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.

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.

Entries are invited for the 2023 Michael King Prize, which is awarded to the UCL PhD awardee with the best thesis on a subject relating to mental health. In this blog, last year’s winner Aaron Kandola, shares his experiences of the award and reveals what he’s been doing since then.

Last year I was awarded the Michael King Prize for my PhD thesis on the relationship between physical activity, fitness, and sedentary behaviour with depression and anxiety symptoms in the population.

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.

In the 2021 census lesbian, gay and bisexual (LGB) people represented 3.2% of the English and Welsh populations.

However, the UK is a heteronormative society where LGB people have experienced systemic and historical persecution under British law; homosexuality was partially decriminalised only in 2017. Legal recognition and protections have advanced since then, but a legacy of discrimination and lack of legal protection has impacted the lives of generations of LGB individuals.  Minority stress theory suggests that experiences such as discrimination or bullying might account for the poorer mental health of LGB people, as suggested in our previous work at UCL.

A project to bring South Asian music and dance to people with dementia will be showcased next month at Bloomsbury Theatre. Dr Naaheed Mukadam, the researcher behind the project, shares her experiences of this project.

I have been a dementia researcher for more than 15 years and have always focused on ethnic inequalities, initially in the diagnostic pathway and more recently in genetic risk, prevention and post diagnostic support.

My research has highlighted the stigma that can exist around memory loss and dementia and I have tried to counteract this during my career so far. I am used to the scientific method – hypothesis testing and use of both qualitative and quantitative methods to answer specific questions. However, after attending public engagement workshops at UCL and reflecting on the power of personal stories in connecting with others, I started to think about how else I could go about capturing the experiences of those with dementia and those who care for them. Music was one way of connecting that I thought would be quite universal.

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. University mental health day is a chance for researchers to reflect on these, write Helen Nicholls, Jo Billings and Danielle Lamb.

Mental wellbeing at work has been relatively neglected until very recently, despite working age adults spending on average 35% of their waking hours at work and 90,000 hours at work over a lifetime. We know that good work can be good for mental health, but that poor working environments – including discrimination and inequality, excessive workloads, lack of resources, limited job control and job insecurity – can pose a risk to mental health.

After living through an extended period of turbulence, how are our children and young people coping? Charlotte Burdge and Tamsin Ford highlight what the research reveals and how we can better support our young people.

The mental health of children and young people deteriorated over the last decade, particularly among young women in their mid-teens and early twenties, who were more likely to struggle with anxiety, depression and self-harm than previously. This may come as no surprise, considering today’s children and young people have lived through what could be called a permacrisis; or an extended period of uncertainty and instability resulting from a chain of catastrophic events. Those born since the Millennium have experienced – directly or indirectly – severe financial crises, COVID-19, war, and increased global insecurity. Many young people have also voiced concerns about their own prospects for longer-term issues such as climate change, political instability, and the cost-of-living crisis. 

This blog was written by Freya Robb, Senior Press Officer for Science Media Centre

The third Institute of Mental Health International Conference took place on the 21^st September 2022. This was the first time the conference had been held in person and was a sell-out event.

Led by its Director, Professor Anthony David, the UCL Institute of Mental Health was created to bring together the best interdisciplinary research to help tackle mental illness. This year’s conference aimed to reflect this broad and diverse approach, covering some key topics of interest that are at the forefront of public discussion and interest.

This blog was written by Dr Andrew Sommerlad, co-lead of the SIG in Social Cognition and Behaviour, for World Mental Health Day 2022. 

Having effective social cognition and social behaviour is central to people being able to integrate with others and form meaningful and supportive social groups. It is therefore essential for maintaining personal happiness and achievement and for wider societal cohesion. However, social cognition and behaviour is affected by many disease states, including neuro-developmental, affective and neurodegenerative disorders, leading to damaging effects on quality of life. Understanding what determines successful social cognition and behaviour and what leads to it becoming impaired has a range of potentially important impacts, from guiding development of new treatments and social policy, to fostering a deepened understanding of human nature.

Social cognition and behaviour is a research focus for UCL academics spanning numerous faculties and departments, and its treatment is a priority for many clinicians in our associated NHS trusts. The scope of this research is wide and varied, encompassing different populations and disease areas, and using a broad range of theoretical and methodological approaches. This means that there is a lot to be learnt from each other.

We therefore established the UCL Institute of Mental Health Special Interest Group (SIG) in Social Cognition and Behaviour to bring together researchers and clinicians who are interested in understanding social cognition and behaviour. We want the SIG to strengthen capacity and collaboration across UCL in research into this area, by providing a forum for academics and clinicians to share their disciplinary perspectives and expertise. We wish to promote discussion and exchange of ideas to encourage interdisciplinary thinking and foster productive relationships in social cognition and behaviour research.

Our SIG currently comprises over 50 members and we have begun to support our aims through our inaugural meeting in September 2022, which we held face to face at UCL to facilitate networking. The meeting showcased the depth and breadth of social cognition and behaviour research at UCL through, first, keynote presentations on the importance of social touch in regulating social and affective needs, and on the social behavioural experience of people with autism during the COVID-19 pandemic, and then flash presentations from 15 academics across UCL. Our MS Teams channel is a forum open to all SIG members to enable us to share resources, and information about funding and conferences, and supervisory opportunities. We will continue working towards our aims through future seminars and other activities.

We want to build this network, so if you are interested in joining our special interest group, please contact us via dop.socialsig@ucl.ac.uk, and join our Teams team. We will keep you updated about all future SIG activities, and we would welcome any suggestions about what the SIG can do to help your social cognition and behaviour research.

This blog was written by UCL Division of Psychiatry PhD Student, Ava Mason.

The Institute of Mental Health (IoMH) Special Interest Group in Psychological Trauma is an interdisciplinary group of UCL researchers and clinicians from our partner NHS trusts. The meetings within this group aim to provide opportunities for collaboration between academics and clinicians, raise the visibility of trauma research at UCL and develop a UCL-wide ‘trauma strategy’. The first meeting included a range of hot topic talks, whereby each of the members discussed their research or clinical focus to the 150 attendees.

Dr Michael Bloomfield who chaired the event explained how one third of individuals who experience psychosis have also experienced previous childhood trauma. Reporting recent results from a large multi-site international study, he stated that 69.9% of participants who had experienced childhood trauma and had an at-risk mental state also had undiagnosed PTSD or complex PTSD. Relating to trauma experienced by children in care, Dr Rachel Hiller discussed key work currently being conducted investigating transdiagnostic predictors of mental health outcomes.  This work could help to develop feasible and effective interventions and inform future service decision making for those in care.

The next hot topic was presented by Shirley McNicholas, who discussed multiple ways in which trauma informed care could be implemented, specifically referring to the women-only Drayton Park crisis house.  She discussed how the environment can be used as a therapeutic tool to help people feel safe, while environment seen as punishing and criminalising negatively impacts women who require support. Trauma informed care also involves helping people connect the past to the present to intervene appropriately, reducing misdiagnosis, inappropriate care planning and compounding self-isolation and shame.  A trauma informed organisational approach within Camden and Islington was then emphasised by Dr Philippa Greenfield.

She discussed the need to increase trauma informed culture embedded within all services and wider communities.  This involves challenging inequality and addressing secondary trauma in the workforce and with patients and acknowledging the impact of adversity and inequality on physical and mental health. Currently, trauma informed collaborative and Hubs have been established to help manage change from within organisations and monthly trauma informed training is being run for staff, service users and carers.

Dr Jo Billings highlighted the considerable impact of occupational trauma within the workplace.  Within the peak of the pandemic, this phenomenon had increased research focus, with studies finding 58% of workers meeting criteria for anxiety, depression, or PTSD.  Within global research on police workers, 25.7% drank hazardously and 14.2% met criteria for PTSD. Focusing on UK research on 253 mental health professionals, high rates of burnout and secondary traumatic stress have been reported.  Strategies that could mitigate this include increased reflective supervision, minimising work exposure where ethically possible and identifying individuals who may be at most risk.

Relating to plasticity enhanced psychotherapy, Dr Ravi Das discussed the importance of research aiming to improve synergy between drug and psychological treatments. Current medication for PTSD does not target causal mechanisms of PTSD, which may explain why many individuals with PTSD do not find medication effective. Drugs like Ketamine block NMDA receptors critical to memory formation and restores lost synaptic plasticity, preventing trauma memories from stabilising. This allows the memory and cognitions of the event to be altered during therapy. Future research should focus on specific medication that target mechanism of change itself to increase the effectiveness of PTSD treatments.

Dr Talya Greene discussed the impact of mass trauma, whereby the same event or a series of traumas affect many people at the same time. The current health system is not built to provide support to many individuals at once following an event, especially when the health workers themselves may be affected by the incident. Additionally, those that are affected by the event vary in many ways, from their cultural, mental health and trauma backgrounds to the way in which they were mentally or physically affected by the event itself. Focus is needed on the effects of early trauma responses on future health outcomes, and how to target groups that don’t normally access support due to physical difficulties or cultural background. Additionally, the current evidence base needs to be increased to see what may be effective specifically in the context of mass trauma settings.

Dr Mary Robertson and Dr Sue Farrier discussed various specialist services within Camden and Islington. One of these was the traumatic stress clinic, working with patients who have a history of complex trauma, including trafficking victims, war and conflict refugees, and individuals with a history of child abuse. The service helps to stabilise the individual before considering which trauma focused individual or group intervention to provide. Additionally, Operation Courage is the term used to describe several Veterans specialist mental health services. They offer comprehensive holistic assessment, referral to local services and in house social support, pharmacological and psychological treatment. These veteran services aim to offer quick support, working alongside statutory and non-statutory agencies where care is shaped by the service users. Alcohol and substance misuse is not seen as a barrier for treatment access, and services also provide peer support and consultation for carers and family.

The audience raised some relevant questions for the panel to discuss, such as how best to strengthen clinical and academic collaborations. Feedback suggested the need to quickly produce trauma informed digestible research that can be rapidly synthesised and relayed back to clinicians. The main barrier to this being a fundamental need for more funding to create a working relationship between academic and clinical services. Within under resourced clinical services, a network approach is required so clinicians can codevelop research questions with other colleagues and trainees to reduce research workload. The need to listen to the voice of marginalised groups within research was also discussed. This involves building a trusting relationship between researchers and BAME groups, to collaborate with service users and consider the impact of historical racism, family dynamics and cultural impact within trauma research. The panel also suggested ways to reduce occupational trauma through having a cohesive team where people can build resilience and support through integrating coping mechanism individually and as a team.

Lastly, Ana Antunes-Martins discussed the Institute of Mental Health Small Grants, providing funding for interdisciplinary teams of all mental health areas, prioritising applications focusing on mechanistic understanding of mental health.

The next meeting will focus more on some of the relevant points raised within this meeting, as well as potential collaboration opportunities. To find out more about this group (and future meeting dates) please visit: https://www.ucl.ac.uk/mental-health/special-interest-group-psychological-trauma