The Mental Health Foundation’s annual Mental Health Awareness Week has put mental health in the spotlight since the first initiative in 2000. Mental health promotion and the prevention of mental ill health are core issues for many researchers within LSE Health and Social Care and we often collaborate with other institutions, governmental departments and charities to build the evidence base. In support of Mental Health Awareness Week, here we highlight some of the research into mental health that has been recently completed or is underway within the Centre.
Here are a few members of the Centre introducing their research.
David McDaid on promoting better mental health
Marya Saidi on mental health and housing services
Annette Bauer on the economics of mental and social wellbeing
Mental health in low and middle income countries
Addressing the burden of mental ill health in low- and middle-income countries (LAMICs) is increasingly becoming a priority but often, policy makers do not have enough information on specific risk factors, such as the relationship between social inequalities and mental ill health, that would allow for targeted interventions.
In a recent blog post, PhD student Victoria DeMenil described the example of Kenya, where NGOs are working with the government to implement mental health policy to strengthen community-based services.
In addition to our research into health systems, a wide range of research within LSE Health and Social Care aims to collate the available evidence, address gaps in the evidence base and thus contribute to the development of effective mental health services in LAMICs.
Examples include research into whether co-morbid depression and diabetes affect socio-economic status or whether it is the other way around (Leone et al. 2012).
Our investigation of the relationship between poverty and post-natal depression in low income countries highlights the need for future research to take into account neighbourhoods and communities to better understand this relationship (Coast et al. 2012), and emphasizes the key role of supportive social relationships in preventing post-natal depression (Jones and Coast 2012).
Another key area for us is suicide prevention. Research into the relationship between suicide and poverty in LMICs found evidence that unemployment, low income, low income inequalities (mass poverty), debt and macro-economic crisis can increase suicide (Iemmi et al. 2011).
Dementia affects about 800,000 people in the UK, usually over the age of 65. Margret Perkins describes a study currently underway that looks at a group of people who often do not receive the services they need because their condition is so rare: those with early-onset dementia.
The Alzheimer’s Society estimates the total costs of dementia at GBP 23 billion per year. How can these enormous costs be reduced? Martin Knapp and colleagues reviewed the literature on cost-effectiveness of prevention, care and treatment strategies for dementia. They identified five key areas for action to achieve better value for money in dementia care (Knapp et al. 2012):
- More and better quality studies of dementia care are needed
- Findings need to be generalisable to a wider population
- Cost measures need to be broad to capture all costs and benefits
- The reluctance to implement evidence based care needs to be overcome
- Coordination of health and social care provision and financing needs to be improved.
Mental health of children and young people
Much of our work in mental health focusses on children and young people because three quarters of mental health disorders start by age 18, making this a key period for prevention. The public sector costs associated with conduct disorder, hyperactivity and emotional disorders for children from age 5 to age 15 have recently been estimated by Tom Snell and colleagues to be as high as GBP 1.47bn per year, mostly because these children need additional support in their education – and this is in addition to the emotional and financial burden on the young people and their families. The costs associated with autism, including costs to wider society, may be as high as GBP 34billion per year, says Martin Knapp in a recent blog post.
Because the costs of childhood mental health problems are so high, effective interventions have a great potential to provide value for money. Early intervention for psychosis for example may save almost GBP 50k per patient (McCrone et al. 2013). Conduct problems are the most common mental health problem in childhood with negative consequences (for example, a higher risk of being unemployed) well into adulthood (Knapp et al. 2011). We recently estimated that parenting programmes that reduce conduct disorder may generate up to 6 GBP per pound invested (Bonin et al. 2011), and Madeleine Stevens won an NIHR grant to look into what type of intervention can help families in the long term.
We are also contributing economic analysis to several projects that aim to improve services for children and young people with anorexia and autism.
Low-level interventions for depression in community and primary care settings
Depression is among the most common mental health problems and 8-12% of people in the UK experience it every year. At the same time, only a quarter of those with mental health problems currently receive treatment (The Centre for Economic Performance’s Mental Health Policy Group 2012). We have helped evaluate several low-level interventions for depression that could give more people access to mental health services because they are relatively cheap to provide. Among them were psycho-educational group-based workshops for sleep problems and self-confidence problems that showed promising results, and a proactive approach to depression care provided by practice nurses in primary care that increased patients’ confidence and self-esteem (McMahon et al. 2012; full report).
For more information on the research happening within the Centre, please visit our website.