MHPRU-2 Projects

This project will include a review of international evidence on early intervention models for young people with common mental health problems, and investigations into the practices and outcomes of newly established Early Support Hubs for young people in England.

Findings will generate evidence on the effectiveness of early intervention models for young people with common mental health problems and assist policy makers in evaluating the outcomes of Early Support Hub programmes and their success in supporting a diverse group of young people.

This project will include:

• A national mapping of acute and crisis care arrangements for people presenting in mental health crisis in England,
• An exploration, at catchment level, of the success of crisis care arrangements in delivering flexible and effective crisis responses,
• An investigation of the relationship between crisis care arrangements and inpatient psychiatric admissions.

Findings will generate evidence on the impacts of a range of approaches to acute care delivery, including their effectiveness as an early intervention response and what approaches are perceived to work best, for which people and in which situations.

This project will examine the first English national database to link health, education and social care information for young people, the ECHILD database. The work will examine risk factors for severe mental health outcomes among young people.

Findings will inform which young people are most at risk of poor mental health outcomes and guide policy discussions around preventative interventions.

This project reviewed the use and impact of surveillance-based technology initiatives in inpatient and acute mental health settings. A systematic review was conducted examining;
(1) how these technologies are implemented, (2) how patients, carers, and staff experience them, (3) and whether they achieve their intended aims.

The findings showed that current evidence does not support the roll-out of surveillance technologies in inpatient mental health settings. Despite some noted benefits, the evidence on their impact was inconsistent or weak, serious ethical concerns were raised and many studies were low quality, had conflicts of interest, and lacked lived experience involvement. 

Dissemination

• Published in BMC Medicine: The use and impact of surveillance-based technology initiatives in inpatient and acute mental health settings: a systematic review
• Mental Elf Blog of our Review: All eyes on the ward: the use and impact of surveillance in inpatient mental health settings

This project is in line with a request from NHSE policymakers to explore relational care approaches to assessing and managing self-harm and suicide risk in inpatient and emergency department settings. Currently, there is a heavy reliance on structured risk assessments and restrictive practices for this process - despite a lack of supporting evidence. This is where alternative approaches are needed.

Our team, in co-production with academic and lived experience researchers and clinicians, developed a definition of 'relational care' and conducted a scoping review of the impacts of 'relational care' approaches in non-forensic inpatient mental health and ED settings in comparison to structured risk assessments and processes.  

Evidence from 29 reviews suggests some relational care approaches can reduce self-harm and suicide, although there is a lack of high-quality research overall. These findings have been shared with NHSE policymakers and the Royal College of Psychiatrists. Further high-quality research is needed to evaluate its effectiveness, how it is experienced by patients, carers, and staff, and exploring what works best for whom, under what circumstances, and why.