Six years of researching mental health – what’s changed?

Professor David Kessler, University of Bristol

 

 

by David Kessler, Professor of Primary Care, Centre for Academic Mental Health and Centre for Academic Primary Care, University of Bristol

In 2017 I wrote a blog for World Mental Health Day. I wrote about the increased societal openness about mental illness over my clinical lifetime, the impact of the widespread availability of talking therapies through IAPT (now renamed NHS Talking Therapies) and described some of the work we had been doing in Bristol and what we planned to do. I talked about research into treatment resistant depression and the threshold for starting antidepressant drugs. What’s happened since in our world, and have we made any progress?

It’s hard to escape the COVID pandemic, but it’s also hard to assess its impact on mental health. The COVID-19 Mental Disorders Collaborators concluded that throughout 2020 the pandemic led to a global increase of over 25% … Read more

Wakey! Evaluating the feasibility of a mental wellbeing app

Dr Sophie Turnbull

 

 

By Sophie Turnbull, Senior Research Associate, Centre for Academic Primary Care, University of Bristol

I have an ongoing interest in how industry and academia can work together to produce really good evidence-led products that can be accessible for the target users, and have more longevity than those produced in purely academic settings.

From experience, when we produce digital interventions in our academic bubble, they are brilliantly researched, but often not maintained in the long-term, meaning they disappear soon after the research funding stops. Or we do not have enough budget to develop something that people are going to want to use.

While exploring how academia and industry can come together to reduce inequalities in access to good quality healthcare, I discovered ZINC. ZINC runs mission-led programmes with people from across disciplines to build commercial solutions to solve some of the most pressing societal issues. I … Read more

Is there value in GPs diagnosing an anxiety disorder?

 

 

 

by Charlotte Archer, Senior Research Associate in Primary Care Mental Health, and Katrina Turner, Professor of Primary Care Research, Centre for Academic Primary Care, University of Bristol

Research has shown that fewer people in primary care are now being diagnosed with anxiety than in the past, despite reports that rates of anxiety have increased in the general population. Individuals with anxiety may be reluctant to seek help for their symptoms. They may also find it difficult to talk to their GP about their mental health or may normalise their symptoms.

Although most anxiety is managed in primary care by GPs, we know very little about whether GPs and patients think it is important to diagnose and manage anxiety disorders. Knowing this might help us identify possible reasons for the decline in their recording, and the potential impact of this on patient care and … Read more

Funerals in the COVID-19 pandemic – how restrictions might affect the bereaved

 

 

 

 

by Dr Alex Burrell, Foundation Year 2 doctor, North Bristol NHS Trust and Dr Lucy Selman, Senior Research Fellow, Centre for Academic Primary Care, University of Bristol

Restrictions on funeral attendance have been put in place to try to prevent the spread of COVID-19. We conducted a rapid systematic review to try to understand what impact these restrictions might have on the bereaved. We found that the impact of funeral practices was not clear-cut: observational studies assessed different outcomes and their results varied. However, there were important lessons from qualitative research. What seems to be most important is helping people create a meaningful personal ritual which provides a sense of social support however they mourn, whether together in person or virtually.

COVID-19 has caused hundreds of thousands of deaths around the world, with over 45,000 confirmed deaths in the UK as of 23 July … Read more

Is it possible to detect future risk of psychosis from a patient’s primary care consultation history?

 

 

By Dr Sarah Sullivan
Research Fellow
Centre for Academic Primary Care

Psychosis is a serious and long-term mental illness. Unfortunately, for many sufferers the outcomes are poor. Many may relapse again after recovery, suffer long-term residual symptoms and have poor social functioning.

Primary care is an important part of the care pathway for patients with psychosis, so GPs need to be able to accurately identify those at high risk. The task is difficult because high-risk symptoms are frequently not specific to psychosis.

We also know that the greater the delay between someone’s first psychotic symptom and receiving specialist mental health treatment is associated with poorer outcomes. GPs play an important role in this, because most people are referred to mental health services by their GP.

In a study recently published in JAMA Network Open, we set out to find out if people had previously consulted their GP … Read more

World Health Day 2017 – ‘Depression: let’s talk’

By Dr David Kessler
Reader in Primary Care
Centre for Academic Mental Health &
Centre for Academic Primary Care

 

 

 

 

 

 

There has been a transformation in social and scientific attitudes to depression in my working lifetime. It is no longer acceptable to stigmatise mental illness or psychological distress. The idea that the common mental disorders of depression and anxiety are an inescapable part of being human has been replaced by a belief that these disabling extremes of sadness and worry are treatable conditions.

Changes in the treatment of depression have been part of wider cultural changes. There is an increased openness about sadness and distress, and a widespread belief, beginning with Freud, that at the very least ‘neurotic misery can be transformed into ordinary unhappiness’. The invention of psychotherapy has spawned numerous schools and sub-disciplines, but all hold to the common belief that with help, … Read more

Listening to the child’s voice in research on domestic violence and abuse

LisaArai071015By Lisa Arai
Senior Research Associate
Centre for Academic Primary Care

Anybody who has worked on a systematic review will know you spend a lot of time thinking about the type of research papers to include in your review and those you will exclude. Tightly defined inclusion criteria, as well as critical appraisal, an explicit synthesis stage and measures to reduce reviewer bias (such as inter-rater checks), are what distinguish systematic from traditional reviews (a point usefully made by Mark Petticrew more than a decade ago, when he sought – among other things – to debunk the notion that systematic reviews are simply larger versions of traditional reviews).

Over many years teaching research methods, I’ve noticed students often regard this early stage of the review process as troublesome. It’s often approached with an uncertainty that, if not properly resolved, can render the review unwieldy. Or its significance might be underestimated; … Read more

Who do GPs go to when they need help?

johanna-spiersBy Johanna Spiers
Research associate
Centre for Academic Primary Care

GPs often say they make the worst patients, but who do they turn to when they need help? That’s what I aim to find out on a new research project about GPs with mental health issues.

My new job is firmly at the centre of the zeitgeist. GPs are all over the news on a daily basis. Doctors are judged by journalists and picked apart by politicians for running unsafe surgeries, for closing their doors to new patients, and for long waiting lists. If you read (and believe) certain sectors of the UK press, you might be forgiven for thinking that GPs have a lot to answer for.

The reality is, of course, way more complex than the Daily Fail might have us believe. Yes, GPs are retiring early. Yes, many practices are unable to add new names … Read more