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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

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
slide9

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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