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£350,000 awarded for 'BEST' research project in Norfolk schools and colleges

​A team led by clinicians from Norfolk and Suffolk NHS Foundation Trust (NSFT) has been awarded £350,000 by the National Institute for Health Research (NIHR) to carry out pioneering research to investigate how to improve the support available to young people experiencing symptoms of borderline personality disorder (BPD).

It will involve training staff from up to eight schools and colleges in Norfolk to work with mental health professionals to deliver a treatment package that has been developed by expert NSFT clinicians to more than 60 young people, aged 13-18.

The research team believes that if health professionals work in partnership with the education sector, more young people can be offered access to the support they need soon after BPD symptoms emerge, which might prevent them from developing the type of long-term difficulties that characterise the serious mental illness.

Called 'BEST' (Brief Education Supported Treatment), the research project will begin later this year and run until March 2021.

It will be led by Dr Jon Wilson, Consultant Psychiatrist and NSFT Research Director. It will also involve four colleagues from the Trust and be supported by academics from the University of East Anglia, the University of Cambridge and the Anna Freud National Centre for Children and Families, a child mental health research, training and treatment centre in London.

Dr Wilson said: “I am thrilled that we have secured funding to test out whether this innovative way of working with young people will be acceptable and valuable.

“NSFT has a national reputation for working with young people in ways better suited to meeting their needs, and clinical teams have been reorganised to work in novel ways.

“This research has been inspired by the views of young people and it is a fantastic opportunity to learn about how we can engage more young people at an earlier stage to help them develop both a better understanding of their problems and the skills to manage themselves.

“This project will also fit neatly into the growing body of service user inspired research which we carry out as an organisation with our partners."

NSFT clinicians have designed a treatment package to promote understanding of BPD symptoms and the development of self-care strategies to enable young people to manage their condition.

Based on therapies such as dialectical behaviour therapy (DBT) and mentalisation-based therapy (MBT), it has three components:

• Psychoeducation – teaching the young person about the early features of BPD, why it can happen and what helps with managing it
• Formulation – helping the young person understand what factors are maintaining their current difficulties and identify areas for change
• Crisis planning – developing a plan to support with managing periods of distress, including the use of self-care strategies to help regulate emotions

Dr Wilson hopes the research project will be the first phase of a much bigger trial. It will be the feasibility stage to try to work out if the treatment package is possible and acceptable to young people and education staff, he added.

BPD is a severe mental health problem characterised by unstable emotions, intense but difficult relationships, lack of a stable identity and impulsive behaviour such as self-harm and suicide. It usually begins during adolescence and continues into adulthood, often with devastating personal, social and economic consequences.

It is estimated that 3% of adolescents have BPD, which equates to approximately one child in every class. Although there are effective treatments for BPD, they are expensive, time-consuming and available only within specialist services which means few young people are currently able to access effective treatment.

Staff from participating schools and colleges will take part in a training workshop where they will learn how to deliver 3-6 sessions to support individual pupils with BPD in conjunction with a child and adolescent mental health services (CAMHS) professional.

The research project will begin on 1 November.

In addition to Dr Wilson, the other NSFT staff in the research team are:

- Dr Tim Clarke, Research Clinical Psychologist and Children, Families and Young People’s (CFYP) Research Development Lead

- Dr Nicola Martin, Clinical Psychologist

- Dr Sarah Maxwell, Consultant Psychiatrist

- Dr Brioney Gee, Postdoctoral Research Associate, NSFT, and Honorary Research Associate, UEA

The funding for the research was secured with the help of NSFT’s Research Development Team, which works with clinicians, service users and academic partners to develop high-quality research proposals which contribute to improving services locally and nationally.

Caption: Dr Jon Wilson

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