Extending the Mental Health Intervention for Children with Epilepsy (MICE) Programme

Health

Extending the Mental Health Intervention for Children with Epilepsy (MICE) Programme

The MICE (Mental Health Intervention for Children with Epilepsy) Programme Development Grant is led by Dr Sophie Bennett and launched in 2026. The project is embedded within the Flexible Interventions for Children and Young People’s Mental Health (FINCH) group within the Institute of Psychiatry, Psychology and Neuroscience.

Children and young people with epilepsy often experience mental health difficulties, however accessing appropriate care for these mental health difficulties remains a challenge. The MICE Programme was developed to address this gap by providing a tailored modular psychological intervention.

Our recent trial (n=334) demonstrated that MICE was effective in reducing emotional and behavioural difficulties (Bennett et al., 2024). As a result of these positive findings, MICE is now part of a funded pilot programme of implementation within the NHS England Children and Young People Transformation Programme ‘Epilepsy Bundle of Care’. A key strength of MICE was the inclusion of neurodivergent children and young people, in line with the NHS England Children and Young People Core20PLUS5 agenda.

We are now aiming to add value to the NHS England implementation programme by improving the effectiveness and reach of the MICE intervention through the consideration of health inequalities.

Patient and Public Involvement

Emma Dalrymple, our Patient and Public Involvement (PPI) lead, is also a co-applicant on our project. Emma and the previous PPI Research Advisory Group on the MICE trial developed the proposal and PPI plan for this project, to ensure that the study answers important questions.

We are building a PPI Research Advisory Group that is representative of the diverse characteristics this study intends to explore. These factors include difference in age, ethnicity, intellectual disability, neurodivergence, and other characteristics prioritised within NHS England’s Core20PLUS5 framework.

Consisting of parents and carers of children with epilepsy and mental health difficulties, and young people with epilepsy and mental health difficulties, the advisory group will be best placed to collaborate with and support the research team to reduce health inequalities. The group will meet quarterly and will ensure genuine, consistent co-production in terms of research design, interpretation of data, and dissemination of findings.

Aims

This project consists of five key objectives:

Objective 1: Identify any sociodemographic inequalities observed in participants’ progression through the MICE trial

This objective explores whether any sociodemographic inequalities were present in the children and young people’s progression through the original MICE clinical trial. We will compare factors such as ethnicity, socioeconomic status, intellectual disability, and autism diagnosis in those enrolled in the MICE trial compared to the target population of children and young people with epilepsy at each site. We will also compare the demographics of those enrolled in the trial to those who did not meet the progression criteria at each screening phase.

This analysis will help us understand whether universal mental health screening in epilepsy clinics may reduce inequalities in access to mental health support.

Objective 2: Establish if the intervention may have worked differently for different groups considering demographic factors, including the inequalities defined by NHS England’s Core20PLUS5 framework

Building on the positive findings from the MICE trial, this work package investigates whether the effectiveness of the MICE intervention differs across demographic groups–including those prioritised within the Core20PLUS5 health inequalities framework. We will explore whether outcomes at both six and 12 months vary by age, ethnicity, socioeconomic status, intellectual disability, autism diagnosis or other characteristics.

These findings will support more equitable implementation of mental health care in epilepsy services.

Objective 3: Investigate whether some participants benefitted from fewer MICE sessions, and if so, identify who those participants were

The original MICE trial found that children typically received around 16 therapy sessions. We will examine outcome trajectories over treatment and explore whether some children might benefit from fewer sessions.

We will explore whether certain patient or therapist characteristics moderate dose-response effects, specifically considering ethnicity, intellectual disability and autism.

Examining the effect of MICE dosage on treatment outcome will help to personalise care and design treatment pathways. It could also help to inform future development of a lower-intensity version of MICE that could be used within a stepped care model.

Objective 4: Examine characteristics of treatment according to different groups

MICE is a highly personalised, modular intervention. This objective will examine whether different patient characteristics, including demographic factors, neurodivergence and co-occurring conditions, were associated with differences in the way the intervention was delivered. This includes number of sessions as well as other factors of the treatment profile such as use of different modules and practices, delivery to parent and/or young person, and remote or in-person delivery.

This will support the design of treatment pathways and future implementation; for example, by informing the key areas for staff training relevant to specific patient groups.

Objective 5: Explore the barriers and facilitators to accessing MICE

Under this qualitative objective, we will speak to young people and their families who were offered MICE, including those who completed the treatment, dropped out and declined the treatment.

Through semi-structured interviews with up to 40 parents, young people, or dyads, in addition to up to 20 clinicians who completed training in delivering MICE, we will explore their experiences including any reasons for declining or discontinuing treatment. We will consider practical, cultural, or service‑level barriers and look at what would make MICE more accessible. We will focus especially on barriers and facilitators relevant to the group identified by NHS England’s Core20PLUS5 agenda.

Findings will guide improvements to broaden the reach and acceptability of MICE in clinical settings.

Methods

Our first four objectives will be met through secondary data analysis of the existing MICE trial data.

Objective 5 will be met through a qualitative study to explore the experiences and views of patients invited to engage in MICE, identifying barriers and facilitators to access and implementation.

Impact

This research will inform the implementation of MICE in clinical practice, as part of NHS England’s ‘Epilepsy Bundle of Care’ and beyond.

Our findings will contribute to ongoing efforts to integrate mental and physical healthcare for children and young people with chronic health conditions, particularly epilepsy, with a focus on health inequalities and the potential avenues to mitigate the effect of this on accessing healthcare

Project Team

Principal Investigator

Dr Sophie Bennett (Reader in Clinical Psychology and Clinical Psychologist)

Co-investigators

Professor Roz Shafran (Co-applicant, UCL Great Ormond Street Institute of Child Health)
Emma Dalrymple (Co-applicant, Patient and Public Involvement Lead)
Dr Alice Wickersham (Co-applicant, IoPPN)
Dr Anna Coughtrey (Co-applicant, Great Ormond Street Hospital)
Dr Anita Devlin (Co-applicant, Royal Victoria Infirmary)
Dr Robert Qi (Postdoctoral Researcher, IoPPN)
Chloe Bowles (Research Assistant, IoPPN)