Research News

First service user-led research project for NSFT

Sarah Rae, Co-lead on MINDS Sarah Rae, a mental health service user has brought together a nationally recognised team of researchers to develop a major new research study. The NIHR funded study called MINDS aims to improve the outcomes and experiences of those being discharged from mental health hospitals.

Sarah has experienced difficulties when discharged from mental health wards in the past. She will now work alongside researchers at Norfolk and Suffolk NHS Foundation Trust (NSFT) on this one-million-pound study. Sarah is determined to use her lived experience to improve services. She will co-lead the research.

“I have had two long stay admissions. On the first occasion I was discharged at very short notice. During a more recent admission I became institutionalised after spending 8 months on the ward. I was terrified of going back into the community. This fear was made worse by the fact that staff did not try to understand my worries or offer any coping strategies. There was no collaborative discharge planning before leaving hospital. The knock-on effect on my well-being and recovery was huge.

When I approached Corinna Hackmann and Jon Wilson at NSFT research they were both enthusiastic about my idea for a research project. They regarded my lived experience to be of equal value to their academic skills. We had a shared vision from the outset. They recognised how service users could benefit from research into how discharge processes could be improved.”

Sarah Rae, Co-lead on MINDS

Around 50,000 people leave mental healthcare hospitals every year. However, a national survey from the mental health charity Mind found that 40% of people leaving mental health hospitals have no plan in place to support them after they leave.

The research team, including leading academics from across the UK, will work with mental health service users and carers to develop a new support package for discharge. This is thanks to funding from the National Institute for Health Research (NIHR).

“No care plan, no follow up. I came out last week, again no care plan, no medication,” Service User

Dr Corinna Hackmann, co-investigator on the MINDS project said, “National Institute for Health and Care Excellence (NICE) guidelines state that discharge planning should include staff working together with service users.

"We know that mental health workers want to create a positive experience for those leaving hospital. However there are many complicated factors that can disrupt this. The aim of MINDS is to combine:

  • the expertise of people who have accessed mental health services
  • clinicians
  • researchers
  • engineers
  • commissioners
  • and managers

to develop solutions.”

“The cutting-edge part of this research is the work we are doing with health care systems engineers at the University of Cambridge. We plan to make a tangible ‘aid’ to help in the discharge process”, explained joint-lead on MINDS Consultant Psychiatrist, Jon Wilson.

"The idea is to adopt industry tools to understand and adapt the discharge process from the point of view of the people involved. This will include why discharges are sometimes not well planned and what people feel they need to stay well after leaving hospital. This ‘Engineering Better Care’ toolkit can be tailored to different situations.

“We are delighted that this systems approach, co-developed with:

  • systems engineers
  • health and care professionals
  • improvement experts
  • and patient representatives

can be applied to an important systems challenge such as discharge in mental health,” Professor John Clarkson, Director of the Cambridge Engineering Design Centre at the University of Cambridge

For more information and to register to take part visit the MINDS study page.

Read First service user-led research project for NSFT…

New positions: Exciting opportunities at NSFT research

An exciting opportunity for 3 Research Assistant Psychologists at Norfolk and Suffolk NHS Foundation Trust is available for applicants wishing to start a career in mental health clinical research.

The roles will be supporting work packages of two funded NIHR research studies.

The first study MINDS aims to co-develop mental health adult inpatient discharge processes.

The second study DISCOVERY aims to undertake a realist evaluation to co-produce post-diagnostic dementia support in the Recovery College model.The roles will work collaboratively with service user representatives and our national partners across the NHS and Academia.

The positions are available full-time for 36 months and are ideal for people who are wanting experience of working in a busy clinical research environment.

Deadline for applications: 24 November 2021

Apply here:Job Advert (jobs.nhs.uk)

The third opportunity for a Research Assistant Psychologist will be supporting people living in Norfolk and Suffolk to participate in national mental health and dementia research studies.

The position is initially available for 12 months and is ideal for people who are wanting clinical experience of working in a busy research environment. Opportunities are available for wider research experiences as part of the role.

Deadline for applications: 24 November 2021

Apply here: https://beta.jobs.nhs.uk/candidate/jobadvert/C9246-21-5350

MINDS Study Manager

An exciting opportunity for a MINDS Study Manager at Norfolk and Suffolk NHS Foundation Trust is available for applicants wishing to grow a career in mental health clinical research. The role will be leading on the management and delivery of a funded NIHR research study co-developing mental health adult inpatient discharge processes. The work is supported by ARC East of England.

The role will work collaboratively with service user representatives and our national partners East London and Hertfordshire Partnership NHS Foundation Trusts, alongside Universities of Cambridge, Northumbria, East Anglia, Hertfordshire, Anglia Ruskin University and Kings College London.

The position is available full-time for 36 months and is ideal for someone with previous study management skills and knowledge/experience of qualitative methods and co-production.

Deadline for applications: 30 November 2021

Apply here: https://www.jobs.nhs.uk/xi/direct_apply/?vac_ref=916854169

Read New positions: Exciting opportunities at NSFT research…

Autumn Research Seminar Series: Latest in Collaborative Research

Children and Young People: Thursday 18th November 2-4pm - on MS Teams

Child and youth seminar contributors

A taste of the diverse range of children and young people’s research at NSFT

Come along for a fascinating afternoon;  find out about research on exercise for depression, a study about life story work for children in care, an intervention delivered in schools for BPD (Borderline Personality Disorder) symptoms and our initiative to increase the numbers of young people taking part and helping in the design of mental health research at NSFT.

Speakers: 

  • Dr Daksha Trivedi and Dr David Wellsted, co-leads of the READY trial, University of Hertfordshire
  • Dr Ella Mickleburgh, NSFT Research, introducing the LIMTLESS study.
  • Dr Brioney Gee, Children and Young People’s Lead NSFT, talking about the BEST findings and what comes next.
  • Kayte Rowe, Deputy Manager at NSFT talking about the CHEYENNE initiative.

Click here to join the meeting

There will be a Q&A panel at the end.

Read Autumn Research Seminar Series: Latest in Collaborative Research…

Can Granny and Grandads help their grandchildren’s mental health and vice versa?

Granny with her granddaughter looking at a phone

Here at NSFT research we are interested in relationships between grandparents and their grandchildren, and whether working on this relationship could improve the mental health and wellbeing of them both. It is just the beginning of an idea for a study and we want to start by getting your input on what the study might entail. Please watch this short film to find out more from those involved: 

 

The questionnaire will ask about your experience of this topic and whether you think it would be something worth researching. The questionnaire should take less than 5 minutes to complete. Here is the link to the questionnaire:https://www.surveymonkey.co.uk/r/XM9RDZR

The questionnaire is anonymous (you won’t be asked for your name or other information that could identify you) and no-one outside the NSFT research team will have access to your answers. We will share a summary of what we find out and our next steps on the research pages of the NSFT website.

Thank you for your time. If you have any questions or would like to find out more, please email researchinfo@nsft.nhs.uk.

Read Can Granny and Grandads help their grandchildren’s mental health and vice versa?…

Hands, face, space … and a programme of rapid response Covid-19 evaluation

An outgoing reflection of the past year working within the NSFT research department by Sarah St Ledger.

I am just leaving my current position within the NSFT research department to embark on a Doctorate in Clinical Psychology (gulp). So I figured that now was a great opportunity to write about, and reflect upon, the last year within the research team and some of the work that I have been involved in.  

I was employed around a year ago to help the research team design and develop research relating to Covid-19. The Covid work has been fast-paced, diverse and hugely interesting both from a professional and a personal perspective; knowledge is power and at a time when the whole world was grappling with the impacts of Covid it was nice to feel like I was directly involved in the learning.  

One of the first pieces of work I became involved in when I started in the team was the Covid-19 Ethnic Minority Staff Wellbeing Survey whereby almost half of respondents reported poorer mental health since the start of COVID-19, a finding similar to that of the rest of the UK at the time. From this piece of work a dedicated wellbeing officer for ethnic minority staff members was appointed, pandemic wellbeing sessions were arranged by the Black and Ethnic Minority Staff Network, and we are now following up the survey to see if anything has changed over the last 12 months.  

Another memorable piece of work was the Staff COVID-19 Vaccine Intention survey which we completed in December 2020. We knew from the literature that healthcare staff typically have lower vaccine uptake compared to the general population, but our study was able to provide valuable insights into why and what characteristics determined vaccine acceptance, hesitancy or rejection.  Our study demonstrated that vaccine promotion needs to provide healthcare staff with timely and accurate information relating to consent, safety and efficacy through targeted communication strategies to support them with their personal vaccine decisions. The information gained from this study became the catalyst for an increase in targeted communication strategies within the organisation and led to an overall staff vaccine uptake of 94%, a figure much greater than first predicted.  

One of the best things about the last year and the work I’ve been involved in was the ability to rapidly respond to the needs of our staff and service users and I feel proud to have played a small part in the development of knowledge and in seeing that knowledge embedded into clinical decision-making, directly informing the organisational response to the Covid-19 pandemic.  

One thing that has struck me about the last year has been how much I have enjoyed being in a non-clinical, research-based role! I thought working in research would be a bit dry and, dare I say it,  stuffy but it has been the opposite! The department is one of the most dynamic, skilled (brains for days!), forward thinking and compassionate teams I have had the pleasure of working with and whilst I am leaving, I am lucky in that I am not going far and will be able to maintain my connection with them as I continue in my studies. It's been an awesome year to work in research.  

 

Read Hands, face, space … and a programme of rapid response Covid-19 evaluation…

iACT4CARERS: Online Acceptance and Commitment Therapy for Family Carers of People with Dementia

carer and elderly person doing the dishes together

What we did and why we did it

Caring for someone with dementia can be hard, and family carers are much more likely to be depressed or anxious than other carers or non-carers. Unfortunately, family carers are currently under-provided for by NHS psychological services. This is because some carers are unable to travel, others do not have access to skilled therapists and, for others, finding somebody else to look after the person with dementia while they attend psychological services is an issue. Online treatments have the potential to overcome these challenges and improve equity of care. We conducted a preliminary study, funded by the NIHR, exploring whether it is possible to deliver Acceptance and Commitment Therapy (ACT) for family carers of people with dementia online within NHS services and whether this new intervention is acceptable among family carers presenting anxiety or depression.

What we found

The study was successful with more than 100 potential participants being referred to the study in just six months. Thirty-three eligible participants received online ACT, more than we had originally planned.

More than 70% of participants completed seven or all eight online sessions. There was preliminary evidence of improvements in scores of anxiety and depression following the intervention, perhaps more so for anxiety.

Individual interviews with participants highlighted that participants liked the ACT techniques, the user-friendliness of the online system and feedback received from their dedicated online therapist.

Participants also expressed that the intervention led to some improvements in their life such as making them feel it is okay to ask for help and make some time for themselves. The findings revealed that participants also noticed increased activities such as more exercises to take care of themselves due to the intervention.

Take away points

1. Acceptance and Commitment Therapy for family carers of people with dementia can be delivered online within NHS services.

2. The intervention may help cope with carer anxiety and depression, perhaps more so for anxiety.

3. The intervention may lead to some improvements in life such as making family carers feel it is okay to ask for help and make some time for themselves.

What’s Next?

A large-scale trial is now required to evaluate the effectiveness of online ACT and find out whether online ACT should be widely implemented.

The research team will use the findings from this pilot work and apply for a large grant to conduct a large-scale trial

Download the research recap iACT4CARERS.pdf 

Read iACT4CARERS: Online Acceptance and Commitment Therapy for Family Carers of People with Dementia…

“Doing research into Long Covid made me feel validated.”

Picture of Charge Nurse, Dawn Holden

Dawn Holden caught Covid in April 2020 and several months on was still struggling with long term symptoms plus trying to continue to work at NSFT. At the time she was not aware of anyone else who was experiencing long term symptoms where she worked. Dawn was feeling quite alone with what she was experiencing both physically, psychologically and the repercussions of working whilst managing the process of sickness meetings etc.

 

Dawn explains, “I thought that there must be other people within the trust who were experiencing similar difficulties. I think I must have seen something in an email or Trust communications about the research team and thought that I would contact them to ask if they had thought about doing any research based on this.”

 

Dawn had a reply from the Research Team, and she was put in touch with senior research nurse Louise McCarthy.

 

“I found Louise to be wonderful and so friendly,” Dawn explains. “We met up via Teams and discussed what I was experiencing and my thoughts about what should be asked within the research proposal.  Following this a survey was initiated which was sent out to NSFT employees.”

 

The survey looked at the prevalence of post-covid symptoms across the NSFT workforce – the details of the study were recently published in Nursing Research Matters Nursing Research Matters - Learning from COVID-19 (mmp-mmp-email.s3.eu-west-2.amazonaws.com) on page 116 and 117. 

 

“What was lovely,” explains Dawn, “Is that I was included in all of the steps, the questions that were chosen to be asked in the study and the findings. Which was so kind of the research team as I had only done a very small part of this work (asked the questions) and when I was asked if I would like my name included in the research document it was a surprise and very validating for me.”

 

Dawn has found it has given her the confidence to contribute to further research projects that have taken place, answering questionnaires and an interview undertaken by a university.  

 

“I am more aware of the benefit of research and how it is integral to development within NSFT. Participating in this research has also broadened my perspective on possible future careers paths,” explains Dawn.  

 

Dawn would advise other people to get in touch with research particularly if they have an area of interest that they feel passionate about or that they feel needs developing.

 

“Louise was so encouraging and interested in my views and I felt that what I had to say really mattered. Any email I receive now regarding research I pass on to all my immediate team in the hope that this will encourage other NSFT employees to become involved in research,” explains Dawn.

 

If you are interested in sharing an idea for research with the NSFT research team then please email  researchinfo@nsft.nhs.uk  or we have a new section on our website Become Involved | Norfolk and Suffolk NHS (nsft.nhs.uk) under speedy surveys   What would you like to see us research?  where you can suggest your research idea.

Read “Doing research into Long Covid made me feel validated.”…

Trialling a new way to help teenagers with Post Traumatic Stress Disorder

teenager looking at computer

The research team, which has received funding from the Medical Research Council, is seeking to recruit people aged between 12 and 17 who are affected by PTSD. The treatment programme delivers the same therapy and support that has proven effective in face-to-face sessions with children and adolescents affected by PTSD.

Anne Smith at Norfolk and Suffolk Foundation Trust has recently joined the trial team, she is an experienced clinician and trial therapist, she says, “The online version of cognitive therapy for PTSD means that treatment can be accessed via smartphone, tablet or computer. With online treatment there is no need to go and see a therapist every week, this will allow more young people to have the treatment.”

The online therapy involves working through online modules at the young person’s own pace. This can happen at home, guided by a therapist who will speak to them on the phone at least once a week. This will involve reading information, watching videos and inputting some information. There will be follow up reviews after treatment is completed.

The criteria for the young people is:

  • Aged 12-17.
  • Experiencing PTSD symptoms to a single event trauma.
  • Able to speak English to a level where they can engage in therapy without an interpreter.
  • Access to a smartphone and/or computer.
  • Not previously received trauma focused Cognative Behavioural Therapy for the same trauma.

Anne explains, “This particular intervention is targeting young people who have had a single traumatic event anything from car accidents, sexual assault or witnessing other traumatic events which are causing symptoms of PTSD – such as flashbacks or feeling on-edge.”

They have recruited 19 young people to the trial so far and some have given their feedback:

  • “I felt really supported. My therapist was brilliant and the modules, tasks, analogies and metaphors were really good”
  • “Seeing other people’s stories that were similar to mine really clicked with me and made me feel valid”

Clinicians at the South London and Maudsley NHS Foundation Trust and researchers at King’s College London have worked with partners from Oxford University, Cambridge University and the University of East Anglia to develop the app and website that provide personalised therapy and support to young people recovering from PTSD for this study.

If you can think of someone who might benefit from this trial for clinicians to refer Research Referral Form - Clinician/Organisation (office.com) or want to self-refer then please refer yourself via our centralised referral system  Research Referral Form - Service User / Carer / Parent (office.com) or email: researchinfo@nsft.nhs.uk  for further information. This study is called OPTYC and this is the website OPTYC.

 

Read Trialling a new way to help teenagers with Post Traumatic Stress Disorder…

Understanding how families support a person with dementia - the iCARE study

Elderly couple looking towards the camera

What we did and why we did it

Family carers are essential in supporting people with dementia living in their own homes or in care homes. Different challenges in providing care often lead to family carers having a poor quality of life (QoL). We wanted to understand how to best support carers to maintain their QoL while providing support to their family member living with dementia. Carers completed self-reported and interview-based questionnaires to explore the impact of some of the likely things that carers find stressful, for example, low mood, anxiety, hours devoted to caregiving, physical health conditions, sleep quality, psychological flexibility and care recipient’s neuropsychiatric symptoms.

Take away points

1. This project explored potential causes that could worsen the quality of life (QoL) of family carers of people with dementia.

2. 91 family carers with an average age of 69.5 took part in the study.

3. Carers’ anxiety, sleep quality and psychological flexibility seem to have a great impact on carer QoL

What we found

A total of 91 family carers from Norfolk & Suffolk, aged 18 or over, who were currently supporting a person with dementia volunteered to take part in the study. Carers’ average age was 69.5 years old, and they were primarily female family members looking after a person with severe Alzheimer's disease. Carers’ anxiety, sleep quality and psychological flexibility - the ability to do what's most important to you despite the presence of unpleasant thoughts and feelings - were the most important factors that have an influence on QoL.

What’s Next?

We hope the findings from this study will inform the development of new interventions that could help carers maintain their wellbeing across the entire journey of dementia care. Treating anxiety, improving sleep quality and promoting psychological flexibility seem to be critical to support the wellbeing of family carers of people with dementia.

Download the pdf here 177KB

Read Understanding how families support a person with dementia - the iCARE study…

Research: 'Aspirational' new family project.

Brioney and Isabela on the podcast

This week in Mental Health and You we hear about a new research project called ASPIRE.

The aim of ASPIRE is to develop a support package to build resilience in young people who have experienced adverse childhood experiences.

Brioney Gee and Isabela Tavares Junqueira from the research team, explain:

  • what the project involves,
  • the huge role co-production has
  • and how the project is going.

The new support package will empower a child’s caregiver – be it their Mum, Dad or someone else who is looking after them – to use techniques to build their child’s resilience, rather than a professional working with the young person. The National Institute for Health Research (NIHR) fund ASPIRE.

We hear from two members of the stakeholder team who have relevant lived experience. Rachel a parent of three and Seb who is a young person giving input on various parts of the project.

The aim of the support package is to support children who have experienced adverse childhood experiences (ACEs) before the age of 18. Experiences such as:

  • abuse,
  • neglect,
  • family break-up,
  • being bullied,
  • or experiencing a serious illness.

These ACEs have been linked to increased risk of a wide range of negative health outcomes across a person’s life. We also know there is a strong link between the number of ACEs a person is exposed to and their odds of experiencing mental health problems.

However, not all children who experience ACEs develop mental health difficulties. Some young people have social support and personal strengths that allow them to remain healthy despite difficult experiences. Something known as ‘resilience’.

The amount of resilience someone has is not fixed. If we can increase a young person’s resilience, we can decrease their risk of poor mental health.

The co-lead for this project is Cathy Creswell who is based at Oxford University, we also have partners who are based in the US Tim Lomaz and Cleo Berry is based at the University of Sussex. We are also working with co-applicants - two clinicians from NSFT Dr Jon Wilson and Dr Tim Clarke. We also have researcher as someone with lived experience in a parent/carer lead role Tina Walker.

If you want to get involved with ASPIRE then please email

Aspire@nsft.nhs.uk

 

 

Read Research: 'Aspirational' new family project.…
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