Thursday 19 October 2017

Interview with Matthew Broome on the new Institute for Mental Health

In today's post Kathy Puddifoot interviews Matthew Broome, Professor of Psychiatry and Youth Mental Health, on the new Institute for Mental Health at the University of Birmingham that he directs. 

KP: Can you tell me about the make-up of the Institute for Mental Health at the University of Birmingham?

MB: The Institute for Mental Health (IMH) is a cross-college Institute at the University of Birmingham. It is housed within the School of Psychology and the College Life and Environmental Sciences, but the Institute will also include colleagues from the College of Social Sciences, of Arts and Law, and Medical and Dental Sciences. We are hoping that staff at the IMH will have affiliations with each of these groups and represent a variety of disciplinary backgrounds. In terms of appointments, we will have colleagues appointed at different grades, from professor to lecturer, as joint appointment with the Colleges linked to the IMH. Appointments will be made between the Institute and Schools across the University. We will also have some clinical academic staff joining us, as well as core IMH appointments.  

KP: What are the main goals of the IMH?

MB: The main focus is to address issues concerning youth mental health with the recognition that to solve these complex problems will need interdisciplinary work. The focus will be to improve the care of young people with mental health problems and to improve services for those people.  We think that Birmingham has something distinctive to offer here. We can draw together expertise across the different disciplines but also build on the very strong areas we have across the university, such as cognitive neuroscience, philosophy and ethics, and social policy.

KP: Why do think it is important to focus on young people in particular?

MB: The first answer to that question comes from the epidemiology of mental health issues. Most disorders tend to begin in young people. The vast majority of adult mental disorders begin before the age of 25. Focusing on youth allows you to focus on how disorders develop, to detect mental health issues, and intervene early.  The second answer is connected. Mental disorders that begin in young people last a long time so the benefits of intervening in youth will be greater to society. If you help young people to navigate a tricky period of their life then you will see the benefit for them and for society for many years to come.  Also, Birmingham is the youngest and most diverse city in Europe, in terms of population demographics, so our research focus reflects that .

KP: What is the connection between the IMH and the Mental Health Policy Commission?

MB: The connection is that some members of the Institute are leading on the commission. In particular Professor Paul Burstow ,  Dr Karen Newbigging and Professor Jerry Tew. The commission predates the Institute and is doing work around social policy on mental health provision in the West Midlands, in particular examining the gap in care for young people between those who need help for mental health problems, and those that receive it. The commission is a project that the Institute will be connected with and some of its members will be a key part of.

KP: The IMH aims to contribute to the development of interventions based on academic research to improve practice in mental health care. To succeed in this task, you will work with non-academic partners. Can you tell us something about the partners that you intend to work with?

MB: At the moment the key partners are NHS service providers. There are two mental health trusts in Birmingham that we are working with. One is the Forward Thinking Birmingham Trust, which delivers youth mental health care between 0 and 25 years of age, and also the Early Intervention Psychosis services. The other mental health trust is the Birmingham and Solihull Mental Health Foundation Trust. They are our two main non-academic partners. There is also an organization called Birmingham Health Partners, which is a strategic partnership between the University of Birmingham and some of the acute hospitals. These are strong partners for us. I am hoping to expand our partnerships further to include work with charities, the voluntary sector, and involvement with education and social services. That is a step for me to develop over the next couple of months.

KP:  Can you provide an example of an existing successful research-based intervention so that we can understand the nature of the interventions that are going to be produced as a result of the work of the institute?

MB: A good example is the work of a colleague of ours, Dr Jennifer Cummings, who is a Reader in Sports, Exercise and Rehabilitation Sciences and a member of the IMH. Jenn is working using techniques from sports coaching to support young people with complex mental health difficulties who are on the cusp of homelessness. She has done a lot of great work with St Basil's in Birmingham. That is a very clear case where research is leading to practical benefits. 

Some of the more clinical applied work that I have been involved with is around looking at adolescents with psychotic illness and trying to develop pathways for thinking about the best treatments for them utilising psychological and pharmacological treatments.  This is currently part of multi-site feasibility trial, Managing Adolescent first episode Psychosis: afeasibility Study (MAPS).   I am hoping that the Institute will be a place where we can also use neuroscience as a way to help guide new treatment, whether it is medication or psychological treatments.  We are going to be broad and ecumenical in our approach.

The emphasis on positive mental health is also quite central as well. We will be thinking about the effects of exercise, wellbeing, and sleep on promoting mental health more generally, as well as looking at prevention and young people who may be at risk of developing mental health problems.

KP: The Institute aims to explore family and social network based care, the role of the third sector in providing alternative crisis care, and the potential for local authority social care to deliver preventative approaches to mental health. Do you think that there will need to be a dramatic change in the ways that mental health services are provided to reflect the potential of these alternatives ways of delivering services?

MB: Yes, probably. I think that a problem that interests many of us, especially my colleagues in social sciences, is some of the poor experiences that young people and their families have with mental health care and how people fall between various service providers. So the way things are is certainly not working for everybody. We do need to think about how to align acute hospitals, mental health trusts, social services, police, and education in a more coherent way. Thinking about how young people who have complex difficulties, that cross various boundaries, can be seen in a coherent way is a big challenge. The complexity in youth mental health provision is something we would be keen to develop policy, strategy, and grant applications around, and to work with care providers to improve services for young people.

KP: Is there anything more you would like to tell us about the IMH?

MB: I hope what makes us distinct in the IMH is both our focus on youth mental health and our interdisciplinary nature. Further, Birmingham is most diverse city in the United Kingdom, so that is another element that we need to focus on; equivalence of access across different groups.

We genuinely want to work with colleagues from neuroscience to philosophy, from social science to psychiatry. The University of Birmingham sees that as a great strength of the Institute for Mental Health. From what we are hearing from research funders, they also have the same thought -  that the problems we are dealing with need complex interdisciplinary work. I am very excited that we are going to work together with colleagues from across the University, and that I personally can further develop my ongoing collaboration with Professor Lisa Bortolotti.

Finally, we are fortunate that the University has invested in cognitive neuroscience and the Centre for Human Brain Health (CHBH), under the Directorship of Professor Ole Jensen. The IMH will be working closely with the CHBH so that the gains that are being made in neuroscience can have clinical traction and lead to benefits for patients.

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