Research aims to slash waiting times for young people with mental illness

Posted on Friday 3rd September 2010
Hospital

Five-year project to reduce waiting times for treatment

Waiting times for young people experiencing serious mental health problems such as psychosis could be drastically cut thanks to a research project being led by the University of Birmingham.
The delay between the onset of symptoms and effective treatment currently stands at around a year but experts are aiming to reduce this to just three months.

Ultimately, the work being done could save lives among the group of people most vulnerable to developing schizophrenia, recurring or manic depression, eating disorders and bipolar disorder.

Max Birchwood, Professor of Clinical Psychology at the University, said: ‘There is a high risk of suicide, for young men in particular. It’s a big deal. One in ten will kill themselves and most of these instances occur in young people within five years of onset of psychosis.

‘There’s also the issue of self harm during the duration of untreated psychosis and this is distressing for families too. If we’re really serious about tackling mental health problems we need to be getting people into treatment more quickly.’

The impact of psychosis is widespread. It affects three per cent of the UK population with 80 per cent of cases occurring in people aged 16-30. Employment rates are particularly low within this group (four to 12 per cent) and ten per cent will take their own lives, often soon after the onset of the illness.

Professor Birchwood explained: ‘The average age for diagnosis of psychosis is 21and in Birmingham and elsewhere there’s a delay of about a year from the onset of symptoms to someone getting effective treatment.

‘It’s this delay that is really crucial. Like with cancer: the longer you leave it, even after treatment, the more likely there are to be residual symptoms a year or two later.’

Professor Birchwood is Director of Birmingham Early Intervention Services and Director of Research and Development at Birmingham and Solihull Mental Health NHS Foundation Trust and is leading the five-year project to reduce waiting times for treatment during the ‘critical phase’ after diagnosis.

It is being funded by a £1.1 million grant through the NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRC) for Birmingham and Black Country (BBC), with an additional £2 million grant from the NIHR Programme Gant funding stream recently secured to further the initial findings.

The first phase involves pathfinder studies to better understand why there are delays for treatment. At the same time the work will aim to tackle the stigma surrounding mental health issues to encourage more young people to come forward for help.

This is being done through partnerships with schools, colleges and universities, primary care organisations, support groups, churches, mosques and other ethnic outlets. A dedicated website (http://wheres-your-head-at.org/) is also targeting new audiences.

In addition, more than 1,000 people across Birmingham and the Black Country have been questioned in a street survey by CLAHRC researchers from the University to explore the public’s understanding of psychosis.

‘There is a big issue in terms of engaging with the young people we need to reach,’ explained Professor Birchwood. “We need to understand why mental health is such a turn-off and what we can do to tackle the stigma.

‘In particular we need to understand the special needs of black and minority ethnic groups where mental illness is particularly stigmatised.’

The initial work will be completed by October 2010. The second phase will be to integrate knowledge gained into strategy, targeting treatment pathways and changing the shape and image of mental health for young people.

Much of this work will be in collaboration with partners such as Fairbridge, Future Housing, Unity FM, local Health Exchanges, schools, faith leaders and community centres.

Outcomes and results will be continually analysed over the lifespan of the project.

The additional NIHR Programme Grant will further develop services, looking at how mental health practitioners can sustain engagement over a period of time.

Professor Birchwood said: ‘We need to find new ways of sustaining change that don’t necessarily involve knocking on people’s doors. We need to establish to what degree certain people can be maintained within the community with a bit of support and to what degree do mental health teams make sure they maintain engagement at the right level.

‘Essentially, it’s making sure the early gains are there for life and not lost.’

Notes to editors

* The NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRC) for Birmingham and Black Country is one of nine pilot CLAHRCs funded by the National Institute for Health Research (NIHR).

CLAHRCs were established in October 2008 with up to £10 million funding over five years to undertake high-quality applied health research focused on the needs of patients and to support the translation of research evidence into practice in the NHS.

* The CLAHRC for Birmingham and Black Country covers all the Birmingham Primary Care Trusts (PCTs) and extends into the area covered by two of the four Black Country PCTs. University Hospitals Birmingham NHS Foundation Trust is the lead NHS organisation and the University of Birmingham is the lead academic partner.

* The CLAHRC BBC involves nine research and implementation themes.

Theme 3 is: Early detection and interventions in psychosis. Theme 3 aims to dramatically reduce the duration of untreated psychosis (DUP) experienced by young people following the onset of a first episode of psychosis, from 12 months to three months, across Birmingham.

* Specifically this study will: build on previous work to better understand the special needs of black and minority ethnic groups; implement a multi-faceted public health intervention that includes de-stigmatising psychosis and overcoming obstacles to care; evaluate the effect of this intervention.

* For more information about support for young people with mental health issues, visit: http://wheres-your-head-at.org