Michael Sharpe, Professor of Psychological Medicine, University of Edinburgh From Where to Here…?
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Transcript of Michael Sharpe, Professor of Psychological Medicine, University of Edinburgh From Where to Here…?
Michael Sharpe, Professor of Psychological Medicine, University of Edinburgh
From Where to Here…?
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Mental illness
One in six of the population suffers from anxiety or depression
At least 1 in 4 GP consultations for mental ill health
Annual direct care costs £12.5 billion
Annual cost to UK society more than £77 billion
We need better ways of helping mentally ill people
We need research to help us do this
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What research do we need?
Research that is relevant– No only to cause but also to treatment– Relevant to different mental illnesses– Cover all aspects of treatment
Research that gives us high quality evidence– Good ideas– Well done studies– Large and representative samples
Research that is feasible– Results can be delivered
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What research do we have?
Research that is relevant?– Less than 5% of the trials on the Cochrane database are indexed
under mental disorder
Research that gives us high quality evidence?– Studies are generally far too small– The outcomes are too short term– They are too often based on hospital samples– Almost all are of drug treatment
Research that is feasible?– The majority of studies are not completed as planned
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How can we get better research?
Clearly, researchers simply need to work harder and faster to deliver more and better research !
But researchers also need to be able to deliver good research
What obstacles do they see ? Surveys by Dr Craig on CSO 2004 and
by us in 2005.
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Obstacles to better research? What might a Network provide?
Feeling it can’t be done– Galvanize energy and vision and make it feel possible
Lack of expertise staff and infrastructure– Provide design statistical and other practical expertise
Overwhelmed by paperwork– Offer guidance and help to address regulatory requirements
Isolated with limited capacity– Forge links between clinicians and researchers, centres and networks
Can’t get big grants– Offer advice expertise and support to make strong applications
Can’t recruit sufficient patients to studies– Provide manpower to assist
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Medical school
CRFs
Trials Unit
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A Proposal for a Scottish Mental Health Research Network
The challenges– Diffuse concept of ‘mental health’– Small clinical research community– Limited research culture in clinical services
The opportunities– Our population and organized services– Our potential for collaboration– Existing infrastructure
The ‘X’ factor– Determination to make it work
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The original bid for SMHRN
To Link– 4 clinical medical schools– NHS and academic researchers– Other networks
To Provide– Methodological and practical support– Guidance on regulation– Assistance with recruiting
To Supplement– CRFs – R & D departments– Research grants
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The SMHRN 3 year targets (2006)
1. Establishment of a baseline of multicentre clinical research activity in and funding for Scottish MH research.
2. At least six new UK multicentre studies within 3 years.
3. At least three new multi-centre studies led from Scotland within 3 years.
4. The number of patients participating in multi-centre studies increased by at least 20% of baseline every year.
5. Active grant funding for multicentre MH trials in Scotland increased by at least 20% of baseline every year.
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The SMHRN achievements (2009)
1. Establishment of a baseline of multicentre clinical research activity in and funding for Scottish MH research.
2. At least six new UK multicentre studies within 3 years.
3. At least three new multi-centre studies led from Scotland within 3 years.
4. The number of patients participating in multi-centre studies increased by at least 20% of baseline every year.
5. Active grant funding for multicentre MH trials in Scotland increased by at least 20% of baseline every year.
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What we have learned
It remains a challenge– To achieve focus in ‘mental health’– To keep political, CSO, University, NHS and Industry support– To recruit and keep good staff (let studies recruit their own)
It is a long term job– 10 years plus– It need a substantial commitment of senior time
We need to support success but also to grow new Scottish studies– Back winners – Promote PDGs and pilots
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Thanks to the original team
Edinburgh: Professor Michael Sharpe (Academic), Dr Alan Carson (NHS)
Glasgow: Dr Andrew Gumley (Academic), Professor Bob Hunter (NHS).
Aberdeen: Professor Ian Reid (Academic), Dr Ross Hamilton (NHS).
Dundee: Dr Alex Baldacchino (NHS), Dr Rob Durham (Academic)
Primary Care: Professor Jill Morrison (Academic Glasgow),
Public Health: Dr Cameron Stark (NHS Highlands Health Board)
Clinical Research Facilities: Mr Gordon Hill (Wellcome Trust CRF)
Statistics and methodology: Professor Gordon Murray
Manager: Dr Lucy McCloughan
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Also to those who joined later
Board members: Professor Keith Matthews (Dundee); Dr. Jonathan Cavanagh (Glasgow); Professor Stephen Lawrie (Edinburgh – biological psychiatry);
Network Staff: Nadine Dougall; Mark Hazelwood; Gillian McHugh; Ann Doust
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And also to
CSO: Peter Craig, Roma Armstrong; Beatrice Cant; Hilary Lapsley
CRFs: Anne Gordon; Fiona McArdle
NIHR MHRN: Til Wykes and colleagues
University of Edinburgh: Professor Stuart Ralston and Professor Eve Johnstone and colleagues in my research group (PMR)
Scottish Government: Denise Coia