National review highlights CPFT mental health research studies

A new review of recent research into severe mental illness (SMI) highlights several psychosis studies undertaken by experts at Cambridgeshire and Peterborough NHS Foundation Trust.

National review highlights CPFT mental health research studies
20 March 2018

National review highlights CPFT mental health research studies

A new review of recent research into severe mental illness (SMI) highlights several psychosis studies undertaken by experts at Cambridgeshire and Peterborough NHS Foundation Trust.

‘Forward Thinking: Support for people with Severe Mental Illness’ report was published by the NIHR Dissemination Centre. The review provides an overview of recent published research, funded by the NIHR, on support for people living with SMI. These studies address particular uncertainties and evidence gaps identified by those working in and using these services. It also highlights research currently taking place to inform the support and care of people with severe mental illness.

Severe mental illness affects somewhere between one in one hundred and one in two hundred adults. Currently the life-expectancy of people with severe mental illness is 15-20 years shorter than that of the general population, mostly due to preventable causes. This excess mortality is one of the worst health inequalities in England and Wales. People with SMI use emergency services more, and preventative services less, than the general population; are three times more likely to attend A&E; and almost five times more likely to be admitted to hospital as an emergency.

The Liaison with Education and General practiceS study (LEGS) was a cluster randomised controlled trial (RCT), educating GPs to identify and refer young people at high risk of developing psychosis. It was led by CPFT’s Jesus Perez, Consultant Psychiatrist at CAMEO Early Intervention Services (pictured right).

The study explored the beliefs that influence GPs when they see young people with psychosis in primary care. The researchers used those beliefs to develop an educational intervention for GPs. After attending the educational workshop, GPs were found to have doubled the identification and referral of young people with high-risk mental states, first episode psychosis and other mental health problems. This educational approach was found to be cost-effective largely by reducing the costs of unrecognised mental illness in primary care.

Professor Peter Jones, a non-executive director at Cambridgeshire and Peterborough NHS Foundation Trust, provided input and advice through the project steering group as one of the experts. He is Professor of Psychiatry at the University of Cambridge and the Director of the NIHR Collaboration for Leadership in Applied Health Research and Care East of England (CLAHRC EoE), which is hosted by CPFT. 

Before taking on the Directorship of the CLAHRC EoE, Peter (right) was a founder of CPFT’s award-winning CAMEO early intervention service.

Dr Christine Hill, Deputy Director at CLAHRC EoE led on writing the report with the NIHR Dissemination Centre.

The review is available here and studies involving CPFT are listed below.

 

Understanding Causes and Developing Effective Interventions for Schizophrenia and Other Psychoses.
Published March 2016, Professor Peter Jones & Professor Jesus Perez, Consultant Psychiatrist at CAMEO Early Intervention Services, CPFT

This randomised controlled trial evaluated an intervention to enable general practices to identify and refer young people at high risk of developing psychosis.

The researchers developed the Liaison with Education and General PracticeS (LEGS) intervention and looked at whether this led to more people at high risk, being referred by GPs to an early intervention service. 

General practices in Cambridgeshire and Peterborough were randomly assigned to receive either low-intensity liaison (28 practices), which was a postal campaign to help with identification and referral, or high intensity liaison (26 practices), which included a specialist mental health professional to liaise with each practice as well as the postal campaign.

The intervention was run between 2010 and 2013. The primary outcome was the number of high risk referrals per practice. The researchers found that the high intensity intervention doubled GPs’ identification and referral of young people with high risk mental states as well as those with first episode psychosis and other mental health problems. Cost analysis indicated this intervention had clinical and economic value.

The researchers also followed 60 young people (aged 16-35 years) at high risk for 2 years in the Prospective Analysis of At-risk mental states and Transitions into psycHosis (PAATH) study. Only three individuals transitioned to first episode psychosis. Most of the participants at high risk had significant depression and anxiety and many had suffered childhood trauma.

Such early identification means services can offer appropriate and timely treatment. The researchers examined the incidence of new referrals for psychosis, finding considerable psychosis morbidity in diverse, rural communities. They also developed the population-level prediction tool, PsyMaptic, to estimate the numbers of young people who require early-intervention services across the country.

https://doi.org/10.3310/pgfar04020

 Programme Grants for Applied Research 2016.

 

The Epidemiology of First-Episode Psychosis in Early Intervention in Psychosis Services: Findings From the Social Epidemiology of Psychoses in East Anglia [SEPEA] Study. 
Published October 2016, Professor Peter Jones & Professor Jesus Perez, Consultant Psychiatrist at CAMEO Early Intervention Services, CPFT

The SEPEA Study, part-funded by NIHR, investigated if the incidence of psychosis varied by ethnicity, generation status, and age at immigration in a diverse, mixed rural, and urban setting. The study found that people of black African, black Caribbean and Pakistani origins were at the greatest risk of first episode psychosis compared with the white British population. These patterns were observed across rural and urban areas.

 

SUstaining Positive Engagement and Recovery (SuperEDEN) – the next step after Early Intervention for Psychosis.
Published February 2018, Lancet Psychiatry, Professor Peter Jones and others

This was an RCT to evaluate the efficacy of enhancing social recovery from First Episode Psychosis (FEP) by supplementing Early Intervention Services (EIS) with Social Recovery Therapy (SRT). The intervention took place at four specialist EIS in the UK. Participants (aged 16-35 years) had non-affective psychosis, attended EIS for 12-30 months, and had severe social disability (defined as being engaged in less than 30 hours per week of structured activity). EIS was provided by specialist teams, consisting of intensive recovery oriented case management, supported employment, peer support  and family work, alongside CBT for psychosis and medication management. The SRT intervention was developed by the researchers as an outreach and case management package. SRT was delivered by a therapist and consisted of engaging the individual, assessing motivations and goals, preparing for new activities, and activity engagement. Participants were assessed at baseline, 9 months post-intervention and at 15 months follow up. The primary outcome was time spent in structured activity at 9 months. 154 participants took part, 75 were assigned to SRT plus EIS, and 79 assigned to EIS only. 143 participants provided data at 9 months. The study found that receiving SRT plus EIS was significantly associated with an increase in structured activity of 8.1 hours, greater than EIS alone. The authors concluded a more definitive trial with long-term follow up is now needed.

Prof David Fowler, MSc'Correspondence information about the author Prof David FowlerEmail the author Prof David Fowler, Jo Hodgekins, PhD, Prof Paul French, PhD, Prof Max Marshall, MD, Prof Nick Freemantle, PhD, Prof Paul McCrone, PhD, Linda Everard, BSc, Anna Lavis, PhD, , PhD, Tim Amos, MBBS, Prof Swaran Singh, PhD, Prof Vimal Sharma, PhD, Prof Max Birchwood, PhD

NIHR Programme Grants for Applied Research, PGfAR

https://doi.org/10.1016/S2215-0366(17)30476-5

 

ENDS

Notes to editors

About Cambridgeshire and Peterborough NHS Foundation Trust
Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) is a health and social care organisation, providing integrated community, mental health and learning disability services, across Cambridgeshire and Peterborough, and children’s community services in Peterborough. We support around 100,000 people each year and employ more than 3,900 staff. Our largest bases are at the Cavell Centre, Peterborough, and Fulbourn Hospital, Cambridge, but our staff are based in over 90 locations. We are a University of Cambridge Teaching Trust and member of Cambridge University Health Partners, working together with the University of Cambridge Clinical School.

 

For more information please contact:

 

Adrian Ient

Communications Manager

E adrian.ient@cpft.nhs.uk 

T 01223 219470

 

Cambridgeshire and Peterborough NHS Foundation Trust
Elizabeth House, Fulbourn Hospital
Cambridge, CB21 5EF

T 01223 219400 (open 8:30am to 5pm)
F 01480 398501

IIP-logo-reversed Mindful-employer NHS-Employers-web Triangle-of-Care-member Twitter Logo Youtube Logo Facebook Logo Instagram Logo Wordpress Logo