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
Research into service user involvement in mental health care resulted in
the development of an
educational intervention for registered mental health nurses to deliver
appropriate therapeutic interventions for highly distressed and disturbed
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.