Health Service & Population Research

The Centre for Innovation and Evaluation in Mental Health focuses on understanding the impacts of mental disorder on individuals and the development and testing of new models of care for people with mental disorders.

It works across all diagnoses and age groups. There is a strong focus on multi-disciplinary working and service user involvement to design and deliver work of direct relevance to those providing and receiving mental health services in the UK and internationally.

Centre staff are skilled in quantitative, qualitative and mixed methodologies. The Centre's work ranges from the development of new evaluative scales and methodologies and the development and testing of new models of service provision, to randomised controlled trials (pilot, exploratory and definitive) of new interventions (nine recent or current randomised controlled trials (RCTs).

The centre consists of these sections: Community Mental Health (Henderson); Estia Centre for Mental Health and Learning Disabilities (Craig); Mental Health and Ageing (Banerjee); Mental Health Nursing (Bowers); Service User Research Enterprise (SURE, Wykes/Rose); Women's Mental Health (Howard); Recovery (Slade). 

SURE is of particular note as it is, to our knowledge, the first service user research team in mental health in the world. Regarding mental capacity, for example, studies funded by the Wellcome Trust have shown that it can be reliably measured; that a high proportion of both medical (40 per cent) and psychiatric (43 per cent) inpatients lack capacity; and that those lacking capacity are often not recognised by clinical teams. In relation to the new Mental Capacity Act (2005), our results show that the gap between psychiatric and medical patients in their ability to make autonomous treatment decisions may be less than is widely believed.

The Centre for Public Mental Health addresses mental disorder in the community, patterns of help-seeking, and health system responses.

Head of Centre is Professor Martin Prince who is Professor of Epidemiological Psychiatry at the Institute of Psychiatry, and also the Director of International Mental Health at the IoP. He trained in Psychiatry at the Maudsley Hospital and in Epidemiology at the London School of Hygiene and Tropical Medicine.

The Centre has a strong international focus and brings the highest quality epidemiological methods and a public health perspective to bear on improving care for people with mental disorder. A combination of epidemiological and health service research methods are used to identify opportunities for primary and secondary prevention, from population through to primary care.

Research focuses upon:

• Relative impact of mental health conditions in order to inform appropriate policy prioritisation.
• Effectiveness of health systems - coverage, access, and barriers to care.
• Aetiology focusing particularly on modifiable risk factors.

In October 2009, Professor Prince and Professor Vikram Patel founded the Centre for Global Mental Health, which is a collaboration between the London School of Hygiene and Tropical Medicine and King’s Health Partners Academic Health Sciences (KHP AHSC). KHP AHSC being a collaboration between King’s College London, the Institute of Psychiatry and three of London’s most successful NHS Foundation Trusts.

The new Centre aims to foster research and capacity building in policy, prevention, treatment and care of mental illness worldwide. Aiming to close the treatment gap for people living with mental disorders by increasing the coverage of cost-effective interventions.

Research Sections
Within the Centre are the following research sections each with its own Principal Investigator:

• Epidemiology Head of Section: Dr Rob Stewart
• Primary Care Mental Health Head of Section: Professor Andre Tylee
• Social Psychiatry Head of Section: Dr Craig Morgan
• WHO Collaborating Centre for Research and Training in Mental Health and Section of Mental Health Policy Head of Section: Professor Rachel Jenkins.

About the CEMH
The Centre for the Economics of Mental Health (CEMH) is one of three centres that make up the Health Services and Population Research Department (HSPRD), and is led by its Director, Professor Martin Knapp. CEMH comprises of a team of globally-renowned health economists, and the work we do is well described by our name: we look at the economic aspects of mental health. Using economic methods and tools, we examine policy and practice questions, primarily in the mental health field, but sometimes in other areas such as stroke, neurology, cancer and social care.

Collaborations
Most CEMH studies are carried out collaboratively, often with colleagues in the Institute of Psychiatry at King’s College London. We are also working alongside teams in many other UK universities and with groups abroad. Our role in many of these collaborations is to contribute economic evaluation expertise. The eight academic staff currently in CEMH are engaged on over 100 studies.

Economic evaluation is increasingly recognised as essential. Commissioners, providers and policy makers want to know not only whether a treatment or service arrangement is effective, but also whether it is cost-effective. They want to know if it is it worth paying for.

Specialisation
CEMH staff are specialists in the mental health field. We have national and international reputations for our work and its practice, policy and academic impacts. We also have specialist skills in other areas – particularly stroke, autism, diabetes and palliative care – where we apply economic methods to policy and practice studies.

Practice and policy impacts
Much of our work at the practice level looks at the cost-effectiveness of treatment or care arrangements, and we aim to publish our findings in clinical and health services journals that are read by people responsible for practice decisions. Our work has informed National Institute for Health and Clinical Excellence (NICE) Guidelines for depression, schizophrenia, adolescent depression, post-traumatic stress disorder, dementia, antisocial personality disorder, and borderline personality disorder.

Our work regularly informs policy developments, and CEMH studies have been cited in the National Service Frameworks for mental health, children and older people, the recent Department of Health statement of intent, New Horizons, and the European Commission mental health Green Paper.

CEMH work has also informed policy discussion in the Department of Health, Home Office, Ministry of Justice, Department for Children, Schools and Families and the Scottish Executive. It has also been heavily cited in reports from the National Audit Office, and is regularly used by interest groups such as the Alzheimer’s Society, National Autistic Society, Rethink and think tanks such as the King’s Fund.
The award of the Queen’s Anniversary Prize to the whole Department (HSPRD) illustrates that our work is held in high esteem.

Centre for the Economics of Mental Health
Institute of Psychiatry at King’s College London
Health Service and Population Research Department
PO24 David Goldberg Centre
De Crespigny Park
London SE5 8AF

Administration: Linda Parker

Phone: 020 7848 0198
Fax: 020 7848 7600

The Estia Centre for Mental Health and Learning Disability, part of South London and Maudsley NHS Foundation Trust (SLaM), runs a well-established training programme for health professionals working with people with learning disabilities and mental health problems.

The centre is also an academic section of the Health Service and Population Research Department at the IoP. It is based at Guy's Campus near London Bridge. Staff carry out research into the needs of people with learning disabilities and mental health problems and share the results of their studies through the training programmes.The Estia Centre aims to support the development of a competent workforce from support staff to experienced managers and from a variety of services. By working in close collaboration with clinical services, we aim to improve the care of people with learning disabilities, especially those with additional mental health and challenging needs through evidence-based practice.

The centre's director is Tom Craig, Professor of Psychiatry at the IoP and a Consultant Psychiatrist at SLaM.

To find out more about the work of the Estia Centre, visit http://www.estiacentre.org

The Section for Recovery (SfR) is a new Section in the HSPR department, which will undertake recovery-focussed mental health services research. The Section is a substantive multi-professional recovery-focussed research team undertaking high-quality research of national and international relevance. It will co-operate closely with the local Mental Health Trust which has developed a pro-recovery policy, and is in the process of orienting its services around this philosophy of care.

The aims of the SfR are: to provide a focus for international quality recovery research within the Institute of Psychiatry; to develop expertise in organisational change and positive psychology; to co-ordinate a national recovery research network; to establish collaborative links, including joint applications and honorary appointments, with leading recovery research centres in the UK and internationally; and to establish a high-quality web presence as a resource for the field. It will meet these aims by undertaking international-quality recovery research, bringing together currently unco-ordinated local and national initiatives, directly informing mental health policy, having high credibility with key stake-holder groups, including service user and carer representative groups, and contributing to the development of a pro-recovery identity in the local Mental Health Trust.

For more information regarding the Section for Recovery please visit our website http://www.researchintorecovery.com

The section is led by Dr Mike Slade, Reader in Health Services Research and Consultant Clinical Psychologist.

Section for Recovery (PO 29)
Health Service and Population Research Department
David Goldberg Centre
Institute of Psychiatry
De Crespigny Park
London SE5 8AF
Administration: Kelly Davies
Phone: 020 7848 0703
Fax: 020 7848 5056

The Section of Community Mental Health - previously PRiSM - evaluates existing and innovative ways of delivering services for people with mental health problems.

The team continues to produce a plethora of resources for use in the UK and internationally - both conceptual models to better understand, evaluate and develop mental health systems and assessment scales designed to evaluate specific treatments and services.

The Mental Health Matrix, for example, proposes a simple model for community-based services that can help care-providers and planners in different countries diagnose strengths and weakness and increase clinical effectiveness. Choosing Methods in Mental Health Research; Mental Health Research from Theory to Practice, contains appraisals of different mental health research methods and advises on how to choose the most appropriate method - not only to address a specific question, but also to maximise the impact on services. Evidence in Mental Health Care evaluates a range of different research methodologies and types of evidence for mental health services.

Members of the section work in collaboration with the London Health Observatory (www.lho.org.uk) to analyse the use of mental health services in London and advise mental health Trusts on how to benchmark the services they provide. This work has been commissioned by the London Development Centre (www.londondevelopmentcentre.org ), one of the eight Department of Health funded regional development centres that form part of the Care Services Improvement Partnership, working to improve the lives of people who use services and have carers.

Assessment scales developed and tested by Community Mental Health to evaluate the effectiveness of specific mental health interventions include The Camberwell Assessment of Need (CAN) (www.iop.kcl.ac.uk/prism/can ). CAN assesses the health and social needs of people with severe mental health problems, and is the most widely used needs assessment measure across the world. Versions have been developed for adults aged over 65 (CANE), for adults with mental health problems and learning disabilities (CANDID), for adults in forensic mental health settings (CANFOR) and for mothers and pregnant women with mental health problems (CAN-M). CAN has been translated into 20 other languages.

The Threshold Assessment Grid (TAG) (www.iop.kcl.ac.uk/prism/tag) is a one page easy-to-use standardised assessment tool that allows GPs and mental health professionals to assess the severity of an individual's mental health problems.

Members of the Community Mental Health team evaluate innovative treatments and interventions, using multi-method studies including randomised controlled trials. This work includes a programme of research into services and treatments for women with mental health problems, looking at ways of improving access to mental health services and evaluating alternative ways of providing in-patient care for people who are severely ill. In addition, Community Mental Health carries out population research, investigating risk factors for different mental health problems and institutional factors that are associated with high rates of suicide in prisons in England and Wales, for example.

The section works to actively combat stigma and discrimination against people with mental problems, both nationally and internationally and, for the past four years, has worked in partnership with the national charity Rethink (www.rethink.org/index.html ) to this end.

Under the umbrella of Mental Health Awareness in Action, a number of collaborative projects have been carried out to build an evidence base that shows better public understanding of mental health issues would improve the quality of life for people with mental health problems. In addition, there are projects to evaluate education and training schemes designed to challenge negative attitudes toward mental health.

The Section of Community Mental Health team is multi-professional and multidisciplinary, and includes staff who have used mental health services. The section is headed by Dr Claire Henderson, Clinical Senior Lecturer at the Institute of Psychiatry and Consultant Psychiatrist for South London and Maudsley NHS Foundation Trust.

The Section of Epidemiology undertakes community-based research to study the distribution of mental health problems in populations around the world. The research describes the prevalence and impact of mental illness, seeks to define the underlying causes and to develop and evaluate culturally appropriate therapies and treatments.

The Section has taken a leading role, for example, in the study of common mental disorders like depression, anxiety, panic and somatisation in the developing world, where mental health services are often confined to care for people with more severe forms of mental illness. Research in this field has been carried out in Chile, Thailand, China, Taiwan, Zimbabwe, Tanzania, Ethiopia, India and Sri Lanka. Other studies have concentrated on alcohol, one of the most widely used drugs in the world, personality disorder and postnatal depression. Several studies have investigated the mental health consequences of migration in low-income countries.

The epidemiology of dementia and cognitive decline is a major area of research, both in the UK and in developing countries. The 10/66 Dementia Research Group is co-ordinated by Professor Martin Prince, a senior member of the Section, and is a network of more than 100 researchers, many from the developing world, who work together to promote research into the prevalence and causes of dementia in different countries and find evidence-based solutions. The 10/66 Group encourages active collaboration between research groups in different countries and is affiliated to Alzheimer's Disease International (ADI). It was set up in 1998 at an international dementia meeting held in India and the 10/66 Group holds symposia at every annual ADI conference. (www.alz.co.uk/1066/ )

Many of the PhD students based within the Section are from overseas and carry out research in their home country with the support of senior Section members. PhD students from Ethiopia, Pakistan, India, China, Thailand, Sri Lanka and Brazil, for example, have studied women's mental health, maternal depression, infant development, migration, suicide and problem drinking - all public health and social priorities for the individual regions concerned. The Section has strong links with universities in Brazil, China, India, Thailand, Taiwan and South Korea and also collaborates with psychiatric epidemiologists in other departments at the Institute of Psychiatry.

The Section of Epidemiology is headed by Dr Rob Stewart, Senior Lecturer and Honorary Consultant in Liaison Old Age Psychiatry at South London and Maudsley NHS Foundation Trust.

The Section of Mental Health and Ageing works to improve the quality of life for older people who have mental health problems. The team carries out research in order, in the first instance, to understand the needs and problems of older people and their carers, and then to formulate and evaluate ways of meeting those needs and addressing their problems.

According to the Dementia UK report, commissioned by the Alzheimer’s Society and prepared by the IoP and the London School of Economics, in 30 years the numbers of people with dementia will have doubled to 1.4 million and the cost of their care will have trebled to £51 billion per year. The Section works to find effective methods and ways of working to support people with dementia and their carers: it has evaluated the Croydon Memory Service Model of early intervention, for example, and has developed DEMQOL, an instrument to measure the quality of life of people with dementia to allow researchers to gauge the success of new treatments.

Depression in later life is another research focus, as is the evaluation of service developments for older people with mental health problems: the Section seeks to find evidence about the barriers to care faced by older people with mental health problems and how to overcome these.

The Section’s head is Professor Sube Banerjee who is seconded part time to the Department of Health where he is Senior Professional Advisor on Older People’s Mental Health. At the IoP, he holds the post of Professor of Mental Health and Ageing, and is an Honorary Consultant in Old Age Psychiatry for South London and Maudsley NHS Foundation Trust (SLaM). Professor Banerjee is also Clinical Director of the Mental Health of Older Adults Directorate for SLaM, and is responsible for developing services that meet the mental health needs of older people throughout the four London boroughs served by the Trust.

He is involved with the 10/66 Dementia Research Group, a network of more than 100 researchers who work together to promote research into the prevalence and cause of dementia in different countries, particularly in the developing world, and to find evidence-based solutions.

Professor Banerjee is co-editor of the International Journal of Geriatric Psychiatry (www.interscience.wiley.com/cgi-bin/jhome/4294) and a member of the Scientific Advisory Panel of Alzheimer’s Disease International (www.alz.co.uk), the umbrella organisation of Alzheimer associations around the world, and of the Care and Social Issues Expert Advisory Panel of Alzheimer Europe (www.alzheimer-europe.org/).

The Section collaborates with other research teams here at the IoP and also at the London School of Hygiene and Tropical Medicine, the London School of Economics, Columbia University and with universities across the UK and abroad.

Section of Mental Health and Ageing, PO26
Health Service and Population Research Department
The David Goldberg Centre
Institute of Psychiatry
De Crespigny Park
London SE5 8AF

Laraine Colbourne
Phone: 020 7848 5055
Fax: 020 7848 5056
Email: laraine.colbourne@kcl.ac.uk

There are more mental health nurses than any other profession working in mental health services today. They work in all different types of service areas and make a vital contribution to providing care to service users. The Section of Mental Health Nursing aims to strengthen mental health nursing practice in order to improve the health of service users and their experience of services.

Research topics include smoking cessation treatments for those suffering from a mental illness, nurse-patient interaction with those suffering an acute exacerbation of psychosis, recovery from such acute exacerbations, and the systematic ways for nurses to monitor inpatients’ mental states.

However most research in the Section currently focuses on how to reduce rates of conflict and containment on acute wards. By conflict we mean those things that threaten patient and staff safety, such as aggression, rule breaking, drug/alcohol use, absconding, medication refusal, self-harm/suicide etc. By containment we mean those things the staff do to prevent these things occurring, or reduce the amount of harm that occurs, such as giving extra medication, intermittent observation, constant observation, show of force, manual restraint, coerced injections of medication, seclusion, time out, locking of the ward door, and other security policies. We aim to deliver a way to reduce conflict and containment, whilst keeping everybody safer. To do this we also hope to make wards a more therapeutic and supportive environment to be in.

The Section also develops, delivers and evaluates clinical short courses, specifically designed to enhance the knowledge, attitudes and skills of mental health nurses and allied professionals working with people with mental health problems. They currently include:

• Dual Diagnosis in Adult Mental Health Settings for working effectively with adults who have co morbid mental helath and substance misuse issues.
• Dual Diagnosis in CAMHS settings for working effectively with young people who have co morbid mentalhealth and substance misuse issues.
• Dual Diagnosis in Older Adult settings for working effeftively with older adults who have co morbid mental helath and substance use issues.
• Enhanced Skills for Inpatient Mental Health Professionals enables participants to apply a range of evidence-based skills and to work collaboratively with inpatients.
• Medication Management for Psychosis enables participants to work collaboratively with service users to improve the experience of taking antipsychotic medicine.

The Section has been making a significant contribution to mental health nursing practice for many years. We anticipate many new developments in research and teaching in the future, as we work together to make a significant and beneficial contribution to nursing practice locally, nationally and internationally.

The section is led by Professor Len Bowers

Section of Mental Health Nursing, PO30
Health Service and Population Research Department
David Goldberg Centre
Institute of Psychiatry
De Crespigny Park
London SE5 8AF

Administration: Catherine Beaufort
Catherine.beaufort@iop.kcl.ac.uk
Phone: 020 7848 0139
Fax: 020 7848 0458

The Collaborating Centre and Section of Mental Health Policy (Centre/Section) offer support to governments and non-governmental organisations around the world, helping them develop and implement locally appropriate policies, services and training to promote mental health, prevent illness and treat and support people with mental health problems and their families. These projects collaborate with policy makers, professionals and non-governmental organisations in the health, social welfare, education and criminal justice sectors, and the design of teaching and training material suitable for each country's specific needs.

The centre/section has long-term relationships with many low and middle-income countries. In Tanzania, Zanzibar and Kenya, for example, they have worked with the Ministries of Health since 1998 to support the development and implementation of national mental health policies, new legislation, the integration of mental health into health and social sector reforms, liaison with traditional healers and the introduction of training programmes and new ways of working for primary care and specialist workers. The centre/section has worked with the Egyptian Ministry of Health in a similar way since 2000.

In Russia, the centre/section has supported mental health reforms funded by the UK Department for International Development and, since 2000, has been running policy development workshops in Georgia in liaison with the Ministry of Health and key stakeholders.

In Pakistan, the centre/section has advised policy-makers on the integration of mental health into primary care; has given training about research to the University of Health Sciences in Lahore; has trained army psychiatrists about public mental health; and has liaised on disaster relief coordination and helped to prepare training materials for front line health workers. The centre/section also gives support to health promotion and Pakistan's National Action Plan for the prevention and control of non-communicable diseases.

The World Health Organisation (WHO) is the United Nations' agency for health (www.who.int/about/en/ ). An international network of collaborating centres carries out work in support of WHO programmes: visit http://www.who.int/mental_health/policy/en/ to find out about WHO activities and policies on mental health.

The IoP was given WHO Collaborating Centre status in 1992. Professor Rachel Jenkins has directed the centre since 1997 and also heads the Section of Mental Health Policy in Health Service and Population Research.

Other work undertaken at the request of both WHO, the UK Department for International Development and individual nations includes detailed assessments of mental health need; appraisals of mental health policy and services; the development of good practice guidelines; and strategic advice and support to non-governmental organisations through seminars and workshops. The centre/section has also worked with the European Commission on mental health promotion in Europe.

Professor Jenkins has been a member of WHO's expert panel of advisors since 1995 and has sat on more than 20 WHO expert committees on mental health. An honorary consultant psychiatrist with the Maudsley Hospital, she has been a consultant to the World Bank and the UK Department for International Development (for whom she has organised briefings and seminars on mental health) and a consultant to the African Development Bank.

Professor Jenkins delivers keynote and invited lectures around the world. In the UK, she contributes to national policy by joining or advising government committees and national groups. In 1992, she initiated and now continues to contribute to a series of epidemiological surveys, looking at the mental health of the general population, children, carers, prisoners, the homeless, looked-after children and people living in institutions.

The majority of people who have mental health problems initially seek help from their GP. Many continue to be treated in primary care without ever being referred to specialist services. GPs and other health professionals in primary care therefore need the skills to detect mental health problems and offer the best treatment. The research carried out by the Section of Primary Care Mental Health seeks to help GPs, practice nurses, health visitors and other primary care staff better recognise, diagnose and treat mental illness.

In addition, researchers are looking at ways of making sure primary care services are accessible to all people with mental health problems, particularly those who, for cultural reasons, may try to manage alone. They are also involved in mental health promotion.

Much of the research in Primary Care Mental Health is carried out in collaboration with other IoP departments, other research institutions, charities, and three primary care research networks in south London. They are Wandsworth Primary Care Research Centre (formerly Battersea Research Group) (www.wandsworthpct.nhs.uk/work/randd) Lewisham Research Unit (www.lru.org.uk) and STaRNet London (South London Primary Care Research Network) (www.starnet.org.uk).

The section is led by Professor Andre Tylee (Professor of Primary Care Mental Health), a GP for 21 years before joining the IoP.
He was chair of the Primary Care Development Programme of the National Institute for Mental Health in England (NIMHE) until June 2006 (www.nimhe.csip.org.uk ).

He was the founding chair and continues to be president of Primary Care Mental Health Education (PRIMHE), a charity that helps primary care professionals achieve and deliver the best standards of mental health care. It has nearly 3,000 members including professionals and service users, a quarterly journal and an interactive chat room (www.primhe.org). He is a patron of Depression Alliance (www.depressionalliance.org) and medical advisor to the Charlie Waller Memorial Trust (www.cwmt.org). He is editor of the peer review journal Primary Care Mental Health, a professional journal for family practitioners, nurses, social workers, psychotherapists, psychologists, occupational therapists, researchers, teachers, healthcare managers, medical and healthcare libraries. Primary Care Mental Health is published by Radcliffe (www.radcliffe-oxford.com).

Professor Tylee has set up a national special interest research group on nutrition and mental health which meets quarterly at the IoP and is currently planning both research trials and public campaigns. Psychologist and nutritionalist Patrick Holford, a best selling author and leading spokesman on nutrition, food and health (www.PatrickHolford.com) is involved in this group.

The Section of Women’s Mental Health (SWMH) undertakes mental health services research with a primary focus on women’s mental health. The Section aims to carry out research into the needs of women with mental health problems using epidemiological and qualitative methods, and to develop and evaluate interventions to meet those needs.

We have a particular interest in understanding the impact of mental health problems on women and their families and have developed an instrument to measure the health and social care needs of pregnant women and mothers with severe mental illness (the CAN-M). We are evaluating complex interventions for women with mental health problems including women’s crisis houses (CHOICES ), mother and baby units (ALTERNATIVES study; ESMI study) and health visitor delivered non-directive counselling RESPOND. We lead on gender aspects of the South London and Maudsley NHS Foundation Trust /Institute of Psychiatry Biomedical Research Centre Stakeholder Participation Theme and are investigating the impact of stigma on women’s mental health (SAPPHIRE). We also regularly undertake systematic reviews of treatments for perinatal psychiatric disorders. In addition we are carrying out a number of research projects on domestic violence, including examining the response of mental health services to domestic violence (LARA), carrying out systematic reviews on the prevalence of domestic violence experienced by mental health users, and epidemiological research investigating the impact of antenatal domestic violence on women’s mental health antenatally and postnatally and the impact this has on child development using the ALSPAC cohort.

Our epidemiological research has included studies on the outcome of pregnancy in women with psychotic disorders, use of the General Practice Research Database to investigate associations between psychiatric disorders and Sudden Infant Death Syndrome and gender differences in the effect of anti-psychotic medication on osteoporosis. We are currently working on projects researching physical health in mental health service users, using the General Practice Research Database.

The Section’s Head is Professor Louise Howard, Reader in Women’s Mental Health and Consultant Psychiatrist at the South London and Maudsley NHS Foundation Trust (SLaM). She is an executive committee member of the UK and Ireland Marcé Society (UKIMS) and academic lead for the Royal College of Psychiatrists Women in Psychiatry Special Interest Group (WIPSIG) and is a member of the International Editorial Board of the British Journal of Psychiatry.

The Section collaborates with other research teams at the Institute of Psychiatry, King’s College London and also at the London School of Hygiene and Tropical Medicine, University College London, University of Bristol, University of Manchester and other universities across the UK and abroad.

Section of Women’s Mental Health (SWMH)
PO 31
Health Service and Population Research Department
Institute of Psychiatry, King’s College London
De Crespigny Park
London SE5 8AF
Administration: seynam.1.kluvitse@kcl.ac.uk
Phone: 020 7848 5061
Fax: 020 7277 1462


Training:
Domestic Violence Training
CAN-M Training

Please contact Prof Louise Howard for further details of training available.

The Service User Research Enterprise (SURE) undertakes research that tests the effectiveness of services and treatments from the perspective of people with mental health problems and their carers. SURE aims to involve service users in a collaborative way in the whole research process: from design to data collection, through to data analysis and dissemination of results.

SURE was launched in 2001 on the premiss that the research priorities and perspectives of service users were different from those of people who work in mental health services, and from those of people with solely an academic background. It is now one of the largest units within universities in Europe to employ people who have both research skills and first-hand experience of mental health services and treatments. This experience adds a wealth of understanding and alternative perspectives to the local, national and international research they carry out.


History and organisation of SURE
In 2000, a conference was convened by the joint IoP/South London & Maudsley Trust (SLAM) Research and Development Steering Group to establish the research priorities of service users: the top priority identified was service user involvement in all aspects of research. This conference led to the launch of SURE, and also to the development of the Consumer Research Advisory Group (CRAG) (which comprised users of SLaM mental health services, and which was supported by SURE). CRAG sent two representatives to every meeting of the influential Research and Development Steering Group and its views therefore contributed towards the shaping of the joint IoP/SLaM research agenda.

SURE has two co-directors: Dr Diana Rose, a service user researcher, and Professor Til Wykes, a clinical academic, which gives the unit a balanced management structure.

Til Wykes, a Professor of Clinical Psychology and Rehabilitation, heads the Centre for Recovery in Severe Psychosis (CRiSP) in the IoP’s Department of Psychology. CRiSP has a tradition of involving service users in its research and laid the foundations for the launch of SURE.

Dr Diana Rose is Europe’s first Senior Lecturer in User-led Research. She is a social scientist and a mental health service user. Before joining the IoP, she pioneered user-focused research for seven years at a London based charity.

’Stakeholder Participation’ in the new National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health
In April 2007, the South London and Maudsley NHS Foundation Trust and the Institute of Psychiatry, King’s College London received funding to set up a new National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health (BRC). The Biomedical Research Centre for Mental Health will find new ways of preventing, diagnosing and treating mental health problems by ensuring advances in biomedical research are used to benefit service users and carers.

One of the research themes within the BRC is stakeholder participation. This theme will ensure that the participation of two key stakeholder groups, service userse and carers, along with other groups who are frequently under-represented in research on grounds of gender, age, culture and ethnicity, are at the heart of the work of the BRC for Mental Health.

The stakeholder participation theme as a whole is co-led by Professor Til Wykes (Co-Director of SURE) and Professor Graham Thornicroft. Professor Wykes and Dr Diana Rose (the other Co-Director of SURE) lead on service user involvement within the theme. Dr Felicity Callard is the Senior Research Fellow for the Stakeholder Participation theme, and works within SURE.

The BRC for Mental Health is committed to the full engagement of people with experience of mental ill health in its research. The stakeholder participation theme within the BRC has established a Service User Advisory Group to offer advice and expertise to the BRC as a whole and to each of its research themes (which cover most mental health diagnoses in both adults and children, and include the dementias and addictions).


Research conducted by SURE
SURE’s first national study – Consumers’ Perspectives on ECT – was a Department of Health-commissioned systematic review of what patients thought about electroconvulsive therapy. The results influenced 2003 guidelines from the National Institute for Health and Clinical Excellence (NICE) about obtaining consent to ECT and giving information about the treatment. See NICE website on ECT. An analysis of research papers, reports by user organisations and first hand testimonies from patients showed that about half the people receiving the treatment felt they had not received enough information about the procedure and its common side effect of memory loss. About a third felt they had not freely consented – as they must do by law – even when they had signed a consent form. Two of the researchers involved in this project had received ECT themselves.

Since then, all SURE’s research projects have continued to centre on issues important to service users: it undertakes studies relevant to the priorities of services users and carers, and studies which have a substantial amount of consumer involvement. SURE continues to employ people with experience of using mental health services to build both the capacity of the unit and increase the number of service user researchers at the IoP. It publishes the results of its research not just in academic journals, but also in formats and journals accessible to service users.

Further details about SURE are available from:

Service User Research Enterprise (SURE)
PO34
Health Service and Population Research Department
David Goldberg Centre
Institute of Psychiatry
De Crespigny Park
London SE5 8AF

Contact: Diana Rose:

d.rose@iop.kcl.ac.uk

Phone: 020 7848 5066/0430
Fax: 020 7277 1462

Social Psychiatry researches how social factors - people, relationships, families, employment, leisure, positive and negative life events - affect the course and outcome of mental illness.

The section has carried out major studies exploring social factors in the aetiology of depression and other common mental disorders, while other research has sought to develop a better understanding of the impact of social environment on the onset, course and outcome of psychoses. Members of the Social Psychiatry team are collaborators on the Aetiology and Ethnicity of Schizophrenia and Other Psychoses (AESOP) Study, a major UK based multicentre epidemiological study of the aetiology and outcome of psychosis in different ethnic groups.

Staff in the Section also develop and evaluate psychosocial interventions - like social support, social networking and family interventions - to help people with both common mental illnesses and psychosis. They developed a range of psychosocial measures for use in social psychiatry studies and short programmes on how to use these measures are organised on a regular basis.

Cultural Psychiatry studies the occurrence and treatment of mental ill health in black and minority ethnic communities, and researches the role culture and cultural beliefs play in the genesis of illness, pathways into care and treatment. The research team seeks to help mental health professionals understand the needs of patients and carers from different ethnic groups, and to develop services which are sensitive to cultural issues.

One previous study carried out by the section, for example, highlighted a higher incidence of schizophrenia among African Caribbeans living in the UK than people living in Trinidad.

Members of the Cultural Psychiatry team have since collaborated on the AESOP (Aetiology and Ethnicity of Schizophrenia and Other Psychoses) Study, a major UK based multi centre epidemiological study of the aetiology and outcome of psychosis in different ethnic groups. Another previous study carried out by Cultural Psychiatry discovered that 37 per cent of Asian women had common mental disorders, yet GPs who were from the same ethnic and cultural background were able to diagnose only 17 per cent of cases. As a result of this research, an educational intervention was developed which led to an increase in diagnoses of common mental disorders by GPs.

The section has developed Special Study Modules on Cultural Psychiatry for medical students at King's School of Medicine to help them understand how to deal effectively with patients whose culture may be different from their own.

Dr Craig Morgan leads the Social Psychiatry team and other members include emeritus Professor George Brown and Dr Tirril Harris, Professor Tom Craig, a Professor of Community and Social Psychiatry, and Professor Dinesh Bhugra, President of the Royal College of Psychiatrists. .