Mental Health Services Research
Mental health services research seeks to generate information that is of practical help to those who organise and deliver healthcare. Our work in this area has generated an evidence base for a range of treatments and interventions, not only through randomised controlled trials (with or without complementary, multi-method observation of treatment process) but also through other methodologies when trials are deemed unsuitable or non-applicable. These studies generally incorporate information about the cost effectiveness of treatments and address issues concerned with the organisation and management of services. Although many departments of psychiatry in the UK are involved with mental health services research we are at the cutting edge of developing innovative multi-method approaches and methodologies and improving existing research designs in a health service undergoing dramatic change. We are currently planning new studies addressing several important health service issues: harmful alcohol use; health anxiety in general medical clinics; and prevention of suicide.
For example, we have maintained a programme of work in the treatment of substance use using multi-method observational studies. Qualitative research methods have been combined with quantitative assessment of treatment process to assess the factors that promote engagement and retention in a range of treatment modalities, from prescribing services that provide opiate substitution therapy through to structured day programmes and services providing various psychosocial interventions to stimulant drug users. Our research has also concerned psychological aspects of, and interventions for, chronic illness, both physical (rheumatoid arthritis) and mental (bipolar disorder, deliberate self harm, health anxiety, and alcohol misuse). Other work has involved an examination factors aimed at improving quality of care such as the role of users and carers.
In relation to forensic mental health services, we have published outcome studies of patients discharged from medium secure units, evaluated methods for predicting the risk of reconviction, and also carried out a review of homicide inquiries involving patients with schizophrenia, with the aim of improving violence risk management. Further, over the past five years we have undertaken studies examining the practice of service user involvement in mental health and substance misuse services.
