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From Where to Here…?. Michael Sharpe, Professor of Psychological Medicine, University of Edinburgh. Mental illness. One in six of the population suffers from anxiety or depression At least 1 in 4 GP consultations for mental ill health

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From Where to Here…?

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From where to here

From Where to Here…?

Michael Sharpe, Professor of Psychological Medicine, University of Edinburgh


Mental illness

Mental illness

  • One in six of the population suffers from anxiety or depression

  • At least 1 in 4 GP consultations for mental ill health

  • Annual direct care costs £12.5 billion

  • Annual cost to UK society more than £77 billion

  • We need better ways of helping mentally ill people

  • We need research to help us do this


What research do we need

What research do we need?

  • Research that is relevant

    • No only to cause but also to treatment

    • Relevant to different mental illnesses

    • Cover all aspects of treatment

  • Research that gives us high quality evidence

    • Good ideas

    • Well done studies

    • Large and representative samples

  • Research that is feasible

    • Results can be delivered


What research do we have

What research do we have?

  • Research that is relevant?

    • Less than 5% of the trials on the Cochrane database are indexed under mental disorder

  • Research that gives us high quality evidence?

    • Studies are generally far too small

    • The outcomes are too short term

    • They are too often based on hospital samples

    • Almost all are of drug treatment

  • Research that is feasible?

    • The majority of studies are not completed as planned


How can we get better research

How can we get better research?

  • Clearly, researchers simply need to work harder and faster to deliver more and better research !

  • But researchers also need to be able to deliver good research

  • What obstacles do they see ?

  • Surveys by Dr Craig on CSO 2004 and by us in 2005.


Obstacles to better research what might a network provide

Obstacles to better research?What might a Network provide?

  • Feeling it can’t be done

    • Galvanize energy and vision and make it feel possible

  • Lack of expertise staff and infrastructure

    • Provide design statistical and other practical expertise

  • Overwhelmed by paperwork

    • Offer guidance and help to address regulatory requirements

  • Isolated with limited capacity

    • Forge links between clinicians and researchers, centres and networks

  • Can’t get big grants

    • Offer advice expertise and support to make strong applications

  • Can’t recruit sufficient patients to studies

    • Provide manpower to assist


From where to here

Medical school

CRFs

Trials Unit


A proposal for a scottish mental health research network

A Proposal for a Scottish Mental Health Research Network

  • The challenges

    • Diffuse concept of ‘mental health’

    • Small clinical research community

    • Limited research culture in clinical services

  • The opportunities

    • Our population and organized services

    • Our potential for collaboration

    • Existing infrastructure

  • The ‘X’ factor

    • Determination to make it work


The original bid for smhrn

The original bid for SMHRN

  • To Link

    • 4 clinical medical schools

    • NHS and academic researchers

    • Other networks

  • To Provide

    • Methodological and practical support

    • Guidance on regulation

    • Assistance with recruiting

  • To Supplement

    • CRFs

    • R & D departments

    • Research grants


The smhrn 3 year targets 2006

The SMHRN 3 year targets (2006)

  • Establishment of a baseline of multicentre clinical research activity in and funding for Scottish MH research.

  • At least six new UK multicentre studies within 3 years.

  • At least three new multi-centre studies led from Scotland within 3 years.

  • The number of patients participating in multi-centre studies increased by at least 20% of baseline every year.

  • Active grant funding for multicentre MH trials in Scotland increased by at least 20% of baseline every year.


The smhrn achievements 2009

The SMHRN achievements (2009)

  • Establishment of a baseline of multicentre clinical research activity in and funding for Scottish MH research.

  • At least six new UK multicentre studies within 3 years.

  • At least three new multi-centre studies led from Scotland within 3 years.

  • The number of patients participating in multi-centre studies increased by at least 20% of baseline every year.

  • Active grant funding for multicentre MH trials in Scotland increased by at least 20% of baseline every year.


What we have learned

What we have learned

  • It remains a challenge

    • To achieve focus in ‘mental health’

    • To keep political, CSO, University, NHS and Industry support

    • To recruit and keep good staff (let studies recruit their own)

  • It is a long term job

    • 10 years plus

    • It need a substantial commitment of senior time

  • We need to support success but also to grow new Scottish studies

    • Back winners

    • Promote PDGs and pilots


Thanks to the original team

Thanks to the original team

Edinburgh: Professor Michael Sharpe (Academic), Dr Alan Carson (NHS)

Glasgow: Dr Andrew Gumley (Academic), Professor Bob Hunter (NHS).

Aberdeen: Professor Ian Reid (Academic), Dr Ross Hamilton (NHS).

Dundee: Dr Alex Baldacchino(NHS), Dr Rob Durham (Academic)

Primary Care: Professor Jill Morrison (Academic Glasgow),

Public Health: Dr Cameron Stark (NHS Highlands Health Board)

Clinical Research Facilities: Mr Gordon Hill (Wellcome Trust CRF)

Statistics and methodology: Professor Gordon Murray

Manager: Dr Lucy McCloughan


Also to those who joined later

Also to those who joined later

Board members: Professor Keith Matthews (Dundee); Dr. Jonathan Cavanagh (Glasgow); Professor Stephen Lawrie (Edinburgh – biological psychiatry);

Network Staff: Nadine Dougall; Mark Hazelwood; Gillian McHugh; Ann Doust


And also to

And also to

CSO: Peter Craig,Roma Armstrong; Beatrice Cant; Hilary Lapsley

CRFs: Anne Gordon; Fiona McArdle

NIHR MHRN: Til Wykes and colleagues

University of Edinburgh: Professor Stuart Ralston and Professor Eve Johnstone and colleagues in my research group (PMR)

Scottish Government: Denise Coia


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