Towards mental health equality

Towards mental health equality: a manifesto for the next Prime Minister | The Mental Health Policy Group

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This manifesto sets out the following five key areas that the next Prime Minister must address in order to improve the lives of people with mental health problems and promote the mental health of the nation:

  1. Take action to prevent mental illness
  2. Create a cross-government plan for mental health and establish a ‘mental health in all policies’ approach across government
  3. Reform the Mental Health Act
  4. Ensure everyone can access the right mental health support, in the right place, at the right time
  5. Build a mental health workforce fit for the future

Full document: Towards mental health equality: a manifesto for the next prime minister

Using data-driven technologies to transform mental healthcare

Making the right choices: Using data-driven technologies to transform mental healthcare | Reform 

This report examines the current landscape of data-driven technologies and their applications in mental healthcare, highlighting areas where these tools offer the most potential for the NHS and its patients.  It discusses what makes mental health different from other areas of health, and the implications this has for the application of data-driven tools. It examines barriers to implementation, and proposes ways to move forward.

Key recommendations:

  • The National Institute for Care and Health Excellence should make guidelines and protocols machine-readable to inform Clinical Decision Support Systems used in mental healthcare. This would make the guidelines more accessible to frontline practitioners and enable the guidelines to be continuously improved in accordance with up-to-date clinical evidence.
  • In order to improve understanding of mental health conditions, NHS Digital should develop a repository using data held by NHS organisations to help researchers securely identify suitable participants for mental health research studies and assess the feasibility of research projects at early stages. Similar governance frameworks to the Scottish Health Research Register should be employed.
  • NHSX should require all healthcare providers to design interoperable systems and ensure data portability. This would allow data generated from technologies such as wearables and sensors to be transferred across platforms.

Full report: Making the right choices: Using data-driven technologies to transform mental healthcare

Data-Driven Tech in Mental Healthcare: Why is this research important?



CBT could benefit mental health of children with long term conditions

NIHR | June 2019 | CBT could benefit mental health of children with long term conditions

Researchers at the University of Exeter led a systematic review which looked at the impact of cognitive behavioural therapy (CBT) on the mental health of children with long term conditions.  In England, nearly a quarter (23%) of secondary school age pupils reported that they had a long-term medical illness or disability in a recent survey. Children and young people who have long term conditions are four times more likely to experience feelings of depression, anxiety and other mental health issues than those who are physically healthy. 

The team of researchers identified some evidence of the benefits of CBT in inflammatory bowel disease, chronic pain and epilepsy; although the evidence in this area is limited and further research would be valuable (Source: NIHR). 

Study Design: Evidence synthesis of quantitative and qualitative research.

Methods: The search strategy will be developed by an Information Specialist in consultation with topic experts, children, young people and their families. Sources will include electronic databases, citation chasing and hand-searching. Inclusion and exclusion criteria will be applied to the title and abstract of each identified citation independently by two reviewers with disagreements being settled by discussion with a third. Full text will be obtained for papers that appear to meet the criteria and a similar process used. A standardised, piloted data extraction form will be used to collect data from each included paper. Appropriate quality appraisal checklists will be used according to the study design. Quality appraisal and data extraction will be performed by one reviewer and checked by a second, with disagreements settled through discussion with a third. Synthesis methods will be determined in response to the nature of the findings but will include meta-analysis if appropriate. An overarching synthesis will bring together the findings from the two reviews through the systematic development and refinement of a conceptual framework to map out the conjectured links between the different types of intervention and anticipated outcomes, gaps in the evidence and factors that enhance or limit intervention success. Consultation with stakeholders will seek feedback on the credibility of the findings, the clarity of the framework and the extent to which it illustrates their experience.

Population: Children and young people (aged 0-25 years) with a diagnosed long term physical health conditions (LTCs) and a diagnosis of a mental health disorder (assessed by a validated and standardised measure) or at risk of such a diagnosis and experiencing symptoms of mental distress (scoring above an established cut point on a validated questionnaire).

Health Technologies: Any intervention, delivered to children and young people with the aim of reducing mental distress.

Outcomes: Outcomes describing the mental state of children and young people e.g. symptoms of depression, anxiety, emotional distress or behavioural disorders, psychological health, psychological function, suicidal behaviour, psychological aspects of health related quality of life, sleep quality and incidence of self-harm; costs and resource implications and experiences of interventions for children and young people with LTCs and mental ill health.

Timetable: The project is scheduled to take 15 months to complete, with dissemination continuing after this. Month 1-11 Conduct of systematic reviews (literature searches, study selection and retrieval, data extraction, quality appraisal, synthesis); Month 11-13 Overarching synthesis and development of conceptual framework; Month 11-12 – Report drafting; Month 13-14 – Co-creation of plain language summaries; Month 14 – Consultation with stakeholders; Month 15 – Editing.

Expertise: The team comprises a core group experienced at completing systematic reviews to deadline supplemented with people with the necessary experience of LTCs and mental ill health from a clinical perspective. Our Project Advisory Group provides additional expertise from clinical, third sector and family perspectives. In addition we will be recruiting children and young people to a C&YP Research Advisory Group.


Full details from NIHR

Centre for Mental Health publication: In ten years’ time

The Centre for Mental Health | June 2019 | In ten years’ time

The Centre for Mental Health are calling on the government to strengthen the law so that anyone being considered for a prison sentence must have a relevant up to date pre-sentence report before a court can imprison them.
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A recent independent poll commissioned by Revolving Doors Agency shows that public expect much better from our criminal justice system:

  • 76% of people think that magistrates should know whether someone has a mental health condition before sentencing them
  • 68% of people think that magistrates should know whether someone has a learning disability before sentencing them.

Full details from The Centre for Mental Health

In ten years’ time PDF

Female survivors of intimate partner violence and risk of depression, anxiety and serious mental illness

Chandan, J., Thomas, T., Bradbury-Jones, C., Russell, R., Bandyopadhyay, S., Nirantharakumar, K., & Taylor, J. |2019| Female survivors of intimate partner violence and risk of depression, anxiety and serious mental illness| The British Journal of Psychiatry| P.1-6|doi:10.1192/bjp.2019.124
Research that is the first of its kind to study intimate partner violence (IPV) and potential  associations with depression and anxiety in the United Kingdom, has looked at the relationship between intimate partner violence (IPV) exposure and mental health illness.
At baseline almost half (49.5 %) of the cohort who had experienced IPV exposure had some form of mental illness, compared to a quarter of women in the cohort (24.9%) who had not experienced IPV exposure.

BackgroundInternationally, intimate partner violence (IPV) cohorts have demonstrated associations with depression and anxiety. However, this association has not yet been described in a UK population, nor has the association with serious mental illness (SMI).

AimsTo explore the relationship between IPV exposure and mental illness in a UK population.

MethodWe designed a retrospective cohort study whereby we matched 18 547 women exposed to IPV to 74 188 unexposed women. Outcomes of interest (anxiety, depression and SMI) were identified through clinical codes.

ResultsAt baseline, 9174 (49.5%) women in the exposed group had some form of mental illness compared with 17 768 (24.0%) in the unexposed group, described as an adjusted odds ratio of 2.62. Excluding those with mental illness at baseline, 1254 exposed women (incidence rate 46.62 per 1000 person-years) went on to present with any type of mental illness compared with 3119 unexposed women (incidence rate 14.93 per 1000 person-years), with an aIRR of 2.77. Anxiety, depression and SMI were all associated with exposure to IPV.

ConclusionsIPV remains a significant public health issue in the UK. We have demonstrated the significant recorded mental health burden associated with IPV in primary care, at both baseline and following exposure. Clinicians must be aware of this association to reduce mental illness diagnostic delay and improve management of psychological outcomes in this group of patients.

Declaration of interest 
None.Full text of the article is available to read and download from The British Journal of Psychiatry 

In the news:

BBC News Domestic abuse survivors ‘more at risk of serious mental illness’

Parity of Esteem – Delivering Physical Health Equality for those with Serious Mental Health Needs

Royal College of Nursing | May 2019|Parity of Esteem – Delivering Physical Health Equality for those with Serious Mental Health Needs

The Royal College of Nursing (RCN) has developed a Parity of Esteem Programme and is working collaboratively with others to address the problems those with serious mental illness face. Parity of Esteem – Delivering Physical Health Equality for those with Serious Mental Health Needs provides an overview of the work the Royal College of Nursing  (RCN) is doing to address the mortality gap between people with serious mental illness and the rest of the population as well as our work towards establishing parity of esteem between mental and physical health.

Nurses have an important role to play and there is evidence to support how best nurses can help. This brief report is for nursing staff and aims to raise knowledge and awareness of the current mortality gap. It also provides some good practice examples and practical tips about how nurses can influence this important issue (Source: RCN).
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Parity of Esteem – Delivering Physical Health Equality for those with Serious Mental Health Needs


The prevalence and persistence of ethnic and racial harassment and its impact on health: a longitudinal analysis

Institute for Social and Economic Research | May 2019 | The prevalence and persistence of ethnic and racial harassment and its impact on health: a longitudinal analysis

The prevalence and persistence of ethnic and racial harassment and its impact on health:
a longitudinal analysis, presents the findings from the Institute for Social and Economic Research (ISER) of a longitudinal study of the prevalence of ethnic and racial harassment and its impact on health during the period 2009 to 2014. The research was conducted by researchers at the University of Essex using data from the large-scale household panel survey. As part of this study, the research team also looked at measures that can protect ethnic minorities against the mental health costs associated with ethnic and racial harassment.
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Key findings

  • Ethnic minorities are most likely to experience ethnic and racial harassment and anticipate it in streets, shops and public transport.
  •  Chinese men and women, Pakistani men, Indian-Sikh men, Indian-Muslim men and Bangladeshi women are more likely to report such experiences than others – around 15%.
  •  For most ethnic groups, twice as many people anticipate or fear harassment than actually experience it, with the exception of black Caribbean and black African groups.
  • Women are more likely than men to feel unsafe and avoid places, but men are more likely to report actually experiencing ethnic and racial harassment.
  • These patterns persist after account for contextual factors that vary across
    ethnic groups.
  • The likelihood of experiencing ethnic and racial harassment is lower for those
    living with a higher proportion of their own ethnic group members after taking
    into account area level deprivation

The ISER researchers hope their findings will increase awareness among the public, policy-makers, healthcare professionals and law enforcement agencies about how common such harassment experiences are. (Source: ISR).

Institute for Social and Economic Research