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NSFT plays a leading role in watershed moment in mental health diagnosis research
09/07/2019

​Norfolk and Suffolk NHS Foundation Trust (NSFT) has played a leading role in the first study to report service user perspectives and recommendations on proposed World Health Organization (WHO) diagnostic guidelines.

Dr Corinna Hackmann, a research clinical psychologist in NSFT’s Research and Development Department, is the lead researcher of a paper that was published at 11.30pm yesterday by The Lancet Psychiatry.

ICD-11 – The Eleventh Revision of the International Classification of Diseases and Related Health Problems – will be used for health reporting by WHO’s 194 members states from January 2022. The ICD is the most widely used classification system for mental disorders globally.

Dr Hackmann said: “Care needs to be taken with the language of diagnosis and classification because it has the potential to stigmatise service users.

“We wanted to gain views on the ICD-11 from mental health service users in order to offer recommendations to the WHO.

“This research offers a unique insight into the views of service users and has led to recommendations for the WHO coproduced with service users and clinicians.

“Many service users regarded the proposed diagnostic guidelines as useful but, in some cases, they found the content and language confusing or objectionable.

“For example, some with a diagnosis of schizophrenia objected to the words ‘disorganised’ or ‘bizarre’ to describe their behaviour because they perceived these as negative terms, and many service users with depression misunderstood or interpreted the technical term ‘retardation’ in a negative way.”

Dr Hackmann said that the value of “expertise by experience” offered by service users in innovation, service provision and research is increasingly recognised. Their involvement in the ICD-11 study will help to maximise the acceptability of diagnostic guidelines from the service user perspective.

This is a watershed moment in mental health research and the WHO will review and consider the coproduced recommendations before ICD-11 comes into use, she added.

Also involved in the study were the University of East Anglia's (UEA) Norwich Medical School; Columbia University, New York; and the All India Institute of Medical Sciences.

It was carried out in the UK, India and US and involved service users in all three countries taking part in focus group discussions, including service users under the care of NSFT.

The focus groups were used to collect feedback on five diagnoses: depressive episode, generalised anxiety disorder, schizophrenia, bipolar type 1 disorder, and personality disorder.

The Lancet Psychiatry study also acknowledges NSFT library staff and Dr Bonnie Teague, the Trust’s Research Manager, for their advice and support.

* Anyone wishing to read a summary (abstract) of the paper that has been published by The Lancet Psychiatry can so via: www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(19)30093-8/fulltext

Caption: Dr Corinna Hackmann

For press enquiries, email: nsft.communications@nsft.nhs.uk