Ten reasons why you should come along to the the 5th UCL IoMH International Conference on 18th September 2024

By tonydavid, on 11 June 2024

1. The UCL IoMH International Conference (supported by the Grand Challenge of Mental Health & Wellbeing and the charity, MHRUK) is the only UK conference dedicated to the whole spectrum of mental health research – from nerve cells to social policy; from Alzheimer’s to Autism; from data to dialogue.
2. It is not run by a professional organisation; it is not sponsored by the pharmaceutical industry. There is no exam at the end. It is not about a particular condition or treatment modality but tries to take the best of all of these.
3. It’s live! Not one of those online insomnia cures that you have on in the background with your camera off, hoping somehow that new ideas and knowledge will somehow passively seep into you mind. No, this is a proper meeting where other engaged, impressive (sometimes infuriating) human beings will discuss, argue (and hopefully tell a few jokes) while imparting some of the most up-to-date and exciting research and ideas on mental health and illness.
4. This year, as before, we will be taking on some of the most pressing and sometimes controversial issues of the day. You’ll get to hear a plenary lecture from the new Director of the Dementia Research Institute Siddarthan Chandran, the first since he joined UCL, on new treatments based on translational research. This will be followed by a more sceptical view of the new Alzheimer drugs from Rob Howard. And coving the entire biopsychosocial spectrum we are also welcoming Ian James from Northumberland who is an expert in non-pharmacological interventions. We will also be discussing autism and neurodiversity. Flying in from the New York State Psychiatric Institute will be Jeremy Veentra-WanderWeele who is head of the Centre for Autism and the Developing Brain – which gives you a flavour of what he will be talking about. Antonia Hamilton will give us the latest on social cognition while Ginny Russell from Exeter will be broadening out the discourse into what autistic people make of such research and how those with lived experience and those who in some circumstances may need to care for them, differ in their outlook. The congress will finish with a lecture from Sir Mike Owen one of the world’s leading psychiatric geneticists who will take us beyond nature vs nurture to how our inheritance interacts with the environment in conditions like schizophrenia and bipolar disorder, and can point us in the direction of new treatments and biomarkers. https://www.ucl.ac.uk/mental-health/iomh-conference/conference-programme. We are also taking on a topic which is not automatically included in mental health discussions but which is among the greatest challenges of our age: climate change. Elizabeth Marks from Bath will introduce us to the problem of climate anxiety and Kris de Meyer, from UCL will give us a neuroscience perspective.
5. Built into each conference theme there will be plenty of time for discussion, led by other experts from UCL but with ample scope for audience participation.
6. There will be posters as well as oral presentations, so that early career researcher will get a chance to show what they are up to and get feedback from an interested and informed audience.
7. The cost of attending is incredibly reasonable given that it includes lunch, coffee and tea – and there are concessions for students and those eager (and well-organised) early birds. If you want to hob-nob with the presenters and other delegates, you can sign up for the wine reception afterwards. https://www.ucl.ac.uk/event-ticketing/app/?ev=24077
8. The majority of the audience comprises of both researchers and clinicians although people with lived-experience or carers or the merely curious are all welcome.
9. Mid-September is before the start of the new University term, you’ll be back from your holidays, so you will have some time on your hands. The weather is probably going to be a bit meh so what better way is there to get up to speed on mental health topics if you are a student or academic?
10. It’s just one day!

We look forward to seeing our research community come together on 18th September. We are offering a special rate for “early birds” who book before 1 July: www.ucl.ac.uk/mental-health/iomh-conference/conference-registration

Investigating the risk of suicide in patients with cancer: webinar co-hosted by the UCL Institute of Mental Health (IoMH) and the GRID Council (India)

By iomh, on 3 June 2024

Written by Shruti Menon, MSc Student, UCL Division of Psychiatry

I recently attended a webinar held on 22 May 2024 by a team of mental health researchers at the UCL Institute of Mental Health (IoMH) and Generating Research Insights for Development (GRID) Council, India. This was to facilitate a discussion about the quantitative investigation of suicide risk in patients with cancer using routine data in which there was also the opportunity to access Stata/R/Python code and analysis plans from previous analyses. The webinar was supported by the UCL Global Engagement Fund and attended by clinicians and researchers working with data in India, Sri Lanka, Bangladesh, Pakistan, Bhutan, Nepal, Afghanistan and the Maldives. I enrolled as a student in the UCL MSc course in Clinical Mental Health Sciences as I was interested in learning more about how to access and analyse cancer registry data in order to investigate mental health outcomes.

The webinar began with a warm introduction to the event from Dr Neethu Mohan, executive at the State Health Agency of Kerala. Dr Mohan briefly elucidated the aim of the webinar to promote the analysis of cancer registry data linked to mortality data as it would help answer key questions in suicide research. 

This was followed by insights into the findings of a systematic review by Heinrich et al (2022) from Dr Alexandra Pitman at UCL Division of Psychiatry. Through her work as a psychiatrist in a cancer team, she described her experience of having observed the impact of cancer on the mental health of people with cancer including their risk of suicidal thoughts. She summarised the findings which indicated that the risk of suicide was significantly higher in patients with cancer compared to the general population. It highlighted how the mental health needs of cancer patients are often overlooked and how factors including time since diagnosis and stage of cancer are linked to the risk of suicide. Dr Pitman emphasised the need to not only monitor the psychological health of people with cancer but to inquire carefully about any suicidal thoughts and screen for untreated depression and anxiety to improve outcomes and well-being. Finally, the Heinrich et al systematic review also brought attention to the geographical gaps in research literature on this topic as the review was limited to studies conducted in high-income countries.

The webinar then provided participants with an opportunity for discussion in which participants were invited to share their clinical experiences and research priorities. Participants described issues such as medical staff not being trained to screen for mental health problems and suicidal thoughts. Such training could be crucial in vulnerable periods such as immediately after a cancer diagnosis when evidence demonstrates that the risk of suicide is heightened. Important research questions were also raised such as the role of psychiatric conditions in increasing suicide risk in patients with cancer and whether treatment expenditure or lack of social support could potentially heighten the risk of suicide. Participants pointed out the importance of acknowledging to patients how distressing a cancer diagnosis can be so that patients might find it acceptable to disclose any struggles with suicidal thoughts.

Dr Katherine Thackray (née Henson), a data analyst in the National Disease Registration Service (NDRS) at NHS England discussed the methods used in her population-based analysis of English cancer registry data investigating the risk of suicide after cancer diagnosis (Henson et al, 2019). She provided a detailed overview of the analysis, including the statistical techniques used, and sub-groups evaluated. She also outlined the methodological considerations when replicating the analysis such as considering biases in data ascertainment. She highlighted a key limitation of the study which was that due to challenges with linking cancer registry datasets with mental health datasets, the influence of psychiatric disorders on suicide risk in people with cancer could not be explored. She summarised the results of the study which indicated that the risk of suicide was 20% higher in individuals with cancer than in the matched general population, and the increased risk was particularly marked in the first six months post-diagnosis. She also noted that the risk of suicide may have been underestimated as suicide tends to be underreported as a cause of death. Dr Thackray emphasised the implication of these findings namely the potential to prevent these deaths through additional support.

Dr Justin Yang, Research Fellow in the UCL Division of Psychiatry provided a summary of the code used in the study by Henson et al (2019) including details about the variables and confounders to be considered. He also elaborated on various aspects of the analyses such as how to calculate the Standardised Mortality Rate (SMR). This talk illustrated how to conduct the analyses by providing examples of code in different statistical software packages such as Stata, R and Python. Dr Yang discussed the advantages and disadvantages of each of these software packages. While Stata is commonly taught in universities and has supportive online forums, cost can be a limiting factor. R is a free software package with useful statistical functions, however, less formal support tends to be available to researchers using it. While Python has a good capacity to handle large datasets and offers useful statistical functions, it might be the most challenging software to learn. Dr Yang emphasised that the best software to use would be that which one is most familiar with.

A second discussion ensued in which participants identified critical barriers in low and middle-income countries to investigating this research question such as paper records recording deaths, or administrative issues while linking cancer registry data to mortality data. Other important research questions were identified such as exploring the role of acquired capability for suicide in the context of cancer (as patients with cancer may have a reduced fear of death, a reduced pain threshold and/or access to lethal medications) and the need to explore more proximal outcomes than suicide. In particular, risk-taking or self-destructive behaviour such as alcohol use was identified as important to study in people with cancer. The inclusion of participants/researchers with lived experiences in primary research was recognised as beneficial. The participants brainstormed ways to navigate these practical issues, for example by collaborating with data guardians within organisations that collect registry data or using probabilistic data linkage methods to link datasets.

list of 321 cancer registries across South Asia

A wide range of resources were provided on the project website after the session, including annotated data analysis code (with Stata/R/Python versions), a list of 321 cancer registries across South Asia and access to a Slack channel for networking with potential collaborators. Through these resources, the project aimed to create a community of researchers and facilitate collaboration so that future analyses might identify any patient groups at risk who might need increased support. The longer-term goal was therefore to help reduce psychiatric co-morbidity in people with cancer.

I learned a lot about how to evaluate suicide risk in cancer patients using routine data in this webinar and was grateful to all the speakers, the participants for their key insights and the IoMH and GRID council for organising this webinar. I hope that this will foster collaboration among researchers interested in suicide prevention in people with cancer.

Links:

• Investigating risk of suicide in patients with cancer globally
• UCL Special Interest Group in Self-harm and Suicide

Top posts of 2023 on the IoMH blog

By Rosie Niven, on 25 January 2024

We published 22 posts over the course of 2023 – a record for the IoMH blog! Here is the most popular content posted in the past year.

#1: This guest blog marking University Mental Health Day is our top post from 2023. Lucy Foulkes of the University of Oxford looks at the concept of awareness days or weeks and asks whether we are doing enough to measure their outcomes. Read post >

#2. A PhD scholarship may last just a few years, but today’s scholar could become tomorrow’s supervisor as Jen Dykxhoorn from UCL’s Division of Psychiatry wrote in February, as a prestigious Mental Health Research UK scholarship opened for applications. Read post >

#3 Research from UCL’s Marie Curie Palliative Care Department shows that people with SPMI want to make their own choice about end-of-life care – just like anyone else. Nivedita Ashok describes the findings. Read post >

#4 The discoveries and positive impacts of academic research can give researchers great job satisfaction but the role also brings stresses that pose a risk to their mental health, write Helen Nicholls, Jo Billings and Danielle Lamb. Read Post >

#5 Recent UCL research finds that lesbian, gay, and bisexual adults report higher rates of suicidal thoughts and suicide attempts than their heterosexual peers. In this blog Garrett Kidd describes how the study came about and its significance. Read post >

…and the rest of the top 10

6. IoMH Conference 2023 – a PhD student’s report – Jennifer Fielder
7. Mental Health is a human right – a workplace perspective – Sally Belcher
8. Children’s Mental Health and the Permacrisis – Charlotte Burdge and Tamsin Ford
9. University Mental Health Charter Award – how was it for you? Denise Long, Umair Mehmood and Tony David
10. Connecting with others through the power of music – Naaheed Mukadam

Thank you to all our contributors in 2023. If you have an idea for a blogpost about mental health research or clinical practice and would like to contribute to the IoMH blog – do get in touch!

Poor mental health is not random: what can we do to achieve social justice?

By iomh, on 12 January 2024

Earlier this year a prospective PhD supervisor blogged for us about recruiting for a PhD scholarship focused on historically marginalised groups and mental health inequalities. That student is Alua Yeskendir, who provides this post on new research summarising the current state of the evidence around the social determinants of mental health.

We used to see mental health problems as primarily a biological phenomenon. But is it true? If we say that your mental health also depends on the distribution of social, economic and political wealth, power, and resources, does it make easier to solve the problem?

Mental Health is a human right – a workplace perspective

By iomh, on 10 October 2023

UCL’s Head of Workplace Wellbeing, Sally Belcher outlines how dedicated workplace health teams and researchers have come together to support the mental health of members of staff.   

World Mental Health Day is recognised annually on 10^th of October. It is a day that encourages everyone to reflect on their own mental health, and that of those around them. This year’s theme is ‘Mental health is a universal human right’, and in the workplace that means ensuring mental health is treated equitably and with the same respect and dignity as that of a physical injury. Working in Workplace Health, especially around the time of World Mental Health Day is an opportunity to improve knowledge and raise awareness of staff but it also serves as a stark reminder on how far we as a society have to go.

How can we improve end of life care for someone with an intellectual disability or serious mental illness?

By iomh, on 10 October 2023

People with serious and persistent mental illness (SPMI) often have poor experiences of health care, including end-of -life care, yet their voices often go unheard, leading to decisions being made on their behalf. Nivedita Ashok describes research from UCL’s Marie Curie Palliative Care Department, which shows that people with SPMI want to make their own choice, just like anyone else.

People with a diagnosis of intellectual disability or a serious mental illness die much earlier from serious physical illnesses than the general population. Lack of support to have healthier lifestyles, only seeking help when very unwell, late presentation to services, delays in diagnosis, and insufficient treatment provision are all problems.

Despite this gap, they are often excluded from palliative care research, and their experience of healthcare services are often poor, e.g. failure to make reasonable adjustments.

Our research team has been studying these issues to identify the gaps and uncertainties in the evidence. The findings have helped us understand what service users, their families, and the professionals who work with them find challenging, and what they suggest can help improve this.

How we talked to young adults about dementia and end-of-life care

By iomh, on 9 October 2023

Dementia and end of life care is a challenging topic to engage young adults with but the EMBED-Care team took the opportunity to do this by putting together an event for Science Museum Lates to engage young adults with these themes. Sophie Crawley describes their experiences.

The Science Museum in London is a well-known destination for families and children to spend a day looking at all things science related. A lesser-known aspect of the museum’s work are Science Museum Lates. These are primarily targeted as a young adult social event for groups of friends to attend. There is a lively and engaging atmosphere with music, DJs and a bar, while they explore the Museum’s regular exhibits after hours and engage with events and activities run by external groups centred around a specific science-related theme.  

A conversation with the Science Museum about our work to improve the end-of-life care of people dying with or dying from dementia led to an offer to participate in a Lates event celebrating the 75^th Anniversary of the NHS. This was a great opportunity to share our research with a young adult audience who may not have thought about dementia or the end of life, but who will be increasingly affected by dementia as the prevalence, and the need to care for those with a diagnosis, increases. It also gave all the EMBED-Care team from UCL and King’s College London an opportunity to collectively ‘have a go’ at public engagement.

IoMH Conference 2023 – a PhD student’s report

By iomh, on 29 September 2023

The fourth UCL Institute of Mental Health Conference explored a diverse range of topics including health economics, suicide prevention and cognitive neuroscience. UCL Wellcome PhD student Jennifer Fielder shares some of her highlights of the day.

As a PhD student in Mental Health Science, I was excited to hear some of the latest mental health research showcased by leading experts at the Institute of Mental Health (IoMH) Conference.

The first session on mind and body interactions followed warm welcomes from Professor Anthony David, director of UCL IoMH, and Professor Alan Thompson, Dean of the UCL Faculty of Brain Sciences. UCL’s Professor Sarah Garfinkel focused on how our ability to sense internal contexts and signals, known as interoception, shapes mental health. This covered her work on interoceptive training, where people learn to detect their heartbeats more accurately, which decreased anxiety in autistic adults for up to one year after the training. The talk finished with the exciting prospect that effective psychiatric treatments may work via interoceptive pathways. For example, one dose of the antidepressant Citalopram was found to increase interoceptive accuracy.

“Truly alone for the first time in my life”

By iomh, on 19 July 2023

UCL Psychiatry MSc student Kangning Zheng’s research focuses on the experiences of loneliness among international students. This blog describes what her work reveals about the impact on students’ mental health.

Studying in another country might be an exciting prospect for many people but some international students can feel lonely during a period of study abroad. Transient loneliness at the start of a move to a new country is common and can be a positive stimulus to meet more people and establish oneself. However, some people can become chronically lonely, and this poses a threat to health and wellbeing. Loneliness is therefore an important consideration for policymakers in relation to the economic and social benefits of international students.

‘Self-binding directives’ – should it be possible to request involuntary treatment in advance?

By iomh, on 5 July 2023

Earlier this year in a BBC Radio 4 programme Tania Gergel documented her treatment for bipolar. In this blog, she describes how she has used ‘self-binding directives’ to manage the risks associated with these treatments.

Shortly after I moved into the field of mental health ethics and law about twelve years ago, I found my work focusing on one particular area – mental health advance directives or ‘advance choice documents’, as they will soon be known within the upcoming revisions to the Mental Health Act in England and Wales.

Research and practice in this area had been dominated by the idea that advance choice documents could provide a way for people with severe mental illness to avoid hospitalisation and involuntary treatment. But it soon became evident that, in fact, many people might also want to harness the power of advance decision-making to do the opposite – to ensure that they received treatment, even if against their will, during future episodes of illness when they knew from past experience, they would resist.