Lancet Psychiatry podcast on the importance of Research Ethics Committees achieving the right bal... more Lancet Psychiatry podcast on the importance of Research Ethics Committees achieving the right balance between protecting and allowing the voices of vulnerable people to be heard through research.
Background In recent years, projects to develop reporting guidelines have attempted to integrate ... more Background In recent years, projects to develop reporting guidelines have attempted to integrate the perspectives of patients and public members. Best practices for patient and public involvement (PPI) in such projects have not yet been established. We recently developed an extension of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), to be used for systematic reviews of outcome measurement instruments (OMIs): PRISMA-COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) for OMIs 2024. Patients and public members formed a small but impactful stakeholder group. We critically evaluated the PPI component in this project and developed recommendations for conducting PPI when developing reporting guidelines. Plain English summary Reporting guidelines help authors in reporting a specific type of research. They are often presented in the form of a checklist. In recent years, efforts have been made to include the perspectives of patients and members of the public to make sure that what matters to them is also reported. However, best practices for patient and public involvement in such projects do not yet exist. We developed a new reporting guideline for systematic literature reviews of outcome measurement instruments, called "PRISMA-COSMIN for OMIs". In the development of this guideline, one patient partnered as a member of the research team, and five other patients and public members participated in the project. They all had a positive impact on the content and presentation of the guideline. We invited patients and public members to reflect and give feedback on their involvement in the project. Reflections and feedback were mostly positive. Key strengths of our approach were: 1. Limiting power imbalances by having a patient on the research team. 2. Organizing a preparatory meeting for patients and public members to go over key project details and concepts. 3. Remaining flexible in how patients and public members could contribute. This project shows that our approach is feasible. Here, we share insights we gained throughout the project. We translate "lessons learned" into 17 recommendations. These recommendations can be used by researchers who wish to include patient and public perspectives in developing new reporting guidelines.
Objectives: Cognitive remediation (CR) can reduce the cognitive difficulties experienced by peopl... more Objectives: Cognitive remediation (CR) can reduce the cognitive difficulties experienced by people with psychosis. Adapting CR to be delivered remotely provides new opportunities for extending its use. However, doing so requires further evaluation of its acceptability from service users' views. We evaluate the acceptability of therapist-supported remote CR from the perspectives of service users using participatory service user-centred methods. Method: After receiving 12 weeks of therapist-supported remote CR, service users were interviewed by a service user researcher following a semi-structured 18-question interview guide. Transcripts were analysed using reflexive thematic analysis with themes and codes further validated by a Lived Experience Advisory Panel and member checking. Results: The study recruited 26 participants, almost all of whom reported high acceptability of remote CR, and some suggested improvements. Four themes emerged: (1) perceived treatment benefits, (2) remote versus in-person therapy, (3) the therapist's role, and (4) how it could be better. Conclusions: This study used comprehensive service user involvement methods. For some participants, technology use remained a challenge and addressing these difficulties detracted from the therapy experience. These outcomes align with existing research on remote therapy, suggesting that remote CR can expand choice and improve access to treatment for psychosis service users once barriers are addressed. Future use of remote CR should consider technology training and equipment provision to facilitate therapy for service users and therapists.
This is a detailed report which contains information about mental health care and treatment which... more This is a detailed report which contains information about mental health care and treatment which some people may find distressing. This report also contains non-attributable direct quotes and feedback from some of the people who have been in receipt of those services under review. Whilst we have made every effort to limit the use of descriptive or distressing content, it was deemed necessary to include some of this information to place an emphasis on certain findings. We advise strongly that, if you might find some of this information triggering, you are supported to read this report in a safe way. An 'easy read' version of this report is also available.
Background Interventional trials that evaluate treatment effects using surrogate endpoints have b... more Background Interventional trials that evaluate treatment effects using surrogate endpoints have become increasingly common. This paper describes four linked empirical studies and the development of a framework for defining, interpreting and reporting surrogate endpoints in trials.
Background: Approximately 30% of patients experience substantial improvement in depression after ... more Background: Approximately 30% of patients experience substantial improvement in depression after 2 months without treatment, and 45% with antidepressants. The smallest worthwhile difference (SWD) refers to an intervention’s smallest beneficial effect over a comparison patients deem worthwhile given treatment burdens (harms, expenses and inconveniences), but is undetermined for antidepressants. Objective: Estimating the SWD of commonly prescribed antidepressants for depression compared to no treatment. Methods: The SWD was estimated as a patient-required difference in response rates between antidepressants and no treatment after 2 months. An online cross-sectional survey using Prolific, MQ Mental Health and Amazon Mechanical Turk crowdsourcing services in the UK and USA between October 2022 and January 2023 garnered participants (N=935) that were a mean age of 44.1 (SD=13.9) and 66% women (n=617). Findings: Of 935 participants, 124 reported moderate-to-severe depressive symptoms but were not in treatment, 390 were in treatment and 495 reported absent-to-mild symptoms with or without treatment experiences. The median SWD was a 20% (IQR=10–30%) difference in response rates for people with moderate-to-severe depressive symptoms, not in treatment, and willing to consider antidepressants, and 25% (IQR=10–35%) for the full sample. Conclusions: Our observed SWDs mean that the current 15% antidepressant benefit over no treatment was sufficient for one in three people to accept antidepressants given the burdens, but two in three expected greater treatment benefits. Implications: While a minority may be satisfied with the best currently available antidepressants, more effective and/or less burdensome medications are needed, with more attention given to patient perspectives.
This article advocates for integrating procedural justice principles into forensic mental health ... more This article advocates for integrating procedural justice principles into forensic mental health services to enhance patient engagement and autonomy. Procedural justice, broadly defined as fair decision-making processes, is introduced and key principles including voice, neutrality, respect and trustworthiness are described. Evidence suggestive of positive outcomes following procedural justice experiences, such as improved satisfaction, collaboration and reduced perceptions of coercion is outlined. Practical applications are suggested, including staff training and reflective practices using procedural justice principles. The article then calls for further research to explore patients' and staff members' experiences of procedural justice in forensic settings, develop measurement tools, undertake intervention studies and establish causal links between procedural justice and outcomes important for forensic patients.
Background Interventional trials that evaluate treatment effects using surrogate endpoints have b... more Background Interventional trials that evaluate treatment effects using surrogate endpoints have become increasingly common. This paper describes four linked empirical studies and the development of a framework for defining, interpreting and reporting surrogate endpoints in trials.
International Journal of Methods in Psychiatric Research, 2023
Objectives: Optimal cutoff thresholds are selected to separate 'positive' from 'negative' screeni... more Objectives: Optimal cutoff thresholds are selected to separate 'positive' from 'negative' screening results. We evaluated how depression screening tool studies select optimal cutoffs. Methods: We included studies from previously conducted meta-analyses of Patient Health Questionnaire-9, Edinburgh Postnatal Depression Scale, or Hospital Anxiety and Depression Scale-Depression accuracy. Outcomes included whether an optimal cutoff was selected, method used, recommendations made, and reporting guideline and protocol citation. Results: Of 212 included studies, 172 (81%) attempted to identify an optimal cutoff, and 147 of these 172 (85%) reported one or more methods. Methods were heterogeneous with Youden's J (N = 35, 23%) most common. Only 23 of 147 (16%) studies described a rationale for their method. Rationales focused on balancing sensitivity and specificity without describing why desirable. 131 of 172 studies This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
The United States Preventive Services Task Force (USPSTF) recently recommended that all adults in... more The United States Preventive Services Task Force (USPSTF) recently recommended that all adults in general practice be screened for major depressive disorder and that everyone aged 19-64 be screened for anxiety disorders, including disorders not common in general practice. 1 2 This would involve administering depression and anxiety symptom questionnaires to all patients without a psychiatric diagnosis, classifying positive and negative results, providing comprehensive assessments to those with positive results, and discussing and implementing any indicated treatment. 3
The United States Preventive Services Task Force (USPSTF) recently recommended that all adults in... more The United States Preventive Services Task Force (USPSTF) recently recommended that all adults in general practice be screened for major depressive disorder and that everyone aged 19-64 be screened for anxiety disorders, including disorders not common in general practice. 1 2 This would involve administering depression and anxiety symptom questionnaires to all patients without a psychiatric diagnosis, classifying positive and negative results, providing comprehensive assessments to those with positive results, and discussing and implementing any indicated treatment. 3
The United States Preventive Services Task Force (USPSTF) recently recommended that all adults in... more The United States Preventive Services Task Force (USPSTF) recently recommended that all adults in general practice be screened for major depressive disorder and that everyone aged 19-64 be screened for anxiety disorders, including disorders not common in general practice. 1 2 This would involve administering depression and anxiety symptom questionnaires to all patients without a psychiatric diagnosis, classifying positive and negative results, providing comprehensive assessments to those with positive results, and discussing and implementing any indicated treatment. 3
We (both author and reader) will explore the need to develop a practicable evaluative human right... more We (both author and reader) will explore the need to develop a practicable evaluative human rights-based approach to the care, treatment and discharge of forensic mental health patients. It can be argued that patients in secure and forensic services are potentially the most marginalised and extensively stigmatised of all patient cohorts, and that the extent to which they are discriminated against should not be underestimated. We will consider the concept of right-based practice in secure and forensic mental health settings, and how the quality of practice can be strengthened. We will ground our exploration in the lived experiences of secure and forensic mental health patients and seek through the lens of lived experience to envisage what could constitute fairer and more supportive systems of care.
Background There is an ambitious target to create a UK clinical academic workforce representing 1... more Background There is an ambitious target to create a UK clinical academic workforce representing 1% of clinicians from nursing, midwifery, the allied health professions, healthcare science, pharmacy and psychology (NMAHPPs). Understanding and recording the impact that clinical academics make across healthcare services is crucial if we are to grow, value and support this highly skilled workforce group. However, it is currently difficult to systematically record, collate and report the impacts associated with NMAHPP research activity. The aims of this project were to i) develop a framework outlining the impacts that were important for key stakeholder groups, and ii) create and pilot a research impact capture tool to record these impacts. Methods The framework was developed from the existing literature. It was refined, remodelled and approved by multidisciplinary stakeholder involvement, including patient and public representatives, healthcare managers and research-active clinicians. Th...
We (both author and reader) will explore the need to develop a practicable evaluative human right... more We (both author and reader) will explore the need to develop a practicable evaluative human rights-based approach to the care, treatment and discharge of forensic mental health patients. It can be argued that patients in secure and forensic services are potentially the most marginalised and extensively stigmatised of all patient cohorts, and that the extent to which they are discriminated against should not be underestimated. We will consider the concept of right-based practice in secure and forensic mental health settings, and how the quality of practice can be strengthened. We will ground our exploration in the lived experiences of secure and forensic mental health patients and seek through the lens of lived experience to envisage what could constitute fairer and more supportive systems of care.
There is an ambitious target to create a UK clinical academic workforce representing 1% of clinic... more There is an ambitious target to create a UK clinical academic workforce representing 1% of clinicians from nursing, midwifery, the allied health professions, healthcare science, pharmacy and psychology (NMAHPPs). Understanding and recording the impact that clinical academics make across healthcare services is crucial if we are to grow, value and support this highly skilled workforce group. However, it is currently difficult to systematically record, collate and report the impacts associated with NMAHPP research activity. The aims of this project were to i) develop a framework outlining the impacts that were important for key stakeholder groups, and ii) create and pilot a research impact capture tool to record these impacts.
Lancet Psychiatry podcast on the importance of Research Ethics Committees achieving the right bal... more Lancet Psychiatry podcast on the importance of Research Ethics Committees achieving the right balance between protecting and allowing the voices of vulnerable people to be heard through research.
Background In recent years, projects to develop reporting guidelines have attempted to integrate ... more Background In recent years, projects to develop reporting guidelines have attempted to integrate the perspectives of patients and public members. Best practices for patient and public involvement (PPI) in such projects have not yet been established. We recently developed an extension of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), to be used for systematic reviews of outcome measurement instruments (OMIs): PRISMA-COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) for OMIs 2024. Patients and public members formed a small but impactful stakeholder group. We critically evaluated the PPI component in this project and developed recommendations for conducting PPI when developing reporting guidelines. Plain English summary Reporting guidelines help authors in reporting a specific type of research. They are often presented in the form of a checklist. In recent years, efforts have been made to include the perspectives of patients and members of the public to make sure that what matters to them is also reported. However, best practices for patient and public involvement in such projects do not yet exist. We developed a new reporting guideline for systematic literature reviews of outcome measurement instruments, called "PRISMA-COSMIN for OMIs". In the development of this guideline, one patient partnered as a member of the research team, and five other patients and public members participated in the project. They all had a positive impact on the content and presentation of the guideline. We invited patients and public members to reflect and give feedback on their involvement in the project. Reflections and feedback were mostly positive. Key strengths of our approach were: 1. Limiting power imbalances by having a patient on the research team. 2. Organizing a preparatory meeting for patients and public members to go over key project details and concepts. 3. Remaining flexible in how patients and public members could contribute. This project shows that our approach is feasible. Here, we share insights we gained throughout the project. We translate "lessons learned" into 17 recommendations. These recommendations can be used by researchers who wish to include patient and public perspectives in developing new reporting guidelines.
Objectives: Cognitive remediation (CR) can reduce the cognitive difficulties experienced by peopl... more Objectives: Cognitive remediation (CR) can reduce the cognitive difficulties experienced by people with psychosis. Adapting CR to be delivered remotely provides new opportunities for extending its use. However, doing so requires further evaluation of its acceptability from service users' views. We evaluate the acceptability of therapist-supported remote CR from the perspectives of service users using participatory service user-centred methods. Method: After receiving 12 weeks of therapist-supported remote CR, service users were interviewed by a service user researcher following a semi-structured 18-question interview guide. Transcripts were analysed using reflexive thematic analysis with themes and codes further validated by a Lived Experience Advisory Panel and member checking. Results: The study recruited 26 participants, almost all of whom reported high acceptability of remote CR, and some suggested improvements. Four themes emerged: (1) perceived treatment benefits, (2) remote versus in-person therapy, (3) the therapist's role, and (4) how it could be better. Conclusions: This study used comprehensive service user involvement methods. For some participants, technology use remained a challenge and addressing these difficulties detracted from the therapy experience. These outcomes align with existing research on remote therapy, suggesting that remote CR can expand choice and improve access to treatment for psychosis service users once barriers are addressed. Future use of remote CR should consider technology training and equipment provision to facilitate therapy for service users and therapists.
This is a detailed report which contains information about mental health care and treatment which... more This is a detailed report which contains information about mental health care and treatment which some people may find distressing. This report also contains non-attributable direct quotes and feedback from some of the people who have been in receipt of those services under review. Whilst we have made every effort to limit the use of descriptive or distressing content, it was deemed necessary to include some of this information to place an emphasis on certain findings. We advise strongly that, if you might find some of this information triggering, you are supported to read this report in a safe way. An 'easy read' version of this report is also available.
Background Interventional trials that evaluate treatment effects using surrogate endpoints have b... more Background Interventional trials that evaluate treatment effects using surrogate endpoints have become increasingly common. This paper describes four linked empirical studies and the development of a framework for defining, interpreting and reporting surrogate endpoints in trials.
Background: Approximately 30% of patients experience substantial improvement in depression after ... more Background: Approximately 30% of patients experience substantial improvement in depression after 2 months without treatment, and 45% with antidepressants. The smallest worthwhile difference (SWD) refers to an intervention’s smallest beneficial effect over a comparison patients deem worthwhile given treatment burdens (harms, expenses and inconveniences), but is undetermined for antidepressants. Objective: Estimating the SWD of commonly prescribed antidepressants for depression compared to no treatment. Methods: The SWD was estimated as a patient-required difference in response rates between antidepressants and no treatment after 2 months. An online cross-sectional survey using Prolific, MQ Mental Health and Amazon Mechanical Turk crowdsourcing services in the UK and USA between October 2022 and January 2023 garnered participants (N=935) that were a mean age of 44.1 (SD=13.9) and 66% women (n=617). Findings: Of 935 participants, 124 reported moderate-to-severe depressive symptoms but were not in treatment, 390 were in treatment and 495 reported absent-to-mild symptoms with or without treatment experiences. The median SWD was a 20% (IQR=10–30%) difference in response rates for people with moderate-to-severe depressive symptoms, not in treatment, and willing to consider antidepressants, and 25% (IQR=10–35%) for the full sample. Conclusions: Our observed SWDs mean that the current 15% antidepressant benefit over no treatment was sufficient for one in three people to accept antidepressants given the burdens, but two in three expected greater treatment benefits. Implications: While a minority may be satisfied with the best currently available antidepressants, more effective and/or less burdensome medications are needed, with more attention given to patient perspectives.
This article advocates for integrating procedural justice principles into forensic mental health ... more This article advocates for integrating procedural justice principles into forensic mental health services to enhance patient engagement and autonomy. Procedural justice, broadly defined as fair decision-making processes, is introduced and key principles including voice, neutrality, respect and trustworthiness are described. Evidence suggestive of positive outcomes following procedural justice experiences, such as improved satisfaction, collaboration and reduced perceptions of coercion is outlined. Practical applications are suggested, including staff training and reflective practices using procedural justice principles. The article then calls for further research to explore patients' and staff members' experiences of procedural justice in forensic settings, develop measurement tools, undertake intervention studies and establish causal links between procedural justice and outcomes important for forensic patients.
Background Interventional trials that evaluate treatment effects using surrogate endpoints have b... more Background Interventional trials that evaluate treatment effects using surrogate endpoints have become increasingly common. This paper describes four linked empirical studies and the development of a framework for defining, interpreting and reporting surrogate endpoints in trials.
International Journal of Methods in Psychiatric Research, 2023
Objectives: Optimal cutoff thresholds are selected to separate 'positive' from 'negative' screeni... more Objectives: Optimal cutoff thresholds are selected to separate 'positive' from 'negative' screening results. We evaluated how depression screening tool studies select optimal cutoffs. Methods: We included studies from previously conducted meta-analyses of Patient Health Questionnaire-9, Edinburgh Postnatal Depression Scale, or Hospital Anxiety and Depression Scale-Depression accuracy. Outcomes included whether an optimal cutoff was selected, method used, recommendations made, and reporting guideline and protocol citation. Results: Of 212 included studies, 172 (81%) attempted to identify an optimal cutoff, and 147 of these 172 (85%) reported one or more methods. Methods were heterogeneous with Youden's J (N = 35, 23%) most common. Only 23 of 147 (16%) studies described a rationale for their method. Rationales focused on balancing sensitivity and specificity without describing why desirable. 131 of 172 studies This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
The United States Preventive Services Task Force (USPSTF) recently recommended that all adults in... more The United States Preventive Services Task Force (USPSTF) recently recommended that all adults in general practice be screened for major depressive disorder and that everyone aged 19-64 be screened for anxiety disorders, including disorders not common in general practice. 1 2 This would involve administering depression and anxiety symptom questionnaires to all patients without a psychiatric diagnosis, classifying positive and negative results, providing comprehensive assessments to those with positive results, and discussing and implementing any indicated treatment. 3
The United States Preventive Services Task Force (USPSTF) recently recommended that all adults in... more The United States Preventive Services Task Force (USPSTF) recently recommended that all adults in general practice be screened for major depressive disorder and that everyone aged 19-64 be screened for anxiety disorders, including disorders not common in general practice. 1 2 This would involve administering depression and anxiety symptom questionnaires to all patients without a psychiatric diagnosis, classifying positive and negative results, providing comprehensive assessments to those with positive results, and discussing and implementing any indicated treatment. 3
The United States Preventive Services Task Force (USPSTF) recently recommended that all adults in... more The United States Preventive Services Task Force (USPSTF) recently recommended that all adults in general practice be screened for major depressive disorder and that everyone aged 19-64 be screened for anxiety disorders, including disorders not common in general practice. 1 2 This would involve administering depression and anxiety symptom questionnaires to all patients without a psychiatric diagnosis, classifying positive and negative results, providing comprehensive assessments to those with positive results, and discussing and implementing any indicated treatment. 3
We (both author and reader) will explore the need to develop a practicable evaluative human right... more We (both author and reader) will explore the need to develop a practicable evaluative human rights-based approach to the care, treatment and discharge of forensic mental health patients. It can be argued that patients in secure and forensic services are potentially the most marginalised and extensively stigmatised of all patient cohorts, and that the extent to which they are discriminated against should not be underestimated. We will consider the concept of right-based practice in secure and forensic mental health settings, and how the quality of practice can be strengthened. We will ground our exploration in the lived experiences of secure and forensic mental health patients and seek through the lens of lived experience to envisage what could constitute fairer and more supportive systems of care.
Background There is an ambitious target to create a UK clinical academic workforce representing 1... more Background There is an ambitious target to create a UK clinical academic workforce representing 1% of clinicians from nursing, midwifery, the allied health professions, healthcare science, pharmacy and psychology (NMAHPPs). Understanding and recording the impact that clinical academics make across healthcare services is crucial if we are to grow, value and support this highly skilled workforce group. However, it is currently difficult to systematically record, collate and report the impacts associated with NMAHPP research activity. The aims of this project were to i) develop a framework outlining the impacts that were important for key stakeholder groups, and ii) create and pilot a research impact capture tool to record these impacts. Methods The framework was developed from the existing literature. It was refined, remodelled and approved by multidisciplinary stakeholder involvement, including patient and public representatives, healthcare managers and research-active clinicians. Th...
We (both author and reader) will explore the need to develop a practicable evaluative human right... more We (both author and reader) will explore the need to develop a practicable evaluative human rights-based approach to the care, treatment and discharge of forensic mental health patients. It can be argued that patients in secure and forensic services are potentially the most marginalised and extensively stigmatised of all patient cohorts, and that the extent to which they are discriminated against should not be underestimated. We will consider the concept of right-based practice in secure and forensic mental health settings, and how the quality of practice can be strengthened. We will ground our exploration in the lived experiences of secure and forensic mental health patients and seek through the lens of lived experience to envisage what could constitute fairer and more supportive systems of care.
There is an ambitious target to create a UK clinical academic workforce representing 1% of clinic... more There is an ambitious target to create a UK clinical academic workforce representing 1% of clinicians from nursing, midwifery, the allied health professions, healthcare science, pharmacy and psychology (NMAHPPs). Understanding and recording the impact that clinical academics make across healthcare services is crucial if we are to grow, value and support this highly skilled workforce group. However, it is currently difficult to systematically record, collate and report the impacts associated with NMAHPP research activity. The aims of this project were to i) develop a framework outlining the impacts that were important for key stakeholder groups, and ii) create and pilot a research impact capture tool to record these impacts.
The SPIN-CHAT Program was designed to support mental health among individuals with systemic scler... more The SPIN-CHAT Program was designed to support mental health among individuals with systemic sclerosis (SSc; commonly known as scleroderma) and at least mild anxiety symptoms at the onset of COVID-19. The program was formally evaluated in the SPIN-CHAT Trial. Little is known about program and trial acceptability, and factors impacting implementation from the perspectives of research team members and trial participants. Thus, the propose of this follow-up study was to explore research team members’ and trial participants’ experiences with the program and trial to identify factors impacting acceptability and successful implementation. Data were collected cross-sectionally through one-on-one, videoconference-based, semi-structured interviews with 22 research team members and 30 purposefully recruited trial participants (Mage = 54.9, SD = 13.0 years). A social constructivist paradigm was adopted, and data were analyzed thematically. Data were organized into seven themes: (i) getting star...
In organisations peopled by expert individuals with specific experiential knowledge bases, the kn... more In organisations peopled by expert individuals with specific experiential knowledge bases, the knowledge they have which is of relevance to the organisation may be lost when they leave it. Some of this knowledge may be tacit and not explicitly requested, expressed or recognised. This paper presents an exploration of potential mechanisms of expert experiential knowledge identification, capture and representation with a view to automated reasoning, sharing and handover within organisations.
Madness, Violence, and Power: A Critical Collection , 2019
Madness, Violence, and Power: A Critical Collection disengages from the common forms of discussio... more Madness, Violence, and Power: A Critical Collection disengages from the common forms of discussion about violence related to mental health service users and survivors which position those users or survivors as more likely to enact violence or become victims of violence. Instead, this book seeks to broaden understandings of violence manifest in the lives of mental health service users/survivors, ‘push’ current considerations to explore the impacts of systems and institutions that manage ‘abnormality’, and to create and foster space to explore the role of our own communities in justice and accountability dialogues. This critical collection constitutes an integral contribution to critical scholarship on violence and mental illness by addressing a gap in the existing literature by broadening the “violence lens,” and inviting an interdisciplinary conversation that is not narrowly biomedical and neuro-scientific.
Autistica and the Alan Turing Institute are building a participatory, citizen science platform to... more Autistica and the Alan Turing Institute are building a participatory, citizen science platform to explore how sensory processing affects autistic people’s navigation of the world. Numerous studies have confirmed that autistic people experience sensory processing differences which can significantly impact their lives. One aspect which is not yet fully understood is how these differences affect the ways in which autistic people navigate different environments. At this week's SWC AlternaTea Hour, Dr Sarah Markham (KCL) and I will describe the process and values that we have defined to build a project that is participatory from the ground up. Flipping the traditional scientific study on its head, our goal is to give a voice to the autistic citizen scientists and educate neurotypical people. We seek to empower everyone in supporting autistic people and their families in living long, healthy, happy lives.
1:31:30 / 2:50:50 #MentalHealthPRU Community services for ‘personality disorders’, 2019
The Research Planning Event on Community Personality Disorder Services was hosted by the Mental H... more The Research Planning Event on Community Personality Disorder Services was hosted by the Mental Health Policy Research Unit (King’s College London and University College London) with the purpose of informing a future policy research project which aims to review typologies of community personality disorder services and assess financial costs related to treatment pathways and services. Some key questions that we explored during the event were: How should we define personality disorder? Is the term personality disorder a useful category for service delivery? What current methods exist? Consider service models: what are the key desirable elements for a service for this group? How would we define success of a service? My presentation focuses on the ego-syntonic nature of personality disorder and how this can inform the nosology, care and treatment, and service provision for individuals suffering from a personality disorder.
I will be presenting my research paper 'Knowledge Representation to Capture & Retrieve Experienti... more I will be presenting my research paper 'Knowledge Representation to Capture & Retrieve Experiential Learning in Military Settings' at the ICCRTS-KSCO 2017: 22ND INTERNATIONAL C2 RESEARCH AND TECHNOLOGY SYMPOSIUM / 9TH KNOWLEDGE SYSTEMS FOR COALITION OPERATIONS CONFERENCE 6th-8th November in L.A.
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Method: After receiving 12 weeks of therapist-supported remote CR, service users were interviewed by a service user researcher following a semi-structured 18-question interview guide. Transcripts were analysed using reflexive thematic analysis with themes and codes further validated by a Lived Experience Advisory Panel and member checking.
Results: The study recruited 26 participants, almost all of whom reported high acceptability of remote CR, and some suggested improvements. Four themes emerged: (1) perceived treatment benefits, (2) remote versus in-person therapy, (3) the therapist's role, and (4) how it could be better. Conclusions: This study used comprehensive service user involvement methods. For some participants, technology use remained a challenge and addressing these difficulties detracted from the therapy experience. These outcomes align with existing research on remote therapy, suggesting that remote CR can expand choice and improve access to treatment for psychosis service users once barriers are addressed. Future use of remote CR should consider technology training and equipment provision to facilitate therapy for service users and therapists.
Objective: Estimating the SWD of commonly prescribed antidepressants for depression compared to no treatment.
Methods: The SWD was estimated as a patient-required difference in response rates between antidepressants and no treatment after 2 months. An online cross-sectional survey using Prolific, MQ Mental Health and Amazon Mechanical Turk crowdsourcing services in the UK and USA between October 2022 and January 2023 garnered participants (N=935) that were a mean age of 44.1 (SD=13.9) and 66% women (n=617).
Findings: Of 935 participants, 124 reported moderate-to-severe depressive symptoms but were not in treatment, 390 were in treatment and 495 reported absent-to-mild symptoms with or without treatment experiences. The median SWD was a 20% (IQR=10–30%) difference in response rates for people with moderate-to-severe depressive symptoms, not in treatment, and willing to consider antidepressants, and 25% (IQR=10–35%) for the full sample.
Conclusions: Our observed SWDs mean that the current 15% antidepressant benefit over no treatment was sufficient for one in three people to accept antidepressants given the burdens, but two in three expected greater treatment benefits.
Implications: While a minority may be satisfied with the best currently available antidepressants, more effective and/or less burdensome medications are needed, with more attention given to patient perspectives.
Method: After receiving 12 weeks of therapist-supported remote CR, service users were interviewed by a service user researcher following a semi-structured 18-question interview guide. Transcripts were analysed using reflexive thematic analysis with themes and codes further validated by a Lived Experience Advisory Panel and member checking.
Results: The study recruited 26 participants, almost all of whom reported high acceptability of remote CR, and some suggested improvements. Four themes emerged: (1) perceived treatment benefits, (2) remote versus in-person therapy, (3) the therapist's role, and (4) how it could be better. Conclusions: This study used comprehensive service user involvement methods. For some participants, technology use remained a challenge and addressing these difficulties detracted from the therapy experience. These outcomes align with existing research on remote therapy, suggesting that remote CR can expand choice and improve access to treatment for psychosis service users once barriers are addressed. Future use of remote CR should consider technology training and equipment provision to facilitate therapy for service users and therapists.
Objective: Estimating the SWD of commonly prescribed antidepressants for depression compared to no treatment.
Methods: The SWD was estimated as a patient-required difference in response rates between antidepressants and no treatment after 2 months. An online cross-sectional survey using Prolific, MQ Mental Health and Amazon Mechanical Turk crowdsourcing services in the UK and USA between October 2022 and January 2023 garnered participants (N=935) that were a mean age of 44.1 (SD=13.9) and 66% women (n=617).
Findings: Of 935 participants, 124 reported moderate-to-severe depressive symptoms but were not in treatment, 390 were in treatment and 495 reported absent-to-mild symptoms with or without treatment experiences. The median SWD was a 20% (IQR=10–30%) difference in response rates for people with moderate-to-severe depressive symptoms, not in treatment, and willing to consider antidepressants, and 25% (IQR=10–35%) for the full sample.
Conclusions: Our observed SWDs mean that the current 15% antidepressant benefit over no treatment was sufficient for one in three people to accept antidepressants given the burdens, but two in three expected greater treatment benefits.
Implications: While a minority may be satisfied with the best currently available antidepressants, more effective and/or less burdensome medications are needed, with more attention given to patient perspectives.
(King’s College London and University College London) with the purpose of informing a future policy research project which aims to review typologies of community personality disorder services and assess financial costs related to treatment pathways and services. Some key questions that we explored during the event were:
How should we define personality disorder?
Is the term personality disorder a useful category for service delivery?
What current methods exist?
Consider service models: what are the key desirable elements for a service for this group? How would we define success of a service?
My presentation focuses on the ego-syntonic nature of personality disorder and how this can inform the nosology, care and treatment, and service provision for individuals suffering from a personality disorder.