The coronavirus disease 2019 (COVID-19) pandemic is having a profound effect on all aspects of society, including mental health and physical health. We explore the psychological, social, and neuroscientific effects of COVID-19 and set out the immediate priorities and longer-term strategies for mental health science research. These priorities were informed by surveys of the public and an expert panel convened by the UK Academy of Medical Sciences and the mental health research charity, MQ: Transforming Mental Health, in the first weeks of the pandemic in the UK in March, 2020. We urge UK research funding agencies to work with researchers, people with lived experience, and others to establish a high level coordination group to ensure that these research priorities are addressed, and to allow new ones to be identified over time. The need to maintain high-quality research standards is imperative. International collaboration and a global perspective will be beneficial. An immediate priority is collecting high-quality data on the mental health effects of the COVID-19 pandemic across the whole population and vulnerable groups, and on brain function, cognition, and mental health of patients with COVID-19. There is an urgent need for research to address how mental health consequences for vulnerable groups can be mitigated under pandemic conditions, and on the impact of repeated media consumption and health messaging around COVID-19. Discovery, evaluation, and refinement of mechanistically driven interventions to address the psychological, social, and neuroscientific aspects of the pandemic are required. Rising to this challenge will require integration across disciplines and sectors, and should be done together with people with lived experience. New funding will be required to meet these priorities, and it can be efficiently leveraged by the UK's world-leading infrastructure. This Position Paper provides a strategy that may be both adapted for, and integrated with, research efforts in other countries.
SUMMARYTrauma-informed approaches emerged partly in response to research demonstrating that trauma is widespread across society, that it is highly correlated with mental health and that this is a costly public health issue. The fundamental shift in providing support using a trauma-informed approach is to move from thinking ‘What is wrong with you?’ to considering ‘What happened to you?’. This article, authored by trauma survivors and service providers, describes trauma-informed approaches to mental healthcare, why they are needed and how barriers can be overcome so that they can be implemented as an organisational change process. It also describes how past trauma can be understood as the cause of mental distress for many service users, how service users can be retraumatised by ‘trauma-uninformed’ staff and how staff can experience vicariously the service user's trauma and can themselves be traumatised by practices such as restraint and seclusion. Trauma-informed mental healthcare offers opportunities to improve service users' experiences, improve working environments for staff, increase job satisfaction and reduce stress levels by improving the relationships between staff and patients through greater understanding, respect and trust.LEARNING OBJECTIVES Appreciate broad-based definitions of traumaGain an understanding of what trauma-informed approaches are and why they have emerged, including the potential for (re)traumatisation in the mental health systemConsider how to practise trauma-informed approaches, including in ‘trauma-uninformed’ organisations, and the potential barriers to and opportunities from doing soDECLARATION OF INTERESTA. S. is funded by a National Institute for Health Research (NIHR) Post-Doctoral Fellowship. This article presents independent research partially funded by the NIHR. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR or the Department of Health.
Purpose-The purpose of this paper is to describe and explain trauma-informed approaches (TIAs) to mental health. It outlines evidence on the link between trauma and mental health, explains the principles of TIAs and their application in mental health and explores the extent to which TIAs are impacting in the UK. Design/methodology/approach-The approach is a conceptual account of TIAs including a consideration of why they are important, what they are and how they can become more prevalent in the UK. This is supported by a narrative overview of literature on effectiveness and a scoping of the spread of TIAs in the UK. Findings-There is strong and growing evidence of a link between trauma and mental health, as well as evidence that the current mental health system can retraumatise trauma survivors. There is also emerging evidence that trauma-informed systems are effective and can benefit staff and trauma survivors. Whilst TIAs are spreading beyond the USA where they developed, they have made little impact in the UK. The reasons for this are explored and ways of overcoming barriers to implementation discussed. Originality/value-This paperauthored by trauma survivors and staffdescribes an innovative approach to mental health service provision that, it is argued, could have immense benefits for staff and service users alike.
BackgroundHealth research is frequently conducted in multi‐disciplinary teams, with these teams increasingly including service user researchers. Whilst it is common for service user researchers to be involved in data collection – most typically interviewing other service users – it is less common for service user researchers to be involved in data analysis and interpretation. This means that a unique and significant perspective on the data is absent.AimThis study aims to use an empirical report of a study on Cognitive Behavioural Therapy for psychosis (CBTp) to demonstrate the value of multiple coding in enabling service users voices to be heard in team‐based qualitative data analysis.DesignThe CBTp study employed multiple coding to analyse service users’ discussions of CBT for psychosis (CBTp) from the perspectives of a service user researcher, clinical researcher and psychology assistant. Multiple coding was selected to enable multiple perspectives to analyse and interpret data, to understand and explore differences and to build multi‐disciplinary consensus.ResultsMultiple coding enabled the team to understand where our views were commensurate and incommensurate and to discuss and debate differences. Through the process of multiple coding, we were able to build strong consensus about the data from multiple perspectives, including that of the service user researcher.DiscussionMultiple coding is an important method for understanding and exploring multiple perspectives on data and building team consensus. This can be contrasted with inter‐rater reliability which is only appropriate in limited circumstances.ConclusionWe conclude that multiple coding is an appropriate and important means of hearing service users’ voices in qualitative data analysis.
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