scholarly journals The advance of research governance in psychiatry: one step forward, two steps back

2013 ◽  
Vol 22 (4) ◽  
pp. 313-320 ◽  
Author(s):  
V. C. Leeson ◽  
P. Tyrer
Keyword(s):  
Mental Health ◽  
Health Research ◽  
Cost Effective ◽  
Evidence Base ◽  
Research Governance ◽  
Additional Time ◽  
Start Date ◽  
Effective Interventions ◽  
Health Studies ◽  
The Uk

Purpose.To investigate the reasons behind difficulties in recruiting patients to randomized controlled trials (RCTs) in psychiatry and to examine a database of RCTs for differences between studies in mental health and other specialities.Methods.A discussion of recent changes in research governance in the UK and Europe followed by an examination of the database of all trials supported by the Health Technology Assessment programme of the National Institute of Health Research in the UK between 1993 and 2007 to determine if three different measures, (i) time between grant approval and study start date, (ii) percentage of additional time given to extend recruitment and (iii) percentage of planned recruitment achieved, changed over the time period studied and differed between mental health, cancer and other medical disciplines.Findings.Despite attempts in the UK to accelerate the process of clinical trials in recent years, there was a significant increase in the extension time for trials to be completed (p = 0.038) and the percentage of planned recruitment to mental health studies (71%) was significantly less than for cancer (90.3%) and other studies (86.1%) (p = 0.032).Summary.These results suggest that, despite the priority afforded to the advancement of RCTs in healthcare, such studies are encountering increasing difficulty in recruiting to time and target. We suggest that this difficulty can be attributed, at least in part, to the excessively byzantine regulation and governance processes for health research in the UK, and unnecessary bureaucracy in the current National Health Service system. Mental health studies appear particularly vulnerable to delay and better systems to facilitate recruitment are required urgently for the evidence base to be improved and facilitate new cost-effective interventions.

scholarly journals Non-communicable diseases and the mental health gap: what is to be done?

2012 ◽  
Vol 9 (4) ◽  
pp. 79-80 ◽  
Author(s):  
Vijay Ganju
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Cost Effective ◽  
Evidence Base ◽  
Policy Makers ◽  
Effective Interventions ◽  
Global Priority ◽  
Advocacy Effort ◽  
Health Gap

The increasing evidence base for cost-effective interventions and a fledgling advocacy effort have given momentum to mental health becoming a global priority. The contention of this editorial is that we are at a tipping point if we can exploit the opportunities that will be afforded to mental health professionals and advocates in the next year or two. The missing links are the development of consensus among mental health stakeholders, the formation of coalitions and partnerships with both advocates and policy-makers, and the mobilisation of a stronger advocacy effort built around consumer and family member ‘voice’ and empowerment.

Brief alcohol interventions – everybody's business

2008 ◽  
Vol 14 (6) ◽  
pp. 469-476 ◽  
Author(s):  
Billy Boland ◽  
Colin Drummond ◽  
Eileen Kaner
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Heavy Drinking ◽  
Significant Risk ◽  
Cost Effective ◽  
Evidence Base ◽  
Excessive Alcohol Consumption ◽  
Alcohol Interventions ◽  
Cost Effective Method ◽  
The Uk

Heavy drinking poses a significant risk to public health in the UK. Opportunistic screening and brief interventions offer a cost-effective method of reducing the harm related to excessive alcohol consumption at both an individual and a public health level. Given the high prevalence of alcohol misuse among patients attending mental health services and its impact on behaviour and health, professionals need to be skilled in identifying and treating these problems in all areas of mental health. There is also a need for effective joint working between mental health and specialist addiction services. This article describes the principles and evidence base for brief alcohol interventions, and methods of implementation in health settings.

scholarly journals The economics of mental health in the workplace: what do we know and where do we go?

2007 ◽  
Vol 16 (4) ◽  
pp. 294-298 ◽  
Author(s):  
David McDaid
Keyword(s):  
Mental Health ◽  
Grey Literature ◽  
Cost Effective ◽  
Evidence Base ◽  
Poor Mental Health ◽  
Health Interventions ◽  
Economic Evaluations ◽  
Policy Makers ◽  
Productivity Losses ◽  
Mental Health Interventions

AbstractTo provide an overview of the economic impact of poor mental health in the workplace and assess the extent to which economic evaluation has been used to further the case for investment in workplace based mental health programmes. Rapid scoping review of published and grey literature. The socio-economic costs of poor mental health in the workplace are substantial but conservative, as few studies have included productivity losses from work cutback, as well as absenteeism. While few economic evaluations of workplace based mental health interventions were identified, the available evidence base suggests that they have the potential to be highly cost effective. Much of this evidence may be from the US and be less applicable elsewhere; it may also have been solely published in company documents making assessment of methodological quality difficult. The potential economic case for workplace based mental health interventions appears good. More collaboration between policy makers and the private sector would help facilitate rigorous and transparent economic evaluations. A number of evaluations are planned. The challenge is to build on these initiatives, in order to address what remains a major gap in our knowledge on the economics of mental health.

Developing policies for adult sexual minorities with mental health needs in secured settings

CNS Spectrums ◽  
2020 ◽  
Vol 25 (5) ◽  
pp. 618-623
Author(s):  
Juan Carlos Arguello
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Cost Effective ◽  
Vocational Programs ◽  
Mental Health Needs ◽  
Transgender People ◽  
Effective Interventions ◽  
Bisexual And Transgender ◽  
Mental Health Treatments ◽  
Lgbt People

Lesbian, Gay, Bisexual, and Transgender (LGBT) people are more likely to be disproportionally placed in a secured setting such jails, prisons, and forensic hospitals. These settings can be traumatizing, hostile, and dangerous—especially for those who are suffering from mental illness. Administrators are encouraged to develop institutional policies that undoubtedly include that LGBT residents should be free of discrimination, victimization, and abuse. LGBT residents should have equal access to safe housing, vocational programs, rehabilitation services, as well as medical and mental health treatments. Several organizations provide guidelines to ensure that LGBT residents are protected. This article provides a general roadmap for developing LGBT policies in secured settings synergizing the recommendations of some of these organizations with emphasis on policy guidelines for transgender people that are not only standards for good care but also very cost-effective interventions that can help reduce symptoms of mental illness for this population.

scholarly journals Longitudinal increases in childhood depression symptoms during the COVID-19 lockdown

2020 ◽  
pp. archdischild-2020-320372
Author(s):  
Giacomo Bignardi ◽  
Edwin S Dalmaijer ◽  
Alexander L Anwyl-Irvine ◽  
Tess A Smith ◽  
Roma Siugzdaite ◽  
...  
Keyword(s):  
Mental Health ◽  
Linear Models ◽  
Short Form ◽  
Child Anxiety ◽  
Depression Scale ◽  
Evidence Base ◽  
Depression Symptoms ◽  
School Closures ◽  
Children’S Depression ◽  
The Uk

ObjectiveThere has been widespread concern that so-called lockdown measures, including social distancing and school closures, could negatively impact children’s mental health. However, there has been little direct evidence of any association due to the paucity of longitudinal studies reporting mental health before and during the lockdown. This present study provides the first longitudinal examination of changes in childhood mental health, a key component of an urgently needed evidence base that can inform policy and practice surrounding the continuing response to the COVID-19 pandemic.MethodsMental health assessments on 168 children (aged 7.6–11.6 years) were taken before and during the UK lockdown (April–June 2020). Assessments included self-reports, caregiver reports, and teacher reports. Mean mental health scores before and during the UK lockdown were compared using mixed linear models.ResultsA significant increase in depression symptoms during the UK lockdown was observed, as measured by the Revised Child Anxiety and Depression Scale (RCADS) short form. CIs suggest a medium-to-large effect size. There were no significant changes in the RCADS anxiety subscale and Strengths and Difficulties Questionnaire emotional problems subscale.ConclusionsDuring the UK lockdown, children’s depression symptoms have increased substantially, relative to before lockdown. The scale of this effect has direct relevance for the continuation of different elements of lockdown policy, such as complete or partial school closures. This early evidence for the direct impact of lockdown must now be combined with larger scale epidemiological studies that establish which children are most at risk and tracks their future recovery.

How much is spent on mental health research: developing a system for categorising grant funding in the UK

2019 ◽  
Vol 6 (5) ◽  
pp. 445-452 ◽  
Author(s):  
Eva Woelbert ◽  
Anne Kirtley ◽  
Neil Balmer ◽  
Sophie Dix
Keyword(s):  
Mental Health ◽  
Health Research ◽  
Mental Health Research ◽  
Grant Funding ◽  
The Uk

scholarly journals How has implementation been incorporated in health technology assessments in the United Kingdom? A systematic rapid review

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Robert Heggie ◽  
Kathleen Boyd ◽  
Olivia Wu
Keyword(s):  
Economic Evaluation ◽  
Health Research ◽  
Research Question ◽  
Behavioural Change ◽  
Complex Interventions ◽  
Cost Effective ◽  
Health Technology ◽  
Rapid Review ◽  
Routine Practice ◽  
Effective Interventions

Abstract Objectives Health interventions in a clinical setting may be complex. This is particularly true of clinical interventions which require systems reorganization or behavioural change, and/or when implementation involves additional challenges not captured within a clinical trial setting. Medical Research Council guidance on complex interventions highlights the need to consider economic evaluation alongside implementation. However, the extent to which this guidance has been adhered to, and how, is unclear. The failure to incorporate implementation within the evaluation of an intervention may hinder the translation of research findings into routine practice. This will have consequences for patient care. This study examined the methods used to address implementation within health research conducted through funding from the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme. Methods We conducted a rapid review using a systematic approach. We included all NIHR HTA monographs which contained the word “implementation” within the title or abstract published between 2014 and 2020. We assessed the studies according to existing recommendations for specifying and reporting implementation approaches in research. Additional themes which were not included in the recommendation, but were of particular relevance to our research question, were also identified and summarized in a narrative synthesis. Results The extent to which implementation was formally incorporated, and defined, varied among studies. Methods for examining implementation ranged from single stakeholder engagement events to the more comprehensive process evaluation. There was no obvious pattern as to whether approaches to implementation had evolved over recent years. Approximately 50% (22/42) of studies included an economic evaluation. Of these, two studies included the use of qualitative data obtained within the study to quantitatively inform aspects relating to implementation and economic evaluation in their study. Discussion A variety of approaches were identified for incorporating implementation within an HTA. However, they did not go far enough in terms of incorporating implementation into the actual design and evaluation. To ensure the implementation of clinically effective and cost-effective interventions, we propose that further guidance on how to incorporate implementation within complex interventions is required. Incorporating implementation into economic evaluation provides a step in this direction.

scholarly journals Participatory action research and oral history as natural allies in mental health research

2021 ◽  
pp. 146879412110399
Author(s):  
Verusca Calabria ◽  
Di Bailey
Keyword(s):  
Mental Health ◽  
Action Research ◽  
Participatory Action Research ◽  
Oral History ◽  
Health Research ◽  
Mental Health Research ◽  
Participatory Action ◽  
Mental Health Settings ◽  
Methodological Approaches ◽  
The Uk

This article explores the similarities and differences between oral history and participatory action research (PAR) as two qualitative research methods that both accord with an interpretivist paradigm. It examines how combining these two methodologies can benefit mental health research, offering opportunities for reflection and reciprocity. Drawing from the authors’ respective knowledge and experience of using oral history and PAR methods within social care and mental health settings in the UK, the article considers these opportunities in relation to key concepts, namely, the sharing of power, reciprocity and positionality that are inherent in both methodological approaches. The article concludes that PAR-led oral history offers a trans-disciplinary methodology that can offer fresh insights for improving practices and social outcomes and for reducing inequalities.

Sign in / Sign up

Export Citation Format

Share Document