventions to enhance decision-making processes. Professor Jenny Kitzinger [JK], the lead researcher, was invited onto the Royal College of Physicians' Working Party revising the College's treatment and communication guidelines. The research generated intense engagement from key stakeholders (e.g. medical and policy experts), prompted changes in thinking among clinicians and informed new training and support materials for both clinicians and families. The findings also enriched public discussion about this highly contentious area of medicine and ethics e.g. through a series of media/cultural interventions and through community engagement events which had a documented impact on participants' knowledge and feelings.
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.
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.
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.