Working with Networks in Mental Health Environments

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Working with Networks in Mental Health
Environments

• Dave Clarke (Associate Director (RD)

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Why Introduce Networks..?

• Mental Health research across many sectors.
• Broad definition (anxiety through to psychosis
  and personality disorder).
• Across settings (community, primary, acute and
  secure care).
• A challenging participant population
• Not always a strong link between academic
  research and services.
• Key element of Best Research for Best Health.
• Part of NIHR Infrastructure

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Establishing Research Networks in Mental Health.

• WHY? Research in mental health has not
  consistently led or supported practice
  development, with either too many small,
  localized studies that cannot result in valid,
  generalized conclusions or too remote from
  practical applicability to service provision and
  has not actively involved service users or
  carers.
• BECAUSE? Difficult to recruit and retain
  participants in most studies, therefore low
  sample size unless access to large populations
  and significant availability of labour intensive
  support. Participant mistrust about
  interventions, especially drug-based.
• RESULT MH research has not generally
  informed policy and has little credibility with
  users professionals, therefore has not
  attracted support from major funding bodies.
• LEADING TO.

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How will Networks Change this?

• AIMS
• To organize deliver large-scale research
  projects
• To broaden the scope and capacity of research
• To develop research capacity
• PROCESS Establishment of Research Interest
  Groups at national and local levels to develop
  key proposals for funding.
• Use of adoptions committee to ensure only high
  quality, feasible studies are taken on.
• Management of performance and accrual rates to
  studies under the UKCRN.

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Networks in LNR (Mental Health)

• Existing virtual networks of academic
  colleagues.
• Mental Health Research Network (Heart of England
  Hub)
• Host (Birmingham Solihull MH NHS Trust)
• Worcester, Birmingham, Black Country, Warwick
  Leicester
• Primary Care Mental Health
• Early Intervention in Psychosis
• Alzheimer's Disease
• Addictions
• Recovery from major mental illness
• Community mental health
• Cognitive and family therapies

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Networks in LNR (Mental Health)

• DeNDron (Thames Valley)
• Host (Oxford Radcliffe Hospital)
• Oxfordshire, Berkshire, Buckinghamshire, South
  Northamptonshire Northampton
• Primary Care Research Network (PCRN-EMSY)
• Potential for mental health research in the
  broadest sense to take place across all
  topic-specific and comprehensive networks.

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MHRN Adopted Studies in LPT
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Examples of Network Studies

• Current
• COMMAND
• RCT of CBT for command hallucinations
• HTA-SADD
• DOMINO-AD
• EURO-HD
• CAMEO
• IPSM
• PRAGMATIC
• SAGE

• Concluded/In Follow-up
• BALANCE
• BYTE
• Computer-based self-help in eating disorders
• GAN
• Genetics of Anorexia Nervosa
• NACHBID
• Neuroleptics in adults with challenging behaviour
  and ID

co-adopted with DeNDRON
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Network Advantages

• Attracts studies in new areas
• Opportunities for staff
• Contribution to research groups.
• Exposure to high-quality research mentoring.
• Breaks down the academic barrier.
• Infrastructure
• Dedicated role of CSO staff
• Reduces burden of recruitment.
• Reduces geographical isolation
• Income generating

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Network Challenges

• Overcoming clinical resistance
• The whats in it for me culture.
• Ensuring safety and real involvement for
  participants
• Commercial studies
• Study Logistics
• Co-ordinating infrastructure across a wide region
• MH research is expensive.!
• Geographical expansion
• Service User Involvement
• Better co-ordination
• Co-working with other topic networks.
• Buy-in from academic units and industry
• Ensuring adoption equates with feasibility.

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So far, so good..

• Network capacity beginning to take off
• Increase in quality studies and opportunities for
  participants
• Expansion in linked sites
• Breaking down parochialism
• Research no longer an exclusive club
• Streamlining governance
• Dedicated, flexible infrastructure
• Support for clinicians
• Development opportunities
• Increased funding opportunities.

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The Final Word